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Sample language may or may not be consistent with current law or rules of court. Any person involved in a legal proceeding would be wise to obtain competent local counsel with recent experience in the relevant area of law as soon as possible. Be advised that even if you claim an exemption, an execution levy may still be served on your employer. If your earnings are levied on after you claim an exemption, you may petition the court for a determination of your exemption. I am presently a recipient of relief based on need.