IN THE STATE COURT OF CHATHAM COUNTY, GEORGIA 133 Montgomery St, Suite 501, Savannah, GA, 31401; P.O. Box 9927, 31412 Case No: Plaintiff(s) Name, Address, City State Zip vs. Defendant(s) Name, Address, , City State Zip Garnishee Name, Address, , City State Zip THIRD-PARTY CLAIM Personally appeared (Print Name) who on oath says that he or she has a claim superior to that of the Plaintiff to the money or other property in the hands of the Garnishee subject to the process of garnishment. The Affiant further states: (check applicable box and complete the information requested) The Affiant obtained a judgment against the Defendant in the Court of County, (State), in Case Number on , 20 (Month Day, Year), and the unpaid balance of such judgment is in the amount of $ . Or The basis of the Affiant's claim is This day of day of , 20 . Sworn to and subscribed before me this 20 . Notary Public OR Deputy Clerk Signature of Affiant Print Name of Affiant American LegalNet, Inc. www.FormsWorkFlow.com CERTIFICATE OF SERVICE This is to certify that I have this day served the Plaintiff or Plaintiff's Attorney, the Defendant, and the Garnishee in the foregoing matter with a copy of this pleading by depositing it in the United States Mail in a properly addressed envelope with adequate postage thereon. This day of , 20 . Third-party Claimant or Third-party Claimant's Attorney American LegalNet, Inc. www.FormsWorkFlow.com