DAYTON MUNICIPAL COURT AFFIDAVIT, ORDER AND NOTICE OF GARNISHMENT OF PERSONAL EARNINGS AND ANSWER OF EMPLOYER (R.C. 2716. 05) revised 11/08/ 04 _____________________________________________________ _____________________________________________________ JUDGMENT CREDITOR DAYTON MUNICIPAL COURT, CIVIL DIVISION P.O. BOX 10700 Dayton, OH 45402 Case No. ______________________________________ Exec. No._____________________________________ (The debt collector is attempting to collect a debt and any information obtained will be used for that purpose). -vs_____________________________________________________ _____________________________________________________ JUDGMENT DEBTOR STATE OF OHIO, COUNTY OF MONTGOMERY, SS.: The undersigned, first duly cautioned and sworn, deposes that I am ________________________________________________________________, the Judgment Creditor herein, and that said Judgment Creditor on the __________________ day of ________________________________________, 20___ , duly recovered a judgment in the ________________________________________Court against the Judgment Debtor named above. I, the affiant, have good reason to believe and do believe that ______________________________________________________________ is an employer of the judgment debtor who may have personal earnings of the same, nonexempt under R.C. 2329.66, that the written demand required by R.C. 2716.02 has been made, that the payment demanded has not been made, nor has a sufficient portion been made to prevent the garnishment of personal earnings pursuant to R.C. 2716.02. I further have no knowledge of any application by Judgment Debtor for the appointment of a trustee so as to preclude garnishment, nor knowledge that the debt is the subject of a debt scheduling agreement of a nature precluding garnishment under R.C. 2716.03(B). ATTORNEY FOR JUDGMENT CREDITOR ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ______________________________________________________ AFFIANT Sworn to and subscribed before me this_____day of ____________________________________, 20__ . _______________________________________________________ NOTARY PUBLIC ========================================================================================================================= SECTION A: COURT ORDER AND NOTICE OF GARNISHMENT TO:____________________________________________________________________________________________________________________ GARNISHEE The Judgment Creditor in the above case has filed an Affidavit, satisfactory to the undersigned, in the Dayton Municipal Court stating that you owe the Judgment Debtor money for personal earnings, which are nonexempt from garnishment under the laws of Ohio and the United States. You are therefore ordered to complete the "Answer of Employer (Garnishee)" in Section B on the back of this form. Return one completed and signed copy of this form to the clerk of this court within five (5) business days after you receive this Order of Garnishment. Deliver one completed and signed copy of this form and the accompanying documents entitled "Notice to the Judgment Debtor" and "Request for Hearing" to the Judgment Debtor. Keep the other completed copy of this form for your files. The total probable amount now due on this judgment is $_______________. (The total probable amount due includes the unpaid portion of the judgment in favor of the Judgment Creditor, which is $__________________; interest on that judgment and, if applicable, prejudgment interest at the rate of _______% per annum payable until that judgment is satisfied in full; and court costs in the amount of $____________________.) This garnishment order of personal earnings is a continuous order that generally requires you to withhold a specified amount, calculated each pay period at the statutory percentage, of the Judgment Debtor's personal disposable earnings, as determined in accordance with the Interim Report and Answer of Garnishee and commencing with the first full pay period beginning after you receive the order until the judgment in favor of the Judgment Creditor and the associated court costs, interest, and, if applicable, prejudgment interest have been paid in full. You must pay the specified amount, calculated each pay period at the statutory percentage, to the Clerk of Court within thirty (30) days after the end of each pay period of the Judgment Debtor and must include with your payment a completed photocopy of the enclosed "Interim Report and Answer of Garnishee" form. You are permitted to deduct a processing fee of up to three dollars ($3) [which shall not be charged as court costs] from the Judgment Debtor's personal disposable earning for any pay period that an amount was withheld for the Garnishment Order. You are not required to file with the court the Interim Report and Answer of Garnishee for any pay period of the Judgment Debtor for which an amount was not withheld for the Garnishment Order. This Garnishment Order will remain in effect until one of the following occurs: 1) The total probable amount due is paid in full as a result of your withholding of the specified amount, calculated each pay period at the statutory percentage, from the Judgment Debtor's personal disposable earnings, that commenced with the first full pay period beginning after you received the order; 2) The Judgment Creditor or the Judgment Creditor's Attorney, files with this court a written notice that the total probable amount due has been satisfied or the Judgment Creditor or the Judgment Creditor's Attorney files a written request to terminate this Order of Garnishment and release you from it; 3) A municipal or county court appoints a trustee for the Judgment Debtor and issues to you an order staying this garnishment; 4) A federal bankruptcy court issues to you an order staying this order of garnishment; 5) A municipal or county court or a common pleas court issues to you another order of garnishment of personal earnings that relates to the Judgment Debtor and a different judgment creditor and Ohio or federal law provides the other order with a higher priority than this order; 6) A municipal or county court or a common pleas court issues to you another order of garnishment of personal earnings that relates to the Judgment Debtor and a different judgment creditor and that does not have a higher priority