FAIRFAX CIRCUIT COURT GARNISHMENT SUMMONS Virginia Code §§8.01-511, 512, 512.3 JUDGMENT CREDITOR: ____________________________ CL-_______ - _______________ Address: Phone: JUDGMENT CREDITOR'S ATTORNEY: __________________________________________________ Address: Versus Va. Bar #: Phone: JUDGMENT DEBTOR: _______________________________________________________________ SSN: Return Date: at 9:00 a.m. This is a garnishment against (check only one) [ ] judgment debtor's wages, salary or other compensation [ ] some other debt due or property of the judgment debtor specifically__________________________ GARNISHEE: Address: Review Date: ___________________________________________________________________________________ STATEMENT Address: Judgment Principal $ Maximum Portion of Disposable Earnings Subject to Garnishment Interest [ ] 50% [ ] 55% [ ] 60% [ ] 65% (If not specified, then 50%) Judgment Costs [ ] State Taxes, 100% Attorney's Fees If none of the above are checked, then §34-29(a) applies. Garnishment Costs ______________ Credits [ ] SUPPORT Late Fees ______________ Total Balance Due $ The Garnishee shall rely on this amount. Judgment Number: _________ Date of Judgment: ___________________ Place of Judgment: ____________________________________________________________ TO ANY AUTHORIZED OFFICER: You are hereby commanded to serve this summons on the judgment debtor and the garnishee. TO THE GARNISHEE: You are hereby commanded to: (1) file a written answer with: Circuit Court of Fairfax County, 4110 Chain Bridge Road, Fairfax, VA 22030 Attn: Civil Case Processing OR (2) deliver payment to this court payable to "CLERK, CIRCUIT COURT," OR (3) appear before this court on the return date and time shown on this summons to answer the Suggestion for Summons in Garnishment of the judgment creditor that, by reason of the lien of writ of fieri facias, there is a liability as shown in the statement upon the garnishee. As garnishee, you shall withhold from the judgment debtor any sums of money to which the judgment debtor is or may be entitled from you during the period between the date of service of this summons on you and the date for your appearance in court, subject to the following limitations: (1) (2) (3) CCR G-80 The maximum amount which may be garnished is the "Total Balance Due" as shown on this summons. You shall not be liable to the judgment creditor for any property not specified in this summons. If the sums of money being garnished are earnings of the judgment debtor, then the provision of "Maximum Portion of Disposable Earnings Subject to Garnishment" shall apply. April 2014 American LegalNet, Inc. www.FormsWorkFlow.com FAIRFAX CIRCUIT COURT If a garnishment summons is served on an employer having one thousand or more employees, then money to which the judgment debtor is or may be entitled from his or her employer shall be considered those wages, salaries, commissions or other earnings which, following service on the garnisheeemployer, are determined and are payable to the judgment debtor under the garnishee-employer's normal payroll procedure with a reasonable time allowance for making a timely return by mail to this court. JOHN T. FREY, CLERK Date of Issuance of Summons Date of Delivery of Writ of Fieri Facias To Sheriff or any authorized Officer if different from Date of Issuance of this Summons. By: _______________________________ Deputy Clerk Creditor / Attorney Signature______________________________ RETURNS: The following garnishee was served, according to law, as indicated below, unless not found. Attorney Bar #______________________ RETURNS: The judgment debtor was served, according to law, as indicated below, unless not found, with a copy of both this summons and the § 8.01-512.4 form. GARNISHEE ....................... .................................... ....... .............. ............. [ ] PERSONAL SERVICE [ ] FEDERAL SERVICE* [ ] Being unable to make personal service, a copy was delivered in the following manner: [ ] Served on registered agent of the corporation. List name and title: ............................................................................ ............................... ............................................................................ ............................... JUDGMENT DEBTOR ....................... .................................. ..... .................. ADDRESS .................................................. ........................ ..... ..................... ..................................................................... ............................. ..... ..... .......... [ ] Delivered to family member (not temporary sojourner or guest) age 16 or older at usual place of abode of party named above after giving information of its purport. List name, age of recipient, and relation of recipient to party named above. ..................................................................... ...................................... ................................................................ ........................................... [ ] PERSONAL SERVICE [ ] Being unable to make personal service, a copy was delivered in the following manner: [ ] Posted on front door or such other door as appears to be the main entrance of usual place of abode, address listed above. (Other authorized recipient not found.) [ ] Delivered to family member (not temporary sojourner or guest) age 16 or older at usual place of abode of party named above after giving information of its purport. List name, age of recipient, and relation of recipient to party named above. ............................................................................... ......... ..................... ............................................................................. .......... ...................... [ ] Delivered to a person found in charge of usual place of business or employment during business hours and giving information of its purpose. [ ] Served on the Secretary of the Commonwealth [ ] Served on the Clerk of the State Corporation Commission, pursuant to § 8.01-513. [ ] Posted on front door or such other door as appears to be the main entrance of usual place of abode, address listed above. (Other authorized recipient not found.) [ ] Not found [ ] Copy mailed to judgment debtor after serving the garnishee on date of service unless a different date of mailing is shown. ......................................................................... ........