STATE OF INDIANA COUNTY OF ALLEN ) ) SS: ) IN THE ALLEN SUPERIOR COURT SMALL CLAIMS DIVISION FORT WAYNE, INDIANA _________________________________________________ Plaintiff CASE NUMBER: VS. _________________________________________________ Defendant XXX-XXSocial Security Number (last 4 digits only) AND BANKING INSTITUTION GARNISHMENT ORDER _________________________________________________ Garnishee Defendant _________________________________________________ Street Address _________________________________________________ City, State Zip Code Plaintiff appears and makes proof of service of notice of hearing upon Defendant, _____________________________________________________________________ and upon Garnishee Defendant ____________________________________________________________________________________________________________. The Court now finds and orders: 1. 2. That the answers to the interrogatories show that the Defendant owns or has an interest in account(s) of deposit maintained by Garnishee Defendant. That Defendant is liable to the Plaintiff on a judgment in an amount as follows: (a) (b) (c) Judgment Interest Costs $______________________________ $______________________________ $______________________________ $______________________________ Total Amount Owing 3. Neither Defendant nor any other depositor claiming an interest in the aforesaid account(s) has claimed that any portion of the funds in said account(s) is exempt from garnishment pursuant to I.C. 28-9-3-4 and 5. The Garnishee Defendant is ordered to pay over to the Clerk of this Court an amount not to exceed the total amount owing in this cause from the Defendant's account of deposit as maintained by Garnishee Defendant. Upon payment, the restriction on withdrawals imposed by order of this Court, pursuant to I.C. 28-9-4-2 and 3, is removed. 4. 5. Date: ____________________________________________ _________________________________________________ Attorney / Party Preparing Garnishment Order _________________________________________________ Judge / Magistrate, Allen Superior Court _________________________________________________ Street Address _________________________________________________ City, State Zip Code _________________________________________________ Telephone Number Supreme Court ID Number SERVICE OF PROCESS I hereby certify that a copy of this garnishment order was sent by U.S. Mail, to the named person, at the address furnished, at Fort Wayne, Indiana. Date: _____________________________________________ __________________________________________________ Clerk of the Allen Circuit and Superior Courts American LegalNet, Inc. www.FormsWorkFlow.com 7/2015 Banking Institution Garnishment Order PAYMENT GUIDELINES FOR THE GARNISHEE DEFENDANT In order for funds to be applied by the Clerk's Office, the following information must be included with every payment submitted: 1) Individual's full name. 2) Court's full case number (located at the upper right corner of the garnishment order, beginning with 02D01, etc.). 3) When a group of names are submitted (rather than one check per person), the above two items should be listed for each person along with the amount of money to be applied to each case. 4) Please remit your payment and the above information to: Clerk of Allen Circuit and Superior Courts Small Claims Division 715 S. Calhoun St., Room 200 Fort Wayne IN, 46802 This information is vital to the timely and accurate processing of payments received. Your cooperation is greatly appreciated. If you have questions regarding the guidelines described above, you may contact the Clerk's Office at (260) 449-7130. American LegalNet, Inc. www.FormsWorkFlow.com