West Virginia Bankruptcy Exemption Worksheet
West Virginia Bankruptcy Exemption Worksheet
Caption
| Court | Designation |
|---|---|
| United States Bankruptcy Court | |
| [Northern / Southern] District of West Virginia |
| Party | Role |
|---|---|
| In re: [DEBTOR NAME], | Debtor(s) |
| Case No.: [__________] | Chapter: ☐ 7 ☐ 11 ☐ 13 |
Section 1 — Debtor Information and Domicile Verification
| Field | Entry |
|---|---|
| Debtor full legal name | [____________________________________] |
| Co-debtor / spouse name (if joint) | [____________________________________] |
| Current West Virginia residence address | [____________________________________] |
| County of residence | [__________] |
| Date debtor established WV domicile | [__/__/____] |
| Anticipated petition date | [__/__/____] |
| Days domiciled in West Virginia preceding petition | [________] days |
1.1 Domicile Eligibility Check (11 U.S.C. § 522(b)(3)(A))
☐ Debtor has been domiciled in West Virginia for the 730 days immediately preceding the petition date (WV exemptions apply).
☐ Debtor has NOT been domiciled in WV for 730 days, BUT was domiciled in WV for the 180-day period (or longer portion thereof) immediately preceding that 730-day period (WV exemptions apply).
☐ Debtor must apply the exemptions of the state of prior domicile: [__________].
☐ Federal § 522(d) fallback in 11 U.S.C. § 522(b)(3)(A) (last sentence) applies because no state law would govern.
1.2 Federal Homestead Cap Verification (11 U.S.C. § 522(p))
☐ Debtor acquired the principal residence interest more than 1,215 days before the petition date (no federal cap).
☐ Debtor acquired the principal residence interest within 1,215 days before the petition; the federal cap (currently $189,050 as adjusted April 1, 2022; verify next triennial adjustment under § 104(a)) applies and overrides any larger WV homestead.
Section 2 — Real Property Schedule
2.1 Principal Residence — Homestead Exemption (W. Va. Code § 38-10-4(a))
| Field | Entry |
|---|---|
| Street address | [____________________________________] |
| County | [__________] |
| Tax map / parcel ID | [__________] |
| Title held as | ☐ Sole ☐ Joint Tenants ☐ Tenancy by the Entireties ☐ Tenants in Common |
| Fair market value (FMV) | $[____________] |
| Total liens (mortgage, HELOC, judgment) | $[____________] |
| Equity (FMV minus liens) | $[____________] |
| WV homestead claimed (§ 38-10-4(a)) | $[____________] (max $35,000 per debtor) |
| Joint doubling (§ 38-10-7)? | ☐ Yes ($70,000 aggregate) ☐ No |
| Federal § 522(p) cap applies? | ☐ Yes ☐ No |
| Nonexempt equity (if any) | $[____________] |
2.2 Other Real Property (Non-Residence)
| Property | FMV | Liens | Equity | Exemption Claimed (wildcard / unused homestead) |
|---|---|---|---|---|
| [_______________] | $[______] | $[______] | $[______] | $[______] |
| [_______________] | $[______] | $[______] | $[______] | $[______] |
Section 3 — Personal Property Schedule
3.1 Motor Vehicle (W. Va. Code § 38-10-4(b)) — up to $5,000 per debtor
| Vehicle (Year/Make/Model) | VIN | FMV | Liens | Equity | Exemption Claimed |
|---|---|---|---|---|---|
| [_______________] | [_______] | $[______] | $[______] | $[______] | $[______] |
| [_______________] | [_______] | $[______] | $[______] | $[______] | $[______] |
Vehicle exemption claimed: $[______] (max $5,000 per debtor; § 38-10-7 doubling for jointly-titled vehicles)
3.2 Household Goods, Furnishings, Apparel, Books, Animals, Crops, Musical Instruments (§ 38-10-4(c))
| Item / Category | FMV | Per-Item Cap ($1,000) Met? | Exemption Claimed |
|---|---|---|---|
| Furniture — living room | $[______] | ☐ each item ≤ $1,000 | $[______] |
| Furniture — bedroom | $[______] | ☐ each item ≤ $1,000 | $[______] |
| Appliances (refrigerator, washer, etc.) | $[______] | ☐ each item ≤ $1,000 | $[______] |
| Apparel (debtor and dependents) | $[______] | ☐ each item ≤ $1,000 | $[______] |
| Books | $[______] | ☐ each item ≤ $1,000 | $[______] |
| Family pets / household animals | $[______] | ☐ each item ≤ $1,000 | $[______] |
| Crops | $[______] | ☐ each item ≤ $1,000 | $[______] |
| Musical instruments (personal/family use) | $[______] | ☐ each item ≤ $1,000 | $[______] |
| Subtotal — Household goods (§ 38-10-4(c)) | $[______] (max $9,000 aggregate) |
3.3 Jewelry (W. Va. Code § 38-10-4(d)) — up to $1,000
| Item | FMV | Exemption Claimed |
|---|---|---|
| [_______________] | $[______] | $[______] |
| [_______________] | $[______] | $[______] |
| Subtotal — Jewelry (§ 38-10-4(d)) | $[______] (max $1,000) |
3.4 Tools, Implements, and Books of Trade (W. Va. Code § 38-10-4(f)) — up to $3,000
| Item | FMV | Exemption Claimed |
|---|---|---|
| [_______________] | $[______] | $[______] |
| [_______________] | $[______] | $[______] |
| Subtotal — Tools of trade (§ 38-10-4(f)) | $[______] (max $3,000) |
3.5 Wildcard — Unused Homestead + Statutory Wildcard (W. Va. Code § 38-10-4(e))
§ 38-10-4(e) gives the debtor (i) $1,150 plus (ii) the unused portion of the § 38-10-4(a) homestead, applicable to ANY property.
