IN THE CIRCUIT COURT OF JACKSON COUNTY, MISSOURI AT KANSAS CITY ______________________________________________________________ AT INDEPENDENCE NO. _________________________________________________ CIRCUIT JUDGE CASE VS. ASSOCIATE CIRCUIT JUDGE CASE ______________________________________________________________ SMALL CLAIMS INTERROGATORIES TO GARNISHEE ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ GARNISHEE INSTRUCTIONS: _________________________________________________________ JUDGMENT DEBTOR You are to answer interrogatories UNDER OATH within ten (10) days after the return date of the summons of garnishment and if you admit below that you have in your possession property that is subject to garnishment, you must pay or deliver such property into the court within that time, without further order of the court. NO FURTHER ORDERS OR INSTRUCTIONS WILL BE FORWARDED TO YOUR COMPANY. Mail the Original to THE DEPARTMENT OF CIVIL RECORDS, Jackson County Courthouse. 415 E. 12th Street, Kansas City, Missouri 64106-2706 308 W. Kansas, Independence, Missouri 64050-3715, and a COPY to the attorney for the judgment creditor (or the judgment creditor individually if there is no attorney) listed on the reverse side. 1. At the time of service of garnishment, or at any time thereafter until the return date stated in the Summons of Garnishment, have you had in your possession or under your control any property, money (excluding wages, salary, and commissions), or effects of the judgment debtor? If so, state what property, how much, of what value, and what money or effects. ANSWER: 2. At the time of service of garnishment, or at any time thereafter until the return date stated in the Summons of Garnishment, did you owe the judgment debtor any money (including wages, salary, and commissions), or do you owe the judgment debtor any now? ANSWER: IF NOT YET DUE, WHEN WILL IT BECOME DUE? If amount owed judgment debtor is for wages, salary, or commission, state: a. Amount owed after deductions required by law (Deductions required by law are limited to federal, state, and city income and earnings taxes and FICA taxes). b. Amount withheld pursuant to the garnishment $ ______________________________________ $ ______________________________________ 3. State the name and last known address of any person, other than the debtor, whom the garnishee knows claims or may claim an interest in or to the property subject to garnishment. 4. Is the judgment debtor still within your employ? If not, state the date his employment terminated. ANSWER: 5. At the time of service of the garnishment, or at any time thereafter until the return date stated in the Summons of Garnishment, will you or have you since become or are you now bound in any contract to pay the judgment debtor money not yet due? If so, state the amount to be paid out and when due and payable. ANSWER: If garnishee is a bank or other financial institution, state whether at the time the writ of garnishment was served or at any subsequent time did the debtor have funds on deposit in an account in which all funds are deposited electronically on a recurring basis and reasonably identified as being funds on deposit that are exempt from garnishment pursuant to Section 513.430.1 (10)(a), (b) or (c), RSMo. Identify each account, state the reason for the believed exemption, and identify the entity electronically depositing those funds. ANSWER: 6. COMPLETE AFFIDAVIT ON PAGE 2 AND RETURN WITH THIS PAGE RETURN ORIGINAL DOCUMENTS TO THE COURT PROVIDE COPY TO ATTORNEY/JUDGMENT CREDITOR CIRCT 1665 ­ 10-2010 (1 OF 2) American LegalNet, Inc. www.FormsWorkFlow.com STATE OF MISSOURI } } S.S. COUNTY OF JACKSON} The undersigned, being duly sworn, on oath states that he/she has read the foregoing interrogatories and the answers given are true to the best of affiant's Knowledge and belief. _______________________________________________________________ SIGNATURE OF GARNISHEE The foregoing answers to interrogatories were subscribed and sworn to before me on ______________________________________. _______________________________________________________________ NOTARY PUBLIC My commission expires: ___________________________________ ATTORNEY FOR JUDGMENT CREDITOR: _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ CIRCT 1665 ­ 10-2010 (PAGE 2 OF2) American LegalNet, Inc. www.FormsWorkFlow.com