Such personal estate selected by the householder under § 34-4, 34-4.1, or 34-13 shall be set apart in a writing signed by him. He shall, in the writing, designate and describe with reasonable certainty the personal estate so selected and set apart and each parcel or article, affixing to each his cash valuation thereof. Such writing shall be admitted to record, to be recorded as deeds are recorded in the county or city wherein such householder resides. However, if such personal estate is claimed exempt in a case filed under Title 11 of the United States Code, the official Schedule of Property Claimed as Exempt filed in the United States Bankruptcy Court claiming such exemptions shall be sufficient to set apart such property as exempt.

The following form, or one which is substantially similar, shall be used and shall be sufficient, when duly admitted to record in the county or city in which the householder resides, to exempt such described personal property from creditor process:

HOMESTEAD DEED FOR PERSONAL PROPERTY

Name of Householder __________________

Is the householder a disabled veteran entitled to claim the additional exemption under § 34-4.1? ________________

Address of Householder __________________

Name(s) and age(s) of dependent(s) __________________

County/city in which householder resides ____________________________________________________________

Description of property claimed as exempt and its value

__________________

__________________

Number of homestead deeds that have been filed by the Householder

__________________

Exemption amount previously claimed on prior homestead deeds

__________________

List the jurisdictions where previous homestead deeds were filed

__________________

__________________ (Signature of Householder)

__________________ [ACKNOWLEDGMENT]

Such writing or deed shall not be required to secure any exemption under this Code except those exemptions created by §§ 34-4, 34-4.1 and 34-13.