| Component | Amount |
|---|---|
| Statutory wildcard (§ 38-10-4(e)(1)) | $1,150 |
| Unused homestead carry-over (§ 38-10-4(a) maximum minus homestead actually claimed in § 2.1) | $[__________] |
| Total wildcard available | $[__________] |
| Asset Absorbed by Wildcard | FMV | Wildcard Allocation |
|---|---|---|
| Cash on hand | $[______] | $[______] |
| Bank accounts (checking / savings) | $[______] | $[______] |
| Excess household goods over $9,000 / $1,000 per-item | $[______] | $[______] |
| Excess jewelry over $1,000 | $[______] | $[______] |
| Electronics not within § 38-10-4(c) | $[______] | $[______] |
| Firearms (verify federal / state restrictions) | $[______] | $[______] |
| Pre-petition tax refunds (federal & WV) | $[______] | $[______] |
| Stocks, bonds, non-retirement investments | $[______] | $[______] |
| Other: [_______________] | $[______] | $[______] |
| Subtotal — Wildcard claimed | $[______] |
3.6 Personal Injury Recoveries (W. Va. Code § 38-10-4(j)(4)) — up to $30,000
| Claim / Cause | Status (pending / settled) | Gross Value | Exemption Claimed |
|---|---|---|---|
| [_______________] | [__________] | $[______] | $[______] (max $30,000, exclusive of pain & suffering / actual pecuniary loss) |
3.7 Other Specific Personal Property Exemptions (§ 38-10-4)
| Item | Statute | Exempt Amount | Owned? | Value | Claimed |
|---|---|---|---|---|---|
| Health aids, professionally prescribed | § 38-10-4(i) | Full | ☐ | $[______] | $[______] |
| Social Security / unemployment / public assistance benefits | § 38-10-4(j)(1) | Full | ☐ | $[______] | $[______] |
| Veterans' benefits | § 38-10-4(j)(2) | Full | ☐ | $[______] | $[______] |
| Disability / illness / unemployment benefits | § 38-10-4(j)(3) | Full | ☐ | $[______] | $[______] |
| Alimony / support reasonably necessary | § 38-10-4(j)(4) | Reasonably necessary | ☐ | $[______] | $[______] |
| Loss of future earnings (reasonably necessary for support) | § 38-10-4(j)(5) | Reasonably necessary | ☐ | $[______] | $[______] |
| Crime-victim reparations | § 38-10-4(k)(1) | Full | ☐ | $[______] | $[______] |
| Wrongful-death recovery (dependent) | § 38-10-4(k)(2) | Reasonably necessary | ☐ | $[______] | $[______] |
| Life insurance proceeds (dependent of insured) | § 38-10-4(k)(3) | Reasonably necessary | ☐ | $[______] | $[______] |
Section 4 — Retirement and Life Insurance
4.1 Retirement Plans (W. Va. Code § 38-10-4(j)(5) and § 38-10-4(l))
§ 38-10-4(l) protects "retirement funds to the extent that those funds are in a fund or account that is exempt from taxation under § 401, § 403, § 408, § 408A, § 414, § 457, or § 501(a) of the Internal Revenue Code of 1986" (mirroring 11 U.S.C. § 522(b)(3)(C)).
