Colorado Bankruptcy Exemption Worksheet

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COLORADO BANKRUPTCY EXEMPTION WORKSHEET

DEBTOR INFORMATION

Field	Entry
Debtor's Full Legal Name	[____________________________________]
Joint Debtor's Full Legal Name (if any)	[____________________________________]
Last 4 Digits of SSN/ITIN (Debtor)	[_____]
Last 4 Digits of SSN/ITIN (Joint Debtor)	[_____]
Bankruptcy Case No.	[_______________________]
Chapter	☐ 7 ☐ 11 ☐ 12 ☐ 13
Date of Filing	[__/__/____]
Address (Domicile)	[____________________________________]
County of Residence	[_______________________]
Date Colorado Domicile Established	[__/__/____]

RESIDENCY AND EXEMPTION-LAW SELECTION (11 U.S.C. § 522(b)(3)(A))

Section A — Residency Determination

Question	Response
Has the debtor been domiciled in Colorado for the 730 days immediately before the petition date?	☐ Yes ☐ No
If No, in which state was the debtor domiciled for the greater part of the 180-day period preceding the 730-day period?	[_______________________]
Does that state's law extend its exemptions to non-residents?	☐ Yes ☐ No ☐ N/A
Does the federal "fall-back" under § 522(b)(3) apply (no state law applies)?	☐ Yes ☐ No
Applicable Exemption Law	☐ Colorado (C.R.S.) ☐ Other state: [______] ☐ Federal § 522(d) (fall-back only)

Section B — 1215-Day Homestead Cap (11 U.S.C. § 522(p) and (q))

Question	Response
Was the debtor's interest in any current Colorado homestead acquired within the 1,215 days before the petition date?	☐ Yes ☐ No
If Yes, the homestead exemption is capped at $214,000 (per the most recent § 104 adjustment effective April 1, 2025; verify current cap before filing). Confirm the cap that applies to this case:	$[_______________]
Does any § 522(q) misconduct trigger apply (securities-law violation, certain criminal acts, or specified torts within the past 5 years)?	☐ Yes ☐ No

PART 1 — REAL PROPERTY (HOMESTEAD)

1.1 Homestead Exemption — C.R.S. § 38-41-201

Item	Detail
Address of Homestead Property	[____________________________________]
County / Parcel ID	[_______________________] / [_______________________]
Form of Ownership	☐ Sole ☐ Joint Tenancy ☐ Tenancy in Common ☐ Tenancy by the Entirety (CO does not recognize) ☐ Other
Date Owner Acquired Title	[__/__/____]
Date Owner Began Occupying as Principal Residence	[__/__/____]
Fair Market Value	$[_______________]
Total Liens (mortgages, deeds of trust, judgment liens, tax liens)	$[_______________]
Equity (FMV minus liens)	$[_______________]
Standard Exemption Amount	$250,000
Elderly/Disabled Exemption Amount (§ 38-41-201(1)(b)) — owner, spouse, or dependent age 60+ or "disabled" as defined in § 38-41-201.5	$350,000
Exemption Claimed (circle one)	☐ $250,000 (standard) ☐ $350,000 (elderly/disabled)
Equity Protected	$[_______________]
Equity Exposed to Trustee	$[_______________]

Homestead Subcategories

Type	Citation	Amount	Claimed?
Standard residence (house, condo, mobile home)	§ 38-41-201(1)(a)	$250,000	☐
Owner/spouse/dependent age 60+ or disabled	§ 38-41-201(1)(b)	$350,000	☐
Proceeds of voluntary sale (held two years)	§ 38-41-207	Same as homestead	☐
Proceeds of involuntary sale (e.g., insurance, condemnation)	§ 38-41-209	Same as homestead	☐

1.2 Other Real Property

Description	FMV	Liens	Equity	Exemption Citation	Amount
[_______________________]	$[_______]	$[_______]	$[_______]	[_______________________]	$[_______]

PART 2 — PERSONAL PROPERTY EXEMPTIONS (C.R.S. § 13-54-102)

2.1 Wearing Apparel — § 13-54-102(1)(a)

Item	Detail
Statutory Cap (per debtor or dependent)	$2,000 aggregate
Aggregate Value Claimed	$[_______________]
Description (general categories acceptable)	[____________________________________]

