STATE OF INDIANA COUNTY OF HAMILTON ) ) SS: ) IN THE HAMILTON SUPERIOR COURT NO. 4 CAUSE NO. 29D04-_________-SC-__________ ________________________________, ________________________________________ Plaintiff (Judgment Creditor), Garnishee Defendant (Financial Institution) vs. ________________________________________ ________________________________, Street address Defendant (Judgment Debtor), and ________________________________________ City, State, and Zip ORDER IN GARNISHMENT TO FINANCIAL INSTITUTION This cause came before the Court on Plaintiff's motion for proceedings supplemental for an unpaid judgment owed by the Defendant (Judgment Debtor). The Court, having received evidence, now finds that Plaintiff is entitled to recover from the account of the Defendant the amount required to satisfy the balance of the judgment owed with costs, interest, and fees until the judgment is fully paid and satisfied. Name on account: ______________________________ Last four digits of account no.: ________________ (see attached green confidential form for entire account no.) Balance of amount Owed: $___________________ The Court orders the named Garnishee Defendant (Financial Institution) to remit to the Clerk of Hamilton County sums to be applied to the judgment until the balance is fully paid and satisfied. The Court orders the Garnishee Defendant (Financial Institution) to send payments to: The Clerk of Hamilton County One Hamilton County Square, Suite 292 Noblesville, IN 46060 and to include this cause number with any payment. Date: _____________________, 201__ ___________________________________________ Judge, Hamilton Superior Court No. 4 sc4form.097 (revised March 1, 2010) American LegalNet, Inc. www.FormsWorkFlow.com