Connecticut Bankruptcy Exemption Worksheet (State vs. Federal Election)

Connecticut Bankruptcy Exemption Worksheet

State vs. Federal Election Analysis Under 11 U.S.C. § 522(b)

Part 1 — Debtor and Case Information

Part 2 — Threshold Domicile and Residency Tests

2.1 — 730-Day Domicile Test (11 U.S.C. § 522(b)(3)(A))

☐ Debtor has been domiciled in Connecticut for the entire 730 days (two years) immediately preceding the petition date.

☐ Debtor has NOT been domiciled in Connecticut for the full 730 days. In that case, the applicable state law is the state where the debtor was domiciled for the longer portion of the 180-day period immediately preceding the 730-day period. Identify that state: [________________________________]

☐ If the prior state's law would render the debtor ineligible for any state exemption, the federal exemptions in 11 U.S.C. § 522(d) are available as a fallback under § 522(b)(3) (last paragraph).

2.2 — 1,215-Day Homestead Cap (11 U.S.C. § 522(p))

☐ Debtor has owned the Connecticut homestead for at least 1,215 days (approximately 40 months) before filing. The full Connecticut $250,000 homestead exemption is available without federal cap.

☐ Debtor has NOT owned the homestead for 1,215 days. The state homestead exemption is capped at the federal § 522(p) ceiling (currently $214,000 for cases filed April 1, 2025 through March 31, 2028; verify current amount): [$________]

☐ Equity rolled from a prior Connecticut homestead. Document the roll-over: [________________________________]

Part 3 — Property Inventory

Total scheduled asset value: $[__________]
Total scheduled net equity: $[__________]

Part 4 — Connecticut State Exemption Column (CGS § 52-352b)

4.1 — Homestead — § 52-352b(21)

☐ Claim Connecticut homestead exemption.

4.2 — Necessary Apparel, Bedding, Foodstuffs, Household Furniture and Appliances — § 52-352b(1)

☐ Claim. Itemize and value (no aggregate dollar cap; limited only by "necessary" standard in § 52-352a(2)).

4.3 — Tools, Books, Instruments, Farm Animals and Livestock Feed Necessary to Occupation, Profession, or Farming — § 52-352b(2)

☐ Claim. Identify trade or profession: [________________________________]

4.4 — Burial Plot — § 52-352b(3)

☐ Claim. Cemetery: [________________________________] Plot ID: [____] Value: $[______]

4.5 — Public Assistance Payments — § 52-352b(4)

☐ Temporary Family Assistance, State Supplement, SNAP, and other public assistance payments and incentive earnings. Monthly amount: $[______]

4.6 — Health and Disability Insurance Payments — § 52-352b(5)

☐ Claim. Source / policy: [________________________________] Monthly benefit: $[______]

4.7 — Health Aids — § 52-352b(6)

☐ Claim. Description (e.g., wheelchair, prosthetic, hearing aid, CPAP): [________________________________] Value: $[______]

4.8 — Workers' Compensation, Social Security, Veterans' and Unemployment Benefits — § 52-352b(7)

4.9 — Court-Approved Child Support Payments — § 52-352b(8)

☐ Claim. Monthly amount received: $[______]

4.10 — Arms, Military Equipment, Uniforms or Musical Instruments of Militia / Armed Forces Member — § 52-352b(9)

☐ Claim. Branch / unit: [________________________________] Items / value: [____________] $[______]

4.11 — Motor Vehicles — § 52-352b(10)

☐ Claim. Up to two motor vehicles, $7,000 aggregate (FMV minus liens and security interests).

4.12 — Wedding and Engagement Rings — § 52-352b(11)

☐ Claim. No statutory dollar cap.

4.13 — Residential Utility and Security Deposits — § 52-352b(12)

☐ Claim. One residential utility deposit and one residential security deposit.

4.14 — Retirement Plans, Education and Medical Savings Accounts — § 52-352b(13) (incorporating § 52-321a)

☐ Claim. Section 52-321a covers ERISA-qualified plans, IRC §§ 401, 403, 408, 408A, 414, 457 plans (including 401(k), 403(b), traditional and Roth IRAs, SEP-IRAs, SIMPLE IRAs, and 457 plans), Coverdell education accounts, qualified tuition (529) plans, Archer MSAs, HSAs, and group annuity contracts.