2.2 Watches, Jewelry, and Articles of Adornment — § 13-54-102(1)(b)

Item	Detail
Statutory Cap (per debtor or dependent)	$2,500 aggregate
Aggregate Value Claimed	$[_______________]
Itemization	[____________________________________]

2.3 Library, Family Pictures, and School Books — § 13-54-102(1)(c)

Item	Detail
Statutory Cap	$2,000 aggregate
Value Claimed	$[_______________]

2.4 Burial Sites — § 13-54-102(1)(d)

Item	Detail
Statutory Cap	One burial site per family member
Cemetery and Plot Number	[____________________________________]
Value Claimed	$[_______________]

2.5 Household Goods — § 13-54-102(1)(e)

Item	Detail
Statutory Cap	$6,000 aggregate
Aggregate Value Claimed	$[_______________]
Description	[____________________________________]

2.6 Provisions and Fuel — § 13-54-102(1)(f)

Item	Detail
Statutory Cap	$600 aggregate
Value Claimed	$[_______________]

2.7 Livestock, Poultry, and Working Animals — § 13-54-102(1)(g)

Item	Detail
Statutory Cap	$5,000 (working animals); see also § 13-54-102(1)(h) for agricultural tools
Value Claimed	$[_______________]
Description	[____________________________________]

2.8 Agricultural Implements, Tools, and Livestock (Farm/Ranch Use) — § 13-54-102(1)(g) and (h)

Item	Detail
Statutory Cap	$50,000 aggregate (livestock, poultry, machinery, tools, equipment used in agriculture)
Value Claimed	$[_______________]
Description	[____________________________________]

2.9 Tools of the Trade / Stock in Trade — § 13-54-102(1)(i)

Item	Detail
Statutory Cap — Primary Gainful Occupation	$60,000 aggregate
Statutory Cap — Other Gainful Occupation	$20,000 aggregate
Occupation	[____________________________________]
Aggregate Value Claimed	$[_______________]
Itemization (machines, tools, equipment, business books, electronics, business materials)	[____________________________________]

2.10 Motor Vehicles — § 13-54-102(1)(j)

Vehicle	Year/Make/Model	VIN	FMV	Lien	Equity	Subsection Used
1	[_______________________]	[_______________]	$[_______]	$[_______]	$[_______]	☐ (j)(I) Standard ☐ (j)(II) Elderly/Disabled ☐ (i) Tools
2	[_______________________]	[_______________]	$[_______]	$[_______]	$[_______]	☐ (j)(I) Standard ☐ (j)(II) Elderly/Disabled ☐ (i) Tools

Cap Type	Amount	Claimed?
Standard (up to two vehicles aggregate)	$15,000	☐
Elderly/Disabled (debtor, spouse, or dependent)	$25,000	☐

2.11 Health Aids — § 13-54-102(1)(p)

Item	Detail
Statutory Cap	Unlimited (professionally prescribed health aids)
Description	[____________________________________]
Value	$[_______________]

2.12 Personal Injury and Wrongful Death Awards — § 13-54-102(1)(n) and (m)

Item	Detail
Personal injury proceeds (compensatory portion only)	Unlimited; non-compensatory portions excluded
Wrongful death proceeds	Unlimited
Description	[____________________________________]
Value	$[_______________]

2.13 Firearms — § 13-54-102(1)(x)

Item	Detail
Statutory Cap	$1,000 aggregate (per debtor)
Value Claimed	$[_______________]

2.14 Security Deposits and Utility Deposits — § 13-54-102(1)(r)

Item	Detail
Statutory Cap	Limited to actual deposit amount; verify subsection
Value Claimed	$[_______________]

PART 3 — FINANCIAL ASSETS, INSURANCE, AND BENEFITS

3.1 Life Insurance — Cash Surrender Value — § 13-54-102(1)(l)

Item	Detail
Statutory Cap	$250,000 cash surrender value (policies owned 48+ months)
Carve-out	No exemption for "extraordinary" contributions during the 48 months preceding any writ
Carrier	[____________________________________]
Policy Number	[_______________________]
Owner-of-Record Date	[__/__/____]
Cash Surrender Value	$[_______________]
Amount Claimed	$[_______________]

