3107C (Rev. 04/06) AFFIDAVIT FOR WAGE GARNISHMENT AND INTERROGATORIES UNITED STATES OF AMERICA STATE OF ILLINOIS COUNTY OF DU PAGE IN THE CIRCUIT COURT OF THE EIGHTEENTH JUDICIAL CIRCUIT CASE NUMBER PLAINTIFF / PETITIONER VS. COPY DEFENDANT / RESPONDENT File Stamp Here AFFIDAVIT FOR WAGE GARNISHMENT _ being first duly sworn upon oath states: 1. Judgment was entered on ____________________ / / in favor of the Judgment Creditor and against Judgment Debtor for $____________________ and costs. 2. $____________________ has been paid on the judgment. 3. There is unpaid on the judgment: $____________________ principal $____________________ costs $____________________ interest $____________________ TOTAL UNPAID 4. I believe Respondent _______________________ is indebted to the Judgment Debtor or has in his/her possession, custody or control property belonging to the Judgment Debtor or in which he/she has an interest. 5. The last known address of the Judgment Debtor is 6. I request that summons be issued to the Respondent I, the undersigned certify under penalties as provided by law pursuant to 735 ILCS 5/1-109 that the statements set forth in thisinstrument are true and correct. Attorney for Judgment Creditor or Judgment Creditor PRO SE Name: DuPage Attorney Number: Subscribed and Sworn to before me. Date: Attorney for: Address: City/State/Zip: Notary Public - Circuit Court Clerk Telephone Number: Four (4) copies of this affidavit for Garnishment and Answer to Interrogatories must be sent to Respondent (735 ILCS 5/12-701) CHRIS KACHIROUBAS, CLERK OF THE 18TH JUDICIAL CIRCUIT COURT © WHEATON, ILLINOIS 60189-0707 п¹» ï ±º î American LegalNet, Inc. www.USCourtForms.com Case Number ___________________________ ANSWER TO INTERROGATORIES BY RESPONDENT 1. When you were served with summons did you have in your possession, custody or control any property belonging to the Judgment Debtor or in which he/she had an interest? ANSWER _______________________________________________ 2. If your answer is yes, describe your property: 3. When you were served with summons were you otherwise indebted to him/her, no matter when payable? ANSWER ________________________________________________ 4. If your answer is yes, state: Description _____________________________________________________________________________________ Amount $_______________________________ Date Due _______________________________________________ AFFIDAVIT ______________________________________ the undersigned certify under penalties as provided by law pursuant to 735 ILCS 5/1-109 that the statements set for in this Answer to Interrogatories are true and correct. I further state that a copy of this Answer to Interrogatories by respondent has been sent by first class mail to the Judgment Creditor or his/her attorney and to the Judgment Debtor at the address specified in the affidavit or any other address or location of the Judgment Debtor known to the Respondent Subscribed and Sworn to before me / / Notary Public or Circuit Court Clerk IMPORTANT INSTRUCTIONS 1. You must mail a copy of your answer to the Circuit Court Clerk. (This must be a notarized answer). 2. You must mail a copy of your answer to the Judgment Creditor or his/her attorney. 3. You must provide a copy of your answer to the Judgment Debtor. 4. Upon receipt in duplicate of a Release of Satisfaction or Judgment or a written order of court, you should remit the total amount deducted for the Judgment Creditor whose name and address appear on the reverse side of this form, or if there is no attorney representing the judgment Creditor, you should remit the total amount deducted to the Judgment Creditor. 5. If the Judgment Debtor has filed a notice to contest the garnishment or to seek exemptions as permitted by law, do not forward any amount deducted without a written order of court 6. At the time that you forward the proceeds deducted, you must also forward to the clerk of the court, the original of the release and satisfaction. This is the only way in which the court records will show that the judgment against you as the Respondent has been satisfied. There is no charge for filing the Release and Satisfaction. Mail the release to: CHRIS KACHIROUBAS, Circuit Court Clerk, P.O. Box 707, Wheaton, Illinois 60189-0707 DO NOT SENT THE MONIES WITHHELD TO THE CIRCUIT COURT CLERK CHRIS KACHIROUBAS, CLERK OF THE 18TH JUDICIAL CIRCUIT COURT © WHEATON, ILLINOIS 60189-0707 п¹» î ±º î American LegalNet, Inc. www.USCourtForms.com