COURT COUNTY . . NOTICE TO. R.ECIPIENTS .OF .AID .TO .FAMILIES. . . . . . . . . . . . . . . . . . . . . . . . . . . . .OF. . . . . . . . . . . . . . . . . : WITH DEPENDENT CHILDREN [AFDC]; NOTICE OF FUNDS EXEMPT FROM GARNISHMENT UNDER LAW IN THE DISTRICT COURT OF THE FIFTH CIRCUIT ______________________________ DIVISION Plaintiff(s) STATE OF HAWAI‘I -against- Plaintiff(s) Form #5DC01 Index No. : Calendar No. : JUDICIAL SUBPOENA : : : Reserved for Court Use Defendant(s) : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .No. . . Civil . . THE PEOPLE OF THE STATE OF NEW YORK Defendant(s) Filing Party(ies)/Filing Party(ies)' Attorney (Name, Attorney Number, Firm Name (if applicable), Address, Telephone and Facsimile Numbers) TO GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at County of in room NOTICE TO RECIPIENTS OF AID TO FAMILIES ,WITH DEPENDENT CHILDREN [AFDC] any recessed , on the day of , 20 at o'clock in the noon, and at or adjourned date, to testify and give evidence as a witness in this action on the part of the A judgment has been entered against you which says that you owe $ to Because of that judgment, this Court has ordered (Judgment Creditor(s)). Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to (Garnishee) the from your checking/savings this subpoena was issued for a But, if any money in this $50 and all damages sustainedWelfare party on whose behalf account(s) to Judgment Creditor(s). maximum penalty of account(s) are payments from the as a to pay money result the Aid failure to comply. Department underof your to Families with Dependent Children [AFDC] Program, you can have this Order cancelled or changed. Your creditors cannot take any money you received under the AFDC Program. Witness, Honorable , one of the Justices of the If the money in your checking/savings account(s) with Garnishee named above was received by you under the AFDC Program, contact Court in County, day of , 20 the Legal Aid Society of Hawai‘i immediately. The Legal Aid Society will help you to keep your AFDC money and will arrange for a court hearing to give you a chance to tell the Judge that you received the money under the AFDC Program. Contact the nearest Legal Aid Society office listed in your local telephone bookmustcall the Legal Aid Society, Kauai Office for (Attorney or sign above and type name below) assistance. NOTICE OF FUNDS EXEMPT FROM GARNISHMENT UNDER LAW Your creditors cannot garnish funds you receive as unemployment or workers' Attorney(s) for compensation benefits or social security payments or pension and retirement plans. If the money in your checking/savings account(s) with Garnishee named above is from any of these sources, you can stop garnishment of the funds in your account(s). You should contact your own attorney to advise and/or represent you or you can contact Judgment Creditor(s) to find out when this matter is set for a court hearing so that you can appear at that hearing to explain to the Judge that some or all of the funds in your checking/savings account(s) are exempt from garnishment. Office and P.O. Address Signature of Filing Party(ies)/Filing Party(ies)' Attorney: Date: Print/Type Name: Telephone No.: In accordance with the Americans with Disabilities Act if you require an accommodation for your disability, please contact the Facsimile No.: District Court Administration Office at PHONE NO. 246-3347, FAX 246-3353, OR TTY 539-4853 at least ten (10) working days E-Mail Address: in advance of your hearing or appointment date. Mobile Tel. No.: AFDC.XX (Amended 4/18/97) v 5D-P-167 (04/03) American LegalNet, Inc. www.USCourtForms.com