| Account Type | Plan / Custodian | Account Balance | Exempt under § 38-10-4(l) |
|---|---|---|---|
| 401(k) | [_______________] | $[______] | ☐ Yes (full) |
| 403(b) | [_______________] | $[______] | ☐ Yes (full) |
| Pension / defined benefit | [_______________] | $[______] | ☐ Yes (full) |
| Profit-sharing | [_______________] | $[______] | ☐ Yes (full) |
| Traditional IRA | [_______________] | $[______] | ☐ Yes (subject to § 522(n)) |
| Roth IRA | [_______________] | $[______] | ☐ Yes (subject to § 522(n)) |
| SEP / SIMPLE IRA | [_______________] | $[______] | ☐ Yes (subject to § 522(n)) |
| Eligible rollover (60-day window) | [_______________] | $[______] | ☐ Yes |
4.2 Life Insurance (W. Va. Code § 33-6-27 and § 38-10-4(g)–(h))
| Policy / Insurer | Insured | Owner / Beneficiary | Cash Surrender Value | Death Benefit | Statute / Exemption |
|---|---|---|---|---|---|
| [_______________] | [_______] | [_______] | $[______] | $[______] | ☐ § 38-10-4(g) (life insurance contract not matured, owned by debtor — full) |
| [_______________] | [_______] | [_______] | $[______] | $[______] | ☐ § 38-10-4(h) (accrued dividend/loan/cash value, up to $8,000) |
| [_______________] | [_______] | [_______] | $[______] | $[______] | ☐ § 33-6-27 (proceeds payable to beneficiary other than debtor) |
Section 5 — Wages and Public Benefits
5.1 Wage Exemption (W. Va. Code § 38-5A-3)
☐ 80% of debtor's disposable earnings, OR 30 times the federal minimum hourly wage per week, whichever is greater, is exempt from suggestion / garnishment.
☐ Exception applies (court-ordered support, taxes, federal student loans): [____________________________________]
5.2 Public Benefits (Verify Each Statute)
| Benefit | Statute | Receiving? | Monthly Amount |
|---|---|---|---|
| Workers' compensation | W. Va. Code § 23-4-18 | ☐ | $[______] |
| Unemployment insurance | W. Va. Code § 21A-10-2 | ☐ | $[______] |
| Social Security | 42 U.S.C. § 407 | ☐ | $[______] |
| SSI / SSDI | 42 U.S.C. § 407, § 1383(d)(1) | ☐ | $[______] |
| Veterans' benefits | 38 U.S.C. § 5301 | ☐ | $[______] |
| TANF / WV Works | W. Va. Code § 9-3-2 | ☐ | $[______] |
| Crime victim compensation | W. Va. Code § 14-2A-24 | ☐ | $[______] |
Section 6 — Property NOT Eligible for Exemption (Disqualifiers)
☐ Property the debtor concealed, transferred, or removed within 1 year preceding petition with intent to hinder, delay, or defraud (11 U.S.C. § 522(o)).
☐ Homestead reduction under 11 U.S.C. § 522(o) for nonexempt property converted to homestead within 10 years preceding petition with fraudulent intent.
☐ § 38-10-4(a) homestead voided after notice and hearing for: federal/state securities-law violations; fraud, deceit, or manipulation in a fiduciary capacity; or criminal acts causing serious bodily injury or death within 5 years preceding petition (11 U.S.C. § 522(q)).
☐ Property subject to a non-avoidable lien (purchase-money security interest, statutory lien, judicial lien not subject to § 522(f) avoidance).
Section 7 — Joint-Petition Doubling Worksheet (W. Va. Code § 38-10-7)
If filing jointly, each debtor may claim the § 38-10-4 exemptions separately. Aggregate caps below assume both spouses have an interest in the property.
