Page 1 of 2 DECLARATION OF JUDGMENT CREDITOR FOR GARNISHMENT OF WAGES; EXHIBIT(S); NOTICE TO EMPLOYER OF JUDGMENT DEBTOR; GARNISHEE INFORMATIONIN THE DISTRICT COURT OF THE FIFTH CIRCUITSTATE OF HAWAI324IPlaintiff(s)Reserved for Court useCivil No.: Defendant(s)Filing Party/Attorney Name, Attorney number,Address, Telephone, and Fax numbersGarnishee (Name and Address) Certified copy of the Judgment attached as Exhibit Current Amount Due: $(If this amount is different from the Judgment Amount, pleaseattach separate sheet showing calculations as Exhibit BJudgment Debtor(s): Current Place of Employment: DECLARATION1.I am the Judgment Creditor of Judgment Creditor222s Attorney;2.Judgment(a copy of which is attached as Exhibit A) was entered on the date shown on the Judgment forJudgment Creditor and against Judgment Debtor(s);3.There is still due and owing [ ] the Judgment amount shown in Exhibit A or [ ] the Current Amount Dueas evidenced by Exhibit B;4.The Judgment has not been appealed (or if appealed, no bond has been filed), reversed, modified, set aside or satisfied except as stated above, and otherwise remains in full force and effect; 5.The Judgment Creditor is still the owner and holder of the Judgment;6.Judgment Debtor is presently believed to be employed at the Current Place of Employment listed above; and7.The Judgment has been in effect for at least 10 days.I DECLARE UNDER PENALTY OF LAW THAT EVERYTHING IN THIS DECLARATION IS TRUE AND CORRECT. Date:Signature of Declarant: Print/Type Name: 5D-P-187 American LegalNet, Inc. www.FormsWorkFlow.com Declaration of Judgment Creditors - Garnishment of Wages Form #DC25 NOTICE TO EMPLOYER OF JUDGMENT DEBTOR The applicable law found in Hawai324i Revised Statutes 652-1(b) provides as follows: 223...the employer shall thereupon either file a disclosure within one week or shall withhold from the wages of the judgment debtor the amounts as [provided by this law] and pay the same to the judgment creditor.224 Prior to making the final payment, you should contact the Judgment Creditor or the Judgment Creditor222s attorney to obtain the final payoff amount, that may include additional interest as allowed by law. If you file a disclosure, send it to: 036District Court of the Fifth Circuit036 Small Claims Division036 3970 Ka324ana Street, Suite 207036 Lihu324e, Hawai324i 96766 036For additional information, please refer to Garnishee Information (Form #DC27)036 In accordance with state and federal disability laws, if you require an accommodation for a disability when working with a court program, service, or activity, please contact the Administration office at PHONE NO. 482-2347, FAX 482-2309, OR TTY 482-2533 at least ten(10) working days before your proceeding, hearing, or appointment date. FOR ALL CIVIL RELATED MATTERS, PLEASE CALL 482-2303 OR VISIT DISTRICT COURT, SMALL CLAIMS DIVISION AT 3970 KA324ANA STREET, LIHU324E, HAWAI324I. Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com