A copy of the notice of Judgment must accompany this application. Judgment Creditor: Address: The judgment was obtained in which Civil Court? (Please check one) Date of Judgment: City: SecTiOni: JudgMenT And cOnTAcT inFORMATiOn Please print clearly. See instructions for more detailed information and mailing addresses. Daytime Phone Number: State: Zip Code: REQUEST FOR AN EXECUTION FROM NYC SMALL CLAIMS OR CIVIL COURT NYC Department of Finance Office of the Sheriff q Commercial Amount of Judgment: q Housing q Landlord/Tenant Court Index #: q Small Claims County of the Court: (Please check one) Judgment Debtor: Address: q New York q Bronx City: Social Security Number (optional): State: q Richmond q Kings q Queens Zip Code: 1. PROPeRTY execuTiOn - A $35 filing fee for Small claims or $50 filing fee for civil court must accompany this application. Debtor's Bank: Bank Address: Debtor's Business Name: Business Address: City: State: Zip Code: City: State: Zip Code: You can only request enforcement of one execution at a time. Two execution requests cannot be filed simultaneously. You must wait for the Sheriff/Marshal to return the first execution to court, before a new execution can be issued. SecTiOn ii: PROPeRTY execuTiOn OR incOMe execuTiOn inFORMATiOn Was an execution on this Court Index # ever sent to a Sheriff or Marshal? If YES, please provide detailed information on a separate sheet and attach to this application. Debtor's Employer/Company Name: Address: 2. incOMe execuTiOn - A $30 debtor filing fee and a $30 employer filing fee must accompany this application. City: State: Zip Code: OR q Yes q No Was an execution on this Court Index # ever sent to a Sheriff or Marshal? If YES, please provide detailed information on a separate sheet and attach to this application. property levied upon, pursuant to an execution issued in the above action. I authorize the Sheriff to provide and complete the execution notice and exemption claim forms on my behalf if required. It is further understood that the Sheriff is relieved from all liability by reason thereof. _____________________________________________________________________ Creditor/Assignee Signature: I, _______________________________________________________ hereby instruct the Sheriff not to place custodians in charge of, nor to remove the Print Creditor/Assignee Name SecTiOn iii: ceRTiFicATiOn q Yes q No _______________________________________________ Date: SH-0100 Visit Finance at nyc.gov/finance 6.1.2015 American LegalNet, Inc. www.FormsWorkFlow.com Who Should use This Application? Use this application to direct the New York City Sheriff to obtain an execution on your behalf from either the New York City Small Claims or Civil Court. If you are an attorney, do not use this application. criteria: The Sheriff can only serve an Income Execution to obtain money owed against a debtor: l l l inSTRucTiOnS FOR cOMPLeTing A RequeST FOR An execuTiOn FROM nYc SMALL cLAiMS OR ciViL cOuRT who resides within the five boroughs, or if the debtor resides outside the State of New York, and the employer is located within the five boroughs. However, the Sheriff cannot serve an employer located outside the five boroughs. After you, the Judgment Creditor, have won a judgment against the Judgment Debtor, the Sheriff can help you collect the money owed to you. However, in order to do so, the Sheriff needs an execution from the court. You must provide all the information requested on this application so that the Sheriff can obtain an execution from the court. Any settlement of judgment must include payment in full of all poundage and fees due to the Sheriff. List the Judgment Creditor's name, address, date of judgment, the county that the judgment was filed in, the court index number and other required information exactly as they appear on the Notice of Judgment. A copy of the Notice of Judgment must accompany this application. An applicant can only claim one execution at a time, either a Property Execution or an Income Execution. Two executions cannot be filed simultaneously. Property and income execution Fees: 1. Property execution: Submit a $35 filing fee with your Property Execution application for Small Claims. Submit a $50 filing fee with your Property Execution application for Civil Court. SecTiOn i: JudgMenT And cOnTAcT inFORMATiOn SecTiOn ii: PROPeRTY execuTiOn OR incOMe execuTiOn inFORMATiOn And FeeS 2. income execution: There is a $30 debtor-filing fee and a $30 employer-filing fee. Submit a separate check for each filing fee with your Income Execution application made payable to the New York City Sheriff. If the employer is the City of New York, include an additional $2 check made payable to the "City Comptroller". Include the debtor's Social Security Number. Make check payable to: The New York City Sheriff, except as noted above. For Property executions, submit this application to the new York city department of Finance, Sheriff division in the county where the Judgment debtor has assets: New York County ................. 66 John Street, 13th Floor, New York, NY 10038 Kings County........................ 210 Joralemon Street, 9th Floor, Brooklyn, NY 11201 Bronx County ....................... 3030 Third Avenue, 2nd Floor, Bronx, NY 10455 (212) 487-9734 (718) 802-3545 (718) 993-3880 MAiLing inSTRucTiOnS Richmond County ................ 350 St. Marks Place, 3rd Floor, Staten Island, NY 10305 Queens County .................... 30-10 Starr Avenue, Long Island City, NY 11101 Office of the Sheriff 66 John Street, 13th Floor New York, NY 10038 (212) 487-8002 income execution Location (718) 815-8407 (718) 610-0448, (718) 610-0454 American LegalNet, Inc. www.FormsWorkFlow.com COUNTY OF __________________________________________ Part _______________________________________________ Claimant(s) / Plaintift(s) _______________________________________________ Defendant(s) COUNTY OF _______________________________ PRINT LAST NAME CIVIL COURT OF THE CITY OF NEW YORK AGAINST STATE OF NEW YORK I am the Judgment Creditor in this action and on ______________________________________________ To this date: ______________________________________________________, being duly sworn, deposes and says: PRINT FIRST NAME } AFFIDAVIT IN SUPPORT OF A REQUEST FOR EXECUTION AGAINST INCOME / PROPERTY Index Number_____________ SS: a judgment was rendered in my behalf for $ __________________________________________________ q q I have collected $__________________ toward the satis