4.15 — Alimony and Non-Child Support — § 52-352b(14)

☐ Claim. To the extent earnings would be exempt under § 52-361a (i.e., 75% of disposable). Monthly received: $[______]

4.16 — Crime Reparations Award — § 52-352b(15)

☐ Claim. Award amount: $[______]

4.17 — Mutual Aid / Sickness or Infirmity Benefits — § 52-352b(16)

☐ Claim. Association: [____________] Monthly: $[______]

4.18 — Insurance Proceeds on Exempt Property — § 52-352b(17)

☐ Claim, to the extent the underlying property was exempt. Loss / claim: [____________] Amount: $[______]

4.19 — Wildcard — § 52-352b(18)

☐ Claim. Up to $1,000 in any property. Apply against:

4.20 — Loan / Dividend Value of Unmatured Life Insurance — § 52-352b(19)

☐ Claim. Up to $4,000 of accrued dividend, interest, or loan value of an unmatured life insurance contract on the exemptioner or a dependent.

4.21 — Cash Surrender Value of Life Insurance Policy on CT Citizen / Resident — § 52-352b(20)

☐ Claim. Cash surrender value of any policy on a CT citizen or resident, unless assigned to or for the benefit of the creditor or transferred with intent to defraud.

4.22 — Wage Execution Limit — § 52-361a (state-court collection rule, applied via § 52-352b(14))

4.23 — Connecticut State Column Subtotal

Part 5 — Federal § 522(d) Exemption Column

Part 6 — Election Comparison

Part 7 — Election Decision

Based on the comparison in Part 6, the debtor elects the following exemption system on Schedule C:

☐ Connecticut state exemptions (CGS § 52-352b et seq.) plus non-bankruptcy federal exemptions (Social Security, ERISA, etc.)

☐ Federal exemptions under 11 U.S.C. § 522(d)

Reason for election (substantial homestead equity, retirement-heavy estate, unique asset, etc.):

[________________________________________________________________________]
[________________________________________________________________________]

If joint case, both spouses elect the same system: ☐ Yes ☐ N/A (single filer)

Part 8 — Non-Exempt Asset Plan

Part 9 — Lien Avoidance Checklist (11 U.S.C. § 522(f))

A debtor may avoid a judicial lien or non-possessory non-purchase-money security interest in exempt property to the extent the lien impairs an exemption.

Part 10 — Certifications

The debtor (and joint debtor, if applicable) certifies:

☐ All assets have been disclosed on Schedules A/B.

☐ Values stated reflect fair market value as of the petition date.

☐ The debtor has read and understands the binding effect of the exemption election under 11 U.S.C. § 522(b).

☐ The debtor has reviewed the residency and 1,215-day cap requirements in 11 U.S.C. § 522(b)(3) and (p).

☐ The debtor has not transferred, concealed, or destroyed property with intent to hinder, delay, or defraud creditors within the look-back periods under 11 U.S.C. §§ 548 and 727(a)(2).

Sources and References

• Conn. Gen. Stat. § 52-352a (definitions): https://www.cga.ct.gov/current/pub/chap_906.htm
• Conn. Gen. Stat. § 52-352b (exempt property, subdivisions (1)–(21)): https://www.cga.ct.gov/current/pub/chap_906.htm
• Conn. Gen. Stat. § 52-321a (retirement, education, medical savings accounts): https://www.cga.ct.gov/current/pub/chap_904.htm
• Conn. Gen. Stat. § 52-361a (wage execution): https://www.cga.ct.gov/current/pub/chap_906.htm
• 11 U.S.C. § 522 (federal exemptions): https://www.law.cornell.edu/uscode/text/11/522
• Public Act 21-161 (homestead increase to $250,000, eff. Oct. 1, 2021): https://www.cga.ct.gov/2021/ACT/PA/PDF/2021PA-00161-R00HB-06466-PA.PDF
• In re Cole, 347 Conn. 284 (2023) (retroactive application of $250,000 cap to pre-2021 debts): https://www.jud.ct.gov/external/supapp/Cases/AROcr/CR347/347CR45.pdf
• U.S. Bankruptcy Court, District of Connecticut: https://www.ctb.uscourts.gov/