STATE OF INDIANA COUNTY OF ALLEN ) ) SS: ) IN THE ALLEN SUPERIOR COURT SMALL CLAIMS DIVISION FORT WAYNE, INDIANA CASE NUMBER: ___________________________________________ Plaintiff(s) VS. ___________________________________________ Defendant ___________________________________________ Street Address ___________________________________________ City, State Zip Code VERIFIED MOTION FOR PROCEEDINGS SUPPLEMENTAL TO DEFENDANT Plaintiff / Plaintiff's counsel appears and states that to the best of its/his/her knowledge: 1. Plaintiff owns the judgment rendered in this case against the Defendant(s); 2. Plaintiff's judgment is unsatisfied, with a balance due upon judgment, interest and costs in the amount of $_________________; and 3. Plaintiff has no cause to believe that levy of execution against the Defendant(s) will satisfy the judgment. Plaintiff requests that the Court issue an order notifying Defendant(s) of hearing on these proceedings and requiring the Defendant(s) to appear to testify concerning its/his/her property. I affirm, under the penalty of perjury, that the foregoing representations are true. _________________________________ Street Address of Plaintiff / Attorney ________________________________ Signature of Plaintiff / Attorney _________________________________ City, State Zip Code ________________________________ Printed Name of Plaintiff / Attorney _________________________________ Telephone Number Supreme Court ID Number Certificate of Service I hereby certify that a copy of this document was sent to the parties or their counsel by ____________________________ (US Mail, E-Service, Sheriff, other manner allowed by IN Trial Rules). _______________________ Date _____________________________________________ Name American LegalNet, Inc. www.FormsWorkFlow.com STATE OF INDIANA COUNTY OF ALLEN ) ) SS: ) IN THE ALLEN SUPERIOR COURT SMALL CLAIMS DIVISION FORT WAYNE, INDIANA CASE NUMBER: ___________________________________________ Plaintiff(s) VS. ___________________________________________ Defendant(s) ___________________________________________ Street Address ___________________________________________ City, State Zip Code ORDER GRANTING MOTION FOR PROCEEDINGS SUPPLEMENTAL TO DEFENDANT Plaintiff files verified motion for proceedings supplemental. Motion granted. Any prior proceedings supplemental pending against Defendant(s)______________________________________________ in this cause is ordered dismissed. TO THE DEFENDANT: You are ordered to appear in this Court on _______________at___________A.M./P.M. in the Allen Superior Court Small Claims Division, 1 West Superior St., Fort Wayne, IN 46802 and bring with you evidence of your income and assets. YOU ARE HEREBY NOTIFIED THAT FAILURE TO APPEAR IN COURT MAY RESULT IN YOUR BEING HELD IN CONTEMPT OF COURT AND BEING PUNISHED BY INCARCERATION IN THE COUNTY JAIL FOR A PERIOD NOT TO EXCEED NINETY (90) DAYS. ________________________ Date _____________________________________ Judge / Magistrate, Allen Superior Court Certificate of Service I hereby certify that a copy of this document was sent to the parties or their counsel by ____________________________ (US Mail, E-Service, Sheriff, other manner allowed by IN Trial Rules). _______________________ Date _____________________________________________ Name American LegalNet, Inc. www.FormsWorkFlow.com