3.2 Life Insurance — Death Proceeds — C.R.S. § 10-7-106

Item	Detail
Death proceeds payable to designated beneficiary	Unlimited
Carrier / Policy / Insured / Beneficiary	[____________________________________]
Value Claimed	$[_______________]

3.3 Group Life and Health Insurance — C.R.S. § 10-16-212

Item	Detail
Statutory Cap	Unlimited (proceeds and avails)
Description	[____________________________________]

3.4 Annuities — § 13-54-102(1)(s)

Item	Detail
Statutory Cap	$250 per month aggregate (verify current cap)
Carrier / Contract Number	[____________________________________]
Value Claimed	$[_______________]

3.5 Pensions and Retirement Benefits — § 13-54-102(1)(s) and (1)(s.5); § 13-54-104.5

Account/Plan Type	Custodian	Account Number (last 4)	Balance	Citation Used	Amount Claimed
401(k)	[_______________________]	[____]	$[_______]	§ 13-54-102(1)(s); 11 U.S.C. § 522(b)(3)(C)	$[_______]
403(b)	[_______________________]	[____]	$[_______]	§ 13-54-102(1)(s); 11 U.S.C. § 522(b)(3)(C)	$[_______]
Defined-Benefit Pension	[_______________________]	[____]	$[_______]	§ 13-54-102(1)(s)	$[_______]
Traditional IRA	[_______________________]	[____]	$[_______]	11 U.S.C. § 522(b)(3)(C) and (n)	$[_______]
Roth IRA	[_______________________]	[____]	$[_______]	11 U.S.C. § 522(b)(3)(C) and (n)	$[_______]
SEP / SIMPLE IRA	[_______________________]	[____]	$[_______]	11 U.S.C. § 522(b)(3)(C)	$[_______]
Colorado PERA	[_______________________]	[____]	$[_______]	C.R.S. § 24-51-212	$[_______]
Federal Civil Service / FERS / TSP	[_______________________]	[____]	$[_______]	5 U.S.C. § 8346, § 8470	$[_______]
Military Retired Pay	[_______________________]	[____]	$[_______]	10 U.S.C. § 1440; 38 U.S.C. § 5301	$[_______]
Railroad Retirement	[_______________________]	[____]	$[_______]	45 U.S.C. § 231m	$[_______]

3.6 Public Benefits and Assistance — § 13-54-102(1)(o), (u), (v)

Benefit	Citation	Cap	Value Claimed
Public Assistance / TANF	C.R.S. § 26-2-131	Unlimited	$[_______]
Aid to Aged, Blind, Disabled (Old Age Pension)	Colo. Const. art. XXIV; § 26-2-131	Unlimited	$[_______]
Crime Victim Compensation	C.R.S. § 24-4.1-114	Unlimited	$[_______]
Earned Income Tax Credit (federal)	11 U.S.C. § 522(b)(3); In re Westby	Unlimited (federal portion)	$[_______]
Colorado EITC / Child Tax Credit	C.R.S. § 13-54-102(1)(o.5)	Verify	$[_______]
Social Security Benefits	42 U.S.C. § 407	Unlimited	$[_______]
Veterans' Benefits	38 U.S.C. § 5301	Unlimited	$[_______]
Unemployment Compensation	C.R.S. § 8-80-103	Unlimited	$[_______]
Workers' Compensation	C.R.S. § 8-42-124	Unlimited (with carve-outs for child support)	$[_______]
Disability Benefits (private and statutory)	§ 13-54-102(1)(s)	$4,000/month (verify)	$[_______]
Child Support and Maintenance Received	§ 13-54-102.5; § 14-14-107	Reasonably necessary	$[_______]

3.7 Wages — Earnings Garnishment Limit — § 13-54-104

Item	Detail
Disposable earnings	The greater of (a) 80% of disposable weekly earnings or (b) 40 × Colorado minimum wage per week is exempt; balance subject to garnishment
Aggregate Wages on Petition Date (last 30 days unpaid)	$[_______________]
Exempt Portion	$[_______________]
Citation Used	C.R.S. § 13-54-104

