2824 - Garn. Aff. Filed (Rev. (12/7/00) CCG N098 A IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS ________________ DEPARTMENT/ ________________ DIVISION-DISTRICT _____________________________________________________ Plaintiff v. _____________________________________________________ Defendant and No. ________________________________________ Return Date ________________________________ _____________________________________________________ Garnishee AFFIDAVIT FOR GARNISHMENT (NON-WAGE) ___________________________________________________________________________________, on oath states: 1. I believe garnishee, ______________________________________________________________ is indebted to the judgment debtor, _________________________________________________________________, other than for wages, or has in his/her possession, custody or control other property belonging to him/her or in which he/she has an interest. 2. The last known address of the judgment debtor is __________________________________________________ ______________________________________________________________________________________________ I request that summons issue directed to garnishee. Atty. No. ______________________ Signed and sworn to before me on this __________ day of Name: _____________________________________ ___________________________________________, ________ Address _______________________________________ __________________________________________________ City/Zip: ______________________________________ Notary Public Telephone ___________________________________ [ ] Under penalties as provided by law pursuant to 735 ILCS 5/1-109 the abovesigned certifes that the statements set forth herein are true and correct. Fax __________________________________________ CERTIFICATE OF ATTORNEY OR NON-ATTORNEY Note: Non-Attorneys must also submit a copy of the underlying judgment or a certification by the Clerk of the Court that entered the judgment with this affidavit. I, the undersigned certify, under penalties as provided by law pursuant to 735 ILCS 5/1-109, to the Court that the following information is true: 1. Judgment in the above captioned case was entered on _____________________________________, ________ 2. The amount of Judgment against ___________________________________ was $ __________________________ 3. Allowable costs previously expended: a. Initial filing fee $ __________________________ b. Original and alias summons c. Filing and summons costs of prior supplementary proceedings 4. Filing and summons cost for this garnishment 5. Interest due on Judgment DEDUCT: Total amount paid by or on behalf of the judgment debtor prior to this garnishment BALANCE DUE JUDGMENT CREDITOR $ __________________________ $ __________________________ $ __________________________ $ __________________________ TOTAL $ __________________________ $ __________________________ $ __________________________ ________________________________________________ Attorney (or Non-Attorney) for Judgment Creditor Page 1 of 2 (OVER) 2824 - Garn. Aff. Filed INTERROGATORIES TO GARNISHEE/RESPONDENT Case No. ____________________________ (Rev. (12/7/00) CCG N098 B Interrogatory - At the time of service of the garnishment summons, did you have in your custody or control any personal property or monies belonging to the judgment debtor? q yes q no ANSWER I, _____________________________________________________, certify under penalty of perjury that with regard to the property of the judgment debtor, the Garnishee/Respondent files the following answer to this Garnishment and on day of service of Garnishment Summons had possession of the following property of the judgment debtor: Circle one or more of the following and indicate the amount held: A) B) C) D) E) F) G) H) Savings Account (Amount withheld) $ __________________________________________________________________ Checking and / or Now Account (Amount withheld) $ _____________________________________________________ Certificate of Deposit (Amount held) $ _________________________________________________________________ Money Market Account (Amount held) $ _______________________________________________________________ Trust Account (Amount held) $ ________________________________________________________________________ Safety Deposit Box $ _______________________________________________________________________________ Adverse Claimant: Name ____________________________________ Address ________________________________ Other Personal Property (Describe) ____________________________________________________________________ Less right of offset for other loans ________________________ Less deduction for fees limited by 205 ILCS 5/48.1 (g) ________________________ Sub Total ___________________________ Agent of Garnishee Total ___________________________ According to the business records kept by the Garnishee/ Respondent, we show the above accounts to be held in the name(s) of others in addition to the defendant. Their name(s) and address(es) are as follows: Garnishee/Agent Name (s) _________________________________________ _________________________________________________ Address __________________________________________ City/State/Zip _____________________________________ Name ______________________________________________ Address ____________________________________________ City/State/Zip ________________________________________ Telephone/Fax _______________________________________ and we show all funds held as of ______________________________. (as of date of service of Garn. Summons) The agent of the garnishee certifies under penalties as provided by law pursuant to 735 ILCS 5/1-109 that the answers to the interrogatories are true. I further certify that I have mailed, to the address indicated on the reverse side, a copy of the completed interrogatories, to the judgment debtor. A copy of the answer to these interrogatories must be filed with the Clerk of the Circuit Court, Room _______________ located at _________________________________________________________________________________________________. (Street) (City) (Zip) (In addition, a copy must be sent to the Judgment creditor's representative, whose name appears on the reverse side.) _________________________________ Agent for Garnishee/Respondent DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS Page 2 of 2