(Revised 7/05) Prepared by: Filer’s name, SC# Filer’s address Filer’s phone number {Filer’s fax phone number} {Filer’s e-mail address} Attorney for Judgment Creditor In The District Court of ______ County, Kansas Judgment Creditor name Judgment Creditor vs. Case No. ______ Judgment Debtor name Judgment Debtor address Judgment Debtor Garnishee name Garnishee Garnishee’s address Garnishee’s county {Garnishee’s fax phone number (if known)} {Garnishee’s e-mail address (if known)} Pursuant to Chapter 61 of Kansas Statutes Annotated TO BE DELIVERED BY THE JUDGMENT CREDITOR TO THE JUDGMENT DEBTOR IN ANY REASONABLE MANNER IMMEDIATELY FOLLOWING SERVICE OF THE GARNISHMENT ORDER ON THE GARNISHEE. NOTICE TO JUDGMENT DEBTOR (nonearnings garnishment) You are hereby notified that the court has issued an order in the above case in favor of (name and address of judgment creditor), the judgment creditor in this proceeding, directing that some of your money, property or credits now in the possession of (name and address of garnishee), the garnishee in this proceeding, be used to satisfy your debt to the judgment creditor. This order was issued to enforce the judgment obtained by the judgment creditor against you in this case on ___________________, ______. This order prohibits the garnishee from releasing all or part of your money or property to you, and the court will order that this money or property be turned over to the judgment creditor unless it finds that there is some reason why this money or property should not be used to satisfy the judgment. The law of Kansas and the United States provides that certain benefit payments cannot be taken from you to pay a debt, even if they are deposited in a bank, savings and loan, or credit union. Such payments are commonly referred to as exempt property. Examples of exempt benefit payments which cannot be attached or executed upon by a creditor are: (1) Social Security disability and retirement benefits; (2) Supplemental Security Income (SSI) benefits; (3) Veteran's benefits; (4) Black lung benefits; American LegalNet, Inc. www.FormsWorkflow.com (5) Cash assistance payments under the Temporary Assistance for Families (TAF) program; (6) Cash assistance payments under the General Assistance (GA) program; (7) Unemployment compensation payments; (8) Workers compensation payments; (9) Certain pension benefits and retirement funds, including KPERS. This is not an exclusive list. Other state and federal exemptions may apply to you. Certain exemptions may not apply to support orders or to back taxes. An attorney can assist you in determining which benefit payments are exempt. If the court order affects property other than money which belongs to you, some or all of this property may also be exempt. Examples of exempt personal property are: (1) Furnishings, equipment and supplies in your possession and reasonably necessary at your principal residence; (2) Personal jewelry and other ornaments up to $1,000 in value; (3) One vehicle regularly used for transportation up to $20,000 in value; (4) Tools and equipment used in your principal trade or business up to $7,500 in value. If you believe that the money or property being held by the garnishee is exempt and should not be given to the judgment creditor, you may request a hearing before the court to assert this claim. In order to request a hearing, you should fill out the form at the bottom of this notice and obtain from the clerk of the court or the court a date and time for the hearing, and file the form with the clerk of the court at (address of court). Immediately after the request for hearing is filed, you shall hand deliver a copy of the request for hearing to the judgment creditor or judgment creditor's attorney, if judgment creditor is represented by an attorney, or mail a copy of the request for hearing to the judgment creditor or judgment creditor's attorney, if judgment creditor is represented by an attorney, by first-class mail at the judgment creditor's, or judgment creditor's attorney's, last known address. You should ask for this hearing as soon as possible, but no later than 10 days after this notice is served on you. If you ask for a hearing to claim that your money or property is exempt, the court will hold a hearing within 10 days after it receives your request. At the hearing you should present any evidence you have to show that your money or property is exempt. The burden is on you to prove that some or all of your property subject to the garnishment is exempt. You may wish to consult an attorney to represent you at this hearing. ______________________________________________________________________________ (Name and address of court) Case No. _______ REQUEST FOR HEARING I request a hearing because the money or property which is being garnished by the judgment creditor is exempt because it is ______________________________________________________________________________ (reason property or money is exempt) _______________________________________ ______________________________________ Name of Judgment Debtor Signature of Judgment Debtor _______________________________________ ______________________________________ Address Date ______________________________________________________________________________ City, State, Zip Code _______________________________________ Telephone No. American LegalNet, Inc. www.FormsWorkflow.com ______________________________________________________________________________ ______________________________________________________________________________ THIS PART SHALL BE COMPLETED BY CLERK OF THE DISTRICT COURT: The hearing requested shall be held on the _______(day) day of _______(month), _______(year), at _______(time) o'clock _______(am or pm). ______________________________________________________________________________ ______________________________________________________________________________ Certificate of Service I delivered a copy of the above request for hearing to the judgment creditor or judgment creditor's attorney, if the judgment creditor is represented by an attorney, by hand-delivery or first-class mail in the following manner and at the following address, on the date shown below: _______________________________________________________ (name of judgment creditor or judgment creditor's attorney) _______________________________________________________ _______________________________________________________ (address of judgment creditor or judgment creditor's attorney) _______________________________________________________ (manner delivered--hand-delivery or first-class mail) _______________________________________________________ (date delivered) _________________________________ Signature of Judgment Debtor American LegalNet, Inc. www.FormsWorkflow.com