| Category | Per-Debtor Cap | Joint Doubled |
|---|---|---|
| Homestead (§ 38-10-4(a)) | $35,000 | $70,000 |
| Vehicle (§ 38-10-4(b)) | $5,000 | $10,000 |
| Household goods (§ 38-10-4(c)) | $9,000 / $1,000 per item | $18,000 / $1,000 per item per spouse |
| Jewelry (§ 38-10-4(d)) | $1,000 | $2,000 |
| Wildcard (§ 38-10-4(e)) | $1,150 + unused homestead | $2,300 + unused homestead × 2 |
| Tools of trade (§ 38-10-4(f)) | $3,000 | $6,000 |
| Life insurance cash value (§ 38-10-4(h)) | $8,000 | $16,000 |
| Personal injury (§ 38-10-4(j)(4)) | $30,000 | $60,000 (each spouse separately injured) |
Section 8 — Summary Totals
| Category | Statute | Amount Claimed |
|---|---|---|
| Homestead (principal residence) | § 38-10-4(a) | $[__________] / max $35,000 |
| Motor vehicle | § 38-10-4(b) | $[__________] / max $5,000 |
| Household goods, furnishings, apparel, books, animals, crops, instruments | § 38-10-4(c) | $[__________] / max $9,000 ($1,000/item) |
| Jewelry | § 38-10-4(d) | $[__________] / max $1,000 |
| Wildcard (statutory + unused homestead) | § 38-10-4(e) | $[__________] / max $1,150 + unused homestead |
| Tools of trade | § 38-10-4(f) | $[__________] / max $3,000 |
| Life insurance — unmatured | § 38-10-4(g) | Full |
| Life insurance — cash value / dividend | § 38-10-4(h) | $[__________] / max $8,000 |
| Health aids | § 38-10-4(i) | Full |
| Public benefits / support / future earnings | § 38-10-4(j) | $[__________] |
| Crime victim / wrongful death / life insurance support | § 38-10-4(k) | $[__________] |
| Personal injury bodily-injury component | § 38-10-4(j)(4) | $[__________] / max $30,000 |
| Retirement funds (IRC-qualified) | § 38-10-4(l) | $[__________] (subject to § 522(n)) |
| Wages (80% / 30× FMW) | § 38-5A-3 | $[__________] |
| TOTAL EXEMPTIONS CLAIMED | $[__________] |
Section 9 — Schedule C Cross-Reference
For each line on Official Form 106C (Schedule C — The Property You Claim as Exempt), enter:
- Description of property (matching Schedule A/B).
- Current value of the portion claimed exempt.
- Amount of exemption claimed (use specific dollar amounts; West Virginia generally does not authorize 100%-of-FMV exemptions).
- Specific West Virginia statute (e.g., "W. Va. Code § 38-10-4(a)").
- Do not check the "11 U.S.C. § 522(d)" column — West Virginia is an opt-out state under § 38-10-1.
Section 10 — Attorney Certification
I, [ATTORNEY NAME], West Virginia Bar No. [________], certify that I have reviewed the debtor's schedules, verified the 730-day domicile rule under 11 U.S.C. § 522(b)(3)(A), confirmed the West Virginia exemption amounts against the current text of W. Va. Code §§ 38-10-1 to 38-10-7 at code.wvlegislature.gov, and analyzed federal cap exposure under 11 U.S.C. § 522(o), (p), (q), and § 522(n).
| Field | Entry |
|---|---|
| Attorney signature | [____________________________________] |
| Date | [__/__/____] |
| Firm | [____________________________________] |
| Address | [____________________________________] |
| Phone / Email | [__________] / [__________] |
Debtor signature (under penalty of perjury, 28 U.S.C. § 1746): [____________________________________]
Date: [__/__/____]
Joint debtor signature: [____________________________________]
Date: [__/__/____]
Sources and References
- W. Va. Code § 38-10-1 (Federal exemptions inapplicable): https://code.wvlegislature.gov/38-10-1/
- W. Va. Code § 38-10-2 (Definitions): https://code.wvlegislature.gov/38-10-2/
- W. Va. Code § 38-10-3 (Property exempt from administration): https://code.wvlegislature.gov/38-10-3/
- W. Va. Code § 38-10-4 (Bankruptcy exemptions of property): https://code.wvlegislature.gov/38-10-4/
- W. Va. Code § 38-10-7 (Joint petitions; doubling): https://code.wvlegislature.gov/38-10-7/
- W. Va. Code § 38-5A-3 (Wage exemption): https://code.wvlegislature.gov/38-5A-3/
- W. Va. Code § 33-6-27 (Life insurance / annuity proceeds): https://code.wvlegislature.gov/33-6-27/
- 11 U.S.C. § 522 (federal exemptions, opt-out, domicile rules, caps).
- Official Form 106C: https://www.uscourts.gov/forms/individual-debtors/property-you-claim-exempt
- U.S. Bankruptcy Court for the Northern District of West Virginia: https://www.wvnb.uscourts.gov/
- U.S. Bankruptcy Court for the Southern District of West Virginia: https://www.wvsb.uscourts.gov/
- Companion templates:
bankruptcy/jurisdictional/wv/homestead_declaration.md;personal_injury/jurisdictional/nc/personal_injury_complaint_auto_accident.md(cross-reference for PI claim documentation feeding § 38-10-4(j)(4)).
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Last updated: May 2026