PART 4 — MISCELLANEOUS EXEMPTIONS — C.R.S. § 13-54-102.5 and Related Sections

Item	Citation	Cap	Value Claimed
Trust funds (529 plans, qualified tuition programs)	§ 13-54-102(1)(t)	Verify subsection and cap	$[_______]
ABLE account	§ 13-54-102(1)(t.5); 11 U.S.C. § 541(b)(6)	Verify cap	$[_______]
College savings (CollegeInvest)	§ 23-3.1-307.4	Verify	$[_______]
Health Savings Account	Verify subsection	Verify	$[_______]
Public-safety officer death benefits	§ 24-33.5-411.5	Unlimited	$[_______]
Firefighter/police pension	§ 31-30.5-208	Unlimited	$[_______]
Property of the business of insurance (proceeds, dividends, refunds)	§ 10-7-205	Verify	$[_______]
Fraternal benefit society benefits	§ 10-14-403	Unlimited	$[_______]

PART 5 — NO STATE WILDCARD

Question	Response
Did the residency analysis in Section A trigger the federal § 522(d) fall-back?	☐ Yes ☐ No
If Yes, list federal wildcard claim under § 522(d)(5):	$[_______________]

PART 6 — DOUBLING FOR JOINT FILERS

Exemption	Doubled?	Notes
Homestead (§ 38-41-201)	No	Single homestead amount per residence
Wearing apparel (§ 13-54-102(1)(a))	Yes	"per debtor or dependent"
Jewelry (§ 13-54-102(1)(b))	Yes	"per debtor or dependent"
Household goods (§ 13-54-102(1)(e))	Verify	Read current text
Motor vehicles (§ 13-54-102(1)(j))	Verify	"kept and used by any debtor"
Tools of trade (§ 13-54-102(1)(i))	Yes	Each debtor's own occupation
Life insurance cash value (§ 13-54-102(1)(l))	Verify	$250,000 per insured

PART 7 — TOTAL SUMMARY

Category	Total Value	Total Exempt	Total Non-Exempt
Real Property (Part 1)	$[_______]	$[_______]	$[_______]
Personal Property (Part 2)	$[_______]	$[_______]	$[_______]
Financial / Insurance / Benefits (Part 3)	$[_______]	$[_______]	$[_______]
Miscellaneous (Part 4)	$[_______]	$[_______]	$[_______]
TOTAL	$[_______]	$[_______]	$[_______]

PART 8 — TRUSTEE-RISK FLAGS

Flag	Response
Any equity exposed above the homestead cap?	☐ Yes ☐ No
Any non-exempt vehicle equity > $0?	☐ Yes ☐ No
Cash, bank balances, or tax refunds with no Colorado exemption shelter?	☐ Yes ☐ No
Anticipated tax refund (Schedule A/B and Form 122A) more than reasonably necessary EITC carve-out?	☐ Yes ☐ No
Pre-petition transfers to insiders within the last year (§ 547(b), § 548)?	☐ Yes ☐ No
Pre-petition transfers to non-insiders within the last 90 days exceeding $600 aggregate (§ 547(c)(8) Chapter 7 threshold; verify current threshold)?	☐ Yes ☐ No
Pre-petition gift or below-FMV transfer within 2 years (§ 548)?	☐ Yes ☐ No
Pre-petition asset conversion from non-exempt to exempt within 1 year?	☐ Yes ☐ No
Any transfer to a self-settled trust within 10 years (§ 548(e))?	☐ Yes ☐ No
Any 1215-day homestead acquisition (§ 522(p))?	☐ Yes ☐ No
§ 522(q) misconduct triggers?	☐ Yes ☐ No
Beneficial interest in non-debtor's property (e.g., resulting trust, joint account)?	☐ Yes ☐ No
Lien-strip candidates under § 522(f) (non-PMSI judgment liens; non-possessory non-purchase money security interests in household goods)?	☐ Yes ☐ No

PART 9 — § 522(f) LIEN AVOIDANCE TARGETS

Lien Holder	Lien Type	Property Encumbered	Value of Property	Lien Amount	Senior Liens	Exemption Claimed	Avoidable?
[_______________________]	☐ Judgment ☐ Non-PMSI Sec. Int.	[_______________________]	$[_______]	$[_______]	$[_______]	$[_______]	☐ Yes ☐ No
[_______________________]	☐ Judgment ☐ Non-PMSI Sec. Int.	[_______________________]	$[_______]	$[_______]	$[_______]	$[_______]	☐ Yes ☐ No

PART 10 — DEBTOR'S CERTIFICATION

I (we), the undersigned, declare under penalty of perjury under the laws of the United States and the State of Colorado that:

☐ I (we) have reviewed every entry on this worksheet and affirm that the values listed are true, accurate, and complete to the best of my (our) knowledge as of the date below.

