MAGISTRATE COURT OF GWINNETT COUNTY P.O. Box 568, Lawrenceville, Georgia 30046 Garnishment #: Plaintiff: O.C.G.A. § 18-4-71 Address: Phone #: Plaintiff's Attorney: vs Defendant: Address: GARNISHMENT ON A FINANCIAL INSTITUTION Garnishee: Address: AFFIDAVIT ( ) Check this box if the Garnishee is a financial institution. ( ) Check this box if garnishment is for the collection of child support or alimony. See OCGA. § 18-4-50 et. seq. Personally appeared who on oath says: 1. I am the (Plaintiff) (Attorney at Law for Plaintiff) (Agent for Plaintiff). [Circle one] 2. The Plaintiff obtained a Judgment against the Defendant in Case Number the Court of , County, State, , in and no agreement requires forbearance from the garnishment which is applied for currently. 3. $ is the balance due, which consists of the sum of $ Principal, $ Postjudgment interest, and $ [exclusive of the costs of this action]). Other (e.g., prejudgment interest, attorney's fees, costs 4. Upon the Affiant's personal knowledge or belief, the sum stated herein is unpaid. This Sworn to and subscribed before me This day of , 20 . Affiant day of , 20 . Notary Public/ Deputy Clerk Approved: _____________________________ Judge of Magistrate Court Print Name of Affiant American LegalNet, Inc. www.FormsWorkFlow.com