AFFIDAVIT, ORDER AND NOTICE OF GARNISHMENT AND ANSWER OF GARNISHMENT (PERSONAL EARNINGS) REVISED 9/30/08 THE STATE OF OHIO COUNTY OF VS. Optional Judgment Creditor , SS Page Court , Ohio Docket No. Case No. Last Four Digits of Debtor's SS #: (The debt collector is attempting to collect a debt and any Information obtained will be used for that purpose). AFFIDAVIT 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 state that the Garnishee named at the address of may be an employer of the judgment debtor and who may have personal earnings of the same. I state that the written demand required by R.C. 2716.02 has been made, that the payment demanded has not been made and a sufficient portion of the payment demanded has not been made to prevent the garnishment of personal earnings as described in 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, not knowledge that the debt is the subject of a debt scheduling agreement of a nature precluding garnishment. ATTORNEY FOR JUDGMENT CREDITOR Sworn to and subscribed before me This day of NOTARY PUBLIC , SECTION A. COURT ORDER AND NOTICE OF GARNISHMENT GARNISHEE The Judgment Creditor in the above case has filed an Affidavit, satisfactory to the undersigned, in this Court stating that you may owe the Judgment Debtor money for personal earnings. 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 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 the 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 commended 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 your 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 than this order; 7) The Judgment Creditor or the Judgment Creditor's Attorney files with this curt a written request to terminate and release the Order of Garnishment, and as a result, the Order of Garnishment will cease to remain in effect. Under any of the circumstances listed above, you are required to file with this court a "Final Report and Answer of Garnishee" from. A copy of the Final Report and Answer of Garnishee form is attached to this Order of Garnishment. Under the circumstances listed in (5) and (6) above, you must cease processing this Order of Garnishment after the expiration of the full pay period within which the one hundred eightysecond (182nd) day after you began processing it falls. Special stacking, priority of payment, and manner of payment rules apply when a Garnishee receives multiple orders, of garnishment with respect to the same Judgment Debtor. These rules are set forth in R.C.27106.041 and you should become familiar with them. An Employer Guide to Processing Continuous Orders of Garnishment is included with the Order of Garnishment. day of , . Witness my hand and the seal of this court this JUDGE American LegalNet, Inc. www.FormsWorkFlow.com TO: SECTION B. ANSWER OF EMPLOYER (GARNISHEE) (Answer All Pertinent Questions) (An employer is one who is required to withhold payroll taxes out of payments of personal earnings made to the Judgment Debtor). Now comes , employer (garnishee) herein, who says: 1. This order of garnishment was received on