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The original and one copy of this form must be filed with the levying officer. This notice was mailed on at (place): (date): , California. 2.The judgment debtor (employee) has filed the attached Claim of Exemption and Financial Statement. Your claim of exemption may be filed with the Sheriff at any time during the wage garnishment period. Upon receipt of this form, the court clerk will send you and the judgment creditor the court hearing date on your claim. Judgment Creditor (person who money is paid to) must fill out this section and attach to one copy of the wage execution application (JD-CV-3). Form NumberForm NameCategoryAO 10AFinancial Disclosure Report RequestOther FormsAO 30Certified CopyOther FormsAO 35Certificate of Official Court ReporterCourt Reporter Forms DISTRICT COURT CLAIM OF EXEMPTION FROM EXECUTION Pdf Fillable Fill out the Claim of Exemption form completely. If the Sheriff "levies on" or takes property that you believe is exempt, you should promptly (i) fill out the REQUEST FOR. A copy of the Claim of Exemption form and instructions for filling it out and returning it to the sheriff has been included with this notice.