☐ I (we) understand that an exemption claim is presumed allowed unless a party in interest objects within 30 days after the conclusion of the meeting of creditors (Fed. R. Bankr. P. 4003(b)).

☐ I (we) understand that intentionally concealing or misrepresenting assets is a federal crime under 18 U.S.C. § 152 and may result in denial of discharge, criminal prosecution, fine of up to $250,000, and imprisonment of up to 5 years.

☐ I (we) have reviewed this worksheet with my (our) bankruptcy attorney or have knowingly elected to proceed pro se.

Signatures	Date
[DEBTOR NAME], Debtor	[__/__/____]
[JOINT DEBTOR NAME], Joint Debtor (if applicable)	[__/__/____]
[ATTORNEY NAME], Counsel for Debtor (if any) — Colo. Bar No. [______]	[__/__/____]

SOURCES AND REFERENCES

Statutes
C.R.S. § 13-54-101 et seq. (Personal Property Exemptions)
C.R.S. § 13-54-102 (Property Exempt — Definitions)
C.R.S. § 13-54-102.5 (Miscellaneous Exemptions)
C.R.S. § 13-54-104 (Restrictions on Garnishment of Earnings)
C.R.S. § 13-54-104.5 (Retirement Plans Exempt)
C.R.S. § 13-54-107 (Federal Bankruptcy Exemptions Denied — Opt-Out)
C.R.S. § 38-41-201 (Homestead Exemption)
C.R.S. § 38-41-201.5 (Disability — Definition)
C.R.S. § 38-41-201.6 (Proceeds — Insurance — Sale)
C.R.S. § 38-41-202 (Homestead — Automatic Creation)
C.R.S. § 24-51-212 (PERA Benefits — Exemption)
C.R.S. § 26-2-131 (Public Assistance — Exemption)
C.R.S. § 8-80-103 (Unemployment Compensation — Exemption)
C.R.S. § 8-42-124 (Workers' Compensation — Assignment Restrictions)
C.R.S. § 10-7-106 (Life Insurance Proceeds — Exemption)
11 U.S.C. § 522(b), (d), (n), (p), (q) (Exemptions; Caps; Limits)
11 U.S.C. § 541 (Property of the Estate)
11 U.S.C. § 547, § 548 (Preferences and Fraudulent Transfers)
18 U.S.C. § 152 (Concealment of Assets — Bankruptcy Crimes)
42 U.S.C. § 407 (Social Security — Anti-Assignment)
38 U.S.C. § 5301 (Veterans' Benefits — Anti-Assignment)
5 U.S.C. § 8346, § 8470 (Federal Civil-Service Retirement)
45 U.S.C. § 231m (Railroad Retirement)
Court Forms
Official Form 106A/B (Schedules A/B — Property)
Official Form 106C (Schedule C — Property Claimed as Exempt)
Official Form 106D (Schedule D — Secured Claims)
Official Form 122A-1, 122A-2 (Chapter 7 Means Test)
Local rules and forms, U.S. Bankruptcy Court for the District of Colorado (cob.uscourts.gov)
Practice Notes
Colorado General Assembly, leg.colorado.gov (verify current dollar amounts; SB 22-086 and subsequent acts)
Judicial Conference § 104 inflation adjustments (effective April 1 every three years; most recent adjustment April 1, 2025)
Colorado Bar Association, Bankruptcy Section practice resources

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About This Template

Bankruptcy is a federal legal process for people and businesses who cannot pay their debts. The right chapter depends on your income, what you own, and whether you want to keep assets like a home or car. The paperwork is extensive and the deadlines are strict, so using the right template for your situation is the first step toward getting your filing accepted and your case moving.

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Last updated: May 2026

Colorado Bankruptcy Exemption Worksheet