JDF 252B SC R 3 / 1 8 MOTION AND ORDER FOR INTERROGATORIES LONG FORM Page 1 of 6 Small Claims Court County, Colorado Court Address: PLAINTIFF(S): Address: City/State/Zip: Phone: Home Work v . DEFENDANT(S): Address: City/State/Zip: Phone: Home Work COURT USE ONLY Case Number: Division Courtroom MOTION AND ORDER FOR INTERROGATORIES LONG FORM The judgment creditor, , re quests this Court to issue an order requiring the judgment debtor, , to appear and answer completely all of the INTERROGATORIES attached within 14 days after receipt, because: 1. On (date) , judgment was entered in favor of the . and against the in the amount of $ , with court costs in the amount of $ , for a total aw ard of $ ; 2. There remains due on this judgment the amount of $ , interest to date of $ , additional costs of $ , for a balance of $ ; 3. Execution may presently issue on this judgment; and 4. Pursuant to C.R.C.P. 517 and 518, the judgment creditor is entitled to an order requiring the judgment debtor to appear Dated: Judgment Creditor Subscribed under oath before me on: Dated: Clerk/Deputy I T IS ORDERED: 1. That the judgment debtor, , APPEAR and ANSWER completely all of the INTERROGATORIES attached, pursuant to C.R.C.P. 517 and 518. 2. That these INTERROGATORIES be signed by the judgment debtor in full legal name, under penalty of perjury, in the presence of a notary public or clerk of court. 3. That these INTERROGATORIES be filed with the Clerk, and that the judgment debtor appear on (date) (time) at (location) . 4. That service of these INTERROGATORIES and this order be made by mailing copies to the judgment debtor, by certified mail, or as provided by C.R.C.P. 304. Dat ed: Judge Magistrate I certify that a copy of this form and interrogatories were mailed to the judgment debtor on: Dated: Clerk/Deputy American LegalNet, Inc. www.FormsWorkFlow.com JDF 252B SC R 3 / 1 8 MOTION AND ORDER FOR INTERROGATORIES LONG FORM Page 2 of 6 INTERROGATORIES TO JUDGMENT DEB TOR Name of Judgment Debtor: . THESE INTERROGATORIES MUST BE COMPLETELY ANSWERED AND FILED WITH THE CLERK OF THE COUNTY COURT AT THE ADDRESS STATED ON PAGE 1 OF THIS FORM ON (date) (time) . YOU MUST APPEAR ON THIS DATE. WARNING : FAILURE TO TRUTHFULLY AND COMPLETELY ANSWER ALL OF THESE QUESTIONS AND RETURN THEM WITHIN 14 DAYS TO THE CLERK OF COUNTY COURT, SMALL CLAIMS DIVISION, SHALL CAUSE A CITATION TO BE ISSUED F OR CONTEMPT OF COURT. A FINDING OF CONTEMPT MAY BE CAUSE FOR A FINE OR JAIL SENTENCE. NOTE : YOU MAY PAY $ (THE AMOUNT OF THE JUDGMENT TOGETHER WITH ANY INTEREST AND COSTS) TO THE CLERK OF THE COURT WITHIN 14 DAYS INSTEAD OF ANSWERING TH ESE QUESTIONS. IF YOU MAKE THE PAYMENT, THIS CASE WILL BE CLOSED. 1. What is your full legal name: List any other names you have been known by: Home address: Home phone number: Work phone number: Date of bi rth: Social Security Number: Drivers license number: State: 2. State your full and correct business address: a. Do you rent or own the premises? b. State the full and correct name and address of your landlord. c. On what day of the month do you pay your rent? d. What is the amount of the deposit with your landlord? 3. State your full and correct home address: a. Do you own or rent the premises? b. S tate the full and correct name and address of your landlord. c. On what day of the month do you pay your rent? d. What is the amount of the deposit with your landlord? 4. State the full and correct address of all real estate you own or have an interest in. Address City/County State Address City/County State Address City/County State Address City/County State 5. State the book and page number and other recording numbers of the deed or other instruments of such property. Book page number of deed Book page number of deed 6. Are th ere any liens, mortgages, or encumbrances against any of the property referred to in No. 4? If so, give the full and correct name and address of the creditor of, and balance due on each. $ Name Address City/State Amount owed $ Name Address City/State A mount owed $ Name Address City/State Amount owed American