STATE COURT OF DEKALB COUNTY AFFIDAVIT FOR GARNISHMENT GEORGIA, DEKALB COUNTY Check this box if the Garnishee is a financial institution Check this box if garnishment is for the collection of child support or alimony. See O.C.G.A § 18-4-50, et seq. ________________________________________ ________________________________________ ________________________________________ Plaintiff (Name & Address) VS ________________________________________ ________________________________________ ________________________________________ Defendant (Name & Address) ________________________________________ ________________________________________ _______________________________________ Garnishee (Name & Address) 1. Personally appeared ___________________________________________________, who on oath says that I am (Plaintiff) (Attorney at Law for Plaintiff) (Agent for Plaintiff) [Circle one] herein, and that the above named Defendant, is indebted to said plaintiff in the sum of and no agreement requires forbearance from the garnishment which is applied for currently. $__________________ Principal $__________________ Interest $__________________ Attorney's Fees $__________________ All Costs [exclusive of the cost of this action] $__________________ Total [balance due] Judgment was obtained in the __________________Court of ___________________ County. _________________________ is the case number Pursuant to O.C.G.A. 18-4-89, Plaintiff/Plaintiff's Attorney makes application for condemnation of any funds delivered to this Court by the Garnishee upon certification being filed with said clerk their proof of service to defendant of this proceeding. Plaintiff's Attorney (Name, Address, Phone & Email) __________________________________________ __________________________________________ __________________________________________ __________________________________________ Bar Number ________________________________ Case Number ______________________________ 2. 3. 4. 5. 6. 7. 8. 9. Affiant further states that no agreement has been made with the Defendant for payment of the Judgment, or if an agreement was made, the defendant is in default and that Affiant has reason to apprehend the loss of said sum or some part thereof unless process of garnishment issues. Upon the Affiant's personal knowledge or belief, the sum stated herein is unpaid. This __________ day of _____________________ 20_______. _____________________________________________ Affiant _____________________________________________ Print Name of Affiant Sworn to and subscribed before me, This ______day of __________________, 20______. __________________________________________ Notary Public or Deputy Clerk of Court Commission Expires__________________________ G:/Affidavit of Regular Garnishment Approved this ______day of ____________________, 20______. ____________________________________________________ Deputy Clerk, State Court of DeKalb County www.dekalbstatecourt.net American LegalNet, Inc. www.FormsWorkFlow.com