Templates Universal Bankruptcy Schedule C – Property Claimed as Exempt Template
Bankruptcy Schedule C – Property Claimed as Exempt Template
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Bankruptcy Schedule C – Property Claimed as Exempt Template

United States Bankruptcy Court
District of [District]

In re: [Debtor Name(s)]
Case No.: [if known]
Chapter: [7/13]

Schedule C: Property Claimed as Exempt

List each item of property claimed as exempt, applicable law, and amount of exemption. Ensure values correspond to Schedule A/B entries.

Description of Property Schedule A/B Line Current Value of Debtor’s Interest Exemption Law Amount of Exemption Claimed
[Household goods and furnishings] [Line] $[Value] [State/Federal statute] $[Amount]
[Motor vehicle] [Line] $[Value] [State/Federal statute] $[Amount]
[Clothing]
[Tools of trade]
[Retirement account (401(k))] 11 U.S.C. § 522(b)(3)(C) $[Value]
[Homestead] [State homestead statute] $[Amount]

Notes

  • Choose state or federal exemption scheme (if applicable) and indicate in heading.
  • For married joint filers, specify whether exemption claimed jointly.
  • If claiming wildcard, note remaining unused amount.

Declaration

I declare under penalty of perjury that the foregoing is true and correct.

Debtor 1 Signature: ____ Date: __

Debtor 2 Signature (if joint case): ____ Date: __

Use Official Form 106C instructions. Attach additional sheets as necessary.

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