LegalNet, Inc. www.FormsWorkFlow.com JDF 252B SC R 3 / 1 8 MOTION AND ORDER FOR INTERROGATORIES LONG FORM Page 3 of 6 7. Employment information: Address of employer: You are paid: hourly $ monthly $ or your annual rate of pay you earn $ you are paid commissions, the manner in which commissions are calculated are: The days or days of the month on which you are paid: 8. If self - employed, do you own or have any interest in any inventory, supplies, machinery, equipment, or t ools? If so, list each of them and whether they are paid for. If you owe money for any item, indicate how much for each item. Type of Item Paid YES or NO If No Amount owed Type of Item Paid YES or NO If No Amount owed Type of Item Paid YES or NO If No Amount owed Type of Item Paid YES or NO If No Amount owed 9. List the full an d correct name and address of all banks and savings institutions you have: Name of Banks Savings & Loan/Credit Union Address/Location City/State Account Number Name of Banks Savings & Loan/Credit Union Address/Location City/State Account Number Name of Banks Savings & Loan/Credit Union Address/Location City/State Account Number 10. Do you have any life, health, or other insurance with a cash surrender value or from which money is or will be due to you? If so, state the name and number of the pol icy and full and correct name and address of the insuring company. Name of Insurance Company Name of Agent Address/Location City/State Policy Number Name of Insurance Company Name of Agent Address/Location City/State Policy Number 11. Have you received any money judgments from any court within the past 12 months? If so, stat e the nature of the action court location, case number, amount received and date judgment entered. Nature of Action Court Location Case Number Amount of Judgment Date Ordered Nature of Action Court Location Case Number Amount of Judgment Date Ordered Nature of Action Court Location Case Number Amount of Judgment Date Ordered 12. Are you entitled to any refund on either or both of your last federal or state income tax returns? a. If so, what is the amount of the refund on each? b. Have you received any of this money as of this date? 13. State the description, amount, and location of any and all stocks, bonds, U.S. Savings Bonds, debentures, or other securities which you own or in which you have an int erest. $ Type of Stock/Bond/Us Saving Bond Location Amount $ Type of Stock /Bond/Us Saving Bond Location Amount $ Type of Stock/Bond/Us Saving Bond Location Amount $ Type of Stock/Bond/Us Saving Bond Location Amount 14. State the amount and location of any cash you have on hand. $ Location of Cash Amount American LegalNet, Inc. www.FormsWorkFlow.com JDF 252B SC R 3 / 1 8 MOTION AND ORDER FOR INTERROGATORIES LONG FORM Page 4 of 6 $ Location of Cash Amount 15. List and describe any and all automobiles, trucks or other motor vehicles owned by you, or vehicles in which yo u have an interest. $ Type of Vehicle Estimated Value a. Are any of these vehicles used daily in your work? If so, identify b. Are any of these vehicles mortgaged? If so, state for what amount and the full and correct name and address of the mortgagee. Name of Bank Sav ing & Loan/Credit Union Address/Location City/State Account Number Name of Bank Saving & Loan/Credit Union Address/Location City/State Account Number 16. Lis t and describe any and all livestock and crops you own or have an interest in, giving the location and present market value of each. $ Type of Livesto ck/Crops Location Estimated Value $ Type of Livestock/Crops Location Estimated Value 17. State the amount, description, and location of any and all o ther personal property you own or have an interest including household furniture and fixtures, motorcycles, boats, photographic and electronic equipment, jewelry, and any other moveable property. If any of this property is mortgaged, state for what amount and the full and correct name and address of the mortgagee(s). (Use last page if necessary.) $ Description Location Estimated Value $ Description Location Estimated Value $ Description Location Estima