171 - 3 (R ev 1 2 /1 7 ) IN THE CIRCUIT COURT OF THE NINETEENTH JUDICIAL CIRCUIT LAKE COUNTY, ILLINOIS ) ) Plaintiff(s) ) vs. ) ) ) Defendant(s) ) Gen No . ) ) Garnishee ) AFFIDAVIT FOR GARNISHMENT NON - WAGE the affiant below , on oath state s that: 1. Judgment was entered on 20 , for the j udgment creditor and against the judgment debtor for $ and costs. 2. $ has been paid on the judgment. 3. There is unpaid on the judgment : A. The amount of Judgment was: ................................ ......................... $ B. Allowable costs previously expended: a. Initial filing fee ................................ ................................ .............. $ b. Original and alias summons ................................ ......................... $ c. Filing and summons cost of prior supplementary proceeding ..... $ C. Filing and summons cost for this proceeding ................................ ... $ D. Statutory interest due on Judgment from date above .................... $ TOTAL UNPAID AMOUNT $ 4. I believe garnishee is indebted to the judgment debtor or has in his possession, custody or control property belonging to him or in which he has an interest. 5. The l ast known ad dress of the judgment debtor is 6. I request that summons be issued and directed to the garnishee. I, the undersigned certify under penalties as provided by law pursuant to section 1 - 109 of the Code of Civil Procedure of the Illinois Compiled Statutes that the statement s set forth in this instrument are true and correct. Signature Prepared by: Name: Pro Se Address: City: State: Phone: Zip Code: ARDC #: E - mail address: American LegalNet, Inc. www.FormsWorkFlow.com 171 - 3 (R ev 1 2 /1 7 ) Gen No . INTERROGATORIES TO GARNISHEE 1. When you were served with the summons did you have in your possession , custody or control any property belonging to the judgment debtor or in which he had an interest? Answer: Yes No 2. If your answer is yes, describe the property: 3. When you were served with the summons were you otherwise indebted to him no matter when payable? Answer: Yes No 4. If your answer is yes, state: Description: Amount: $ Date due: I, the undersigned certify under penalties as provided by law pursuant to section 1 - 109 of the Code of Civil Procedure of the Illinois Compiled Statutes that the statement s set forth in this instrument are true and correct. Signature American LegalNet, Inc. www.FormsWorkFlow.com