IN THE 21ST JUDICIAL CIRCUIT, ST. LOUIS COUNTY, MISSOURIJudge or Division: Case Number: (Date File Stamp) Petitioner(s): Garnishee222s Name/Address: vs. Respondent(s): Judgment Debtor222s Name/Address: Court Address: Interrogatories to Garnis hee Instructions: You are to answer interrogatories under oath during the ten days immediately after the return date of the writ or, in the case of a continuous wage garnishment, within 20 days from the date on which the garnishee is served with the writ, and mail the original to: You are to also file a certificate of service with the court that shows the caption of the case, the name of the party served, the date and manner of service, the designation of the document, e.g. answers to first interrogatories, and the signature of the serving party or attorney. The answers to the interrogatories should be based from the time of service of the garnishment, or any time thereafter until the return date stated in the summons of garnishment or, in the case of a continuous wage garnishment, when judgment is satisfied or the employment is terminated. 1.Have you had in your possession, charge, or under your control any property, money (excluding wages,salary, and commissions), or other effects of the judgment debtor? If yes, state what property, how much, ofwhat value, and what money or effects. In the case of a wage garnishment, state the gross amount ofearnings, as defined in section 525.030, RSMo, due to the debtor and the nonexempt portion of such earningsubject to garnishment.Answer: 2.Did you owe the judgment debtor any money (including wages, salary, and commissions), or do you owe thejudgment 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 laware limited to federal, state, and city income and earnings taxes and FICA taxes.)b.Amount withheld pursuant to the garnishment $ . 3.Is the judgment debtor still employed by you? Yes No If no, state the date his/her employment terminated.Answer: Note: You must notify the garnishor if the judgment debtor222s employment with you is terminated. 1 of 2 Rules 90.07, 90.13; Sections 525.130, 525.140 RSMo OSCA (10-16) CV110 CCCDT67-WS Rev. 0/1 American LegalNet, Inc. www.FormsWorkFlow.com 4.What is the judgment debtor222s last known address?Answer: 5.If the judgment debtor222s wages have been attached by more than one writ of garnishment, please list the casenumber of all senior garnishments.Answer: 6.Will you or have you since become or are you now bound in any contract to pay the judgment debtor money notyet due? Yes No If yes, state the amount to be paid out and when due and payable. Answer: 7.Do you know of any person or entity, other than the judgment debtor, who claims an ownership interest in anyproperty, money or effects of the judgment debtor or any amounts owed to the judgment debtor as disclosed byyou in answer to interrogatories 1, 2, and 6? If yes, please provide the name and address of each such personor entity and identify the property, money or effects of the judgment debtor in which each such person or entityclaims an interest?Answer: 8.If garnishee is a bank or other financial institution, state whether at the time the writ of garnishment was servedor at any subsequent time did the debtor have funds on deposit in an account in which all funds are depositedelectronically on a recurring basis and reasonably identified as being funds on deposit that are exempt fromgarnishment pursuant to section 513.430.1(10)(a), (b), or (c), RSMo, or subject to the exemptions under Title 31C.F.R. Part 12. Yes No If yes, identify each account, state the reason for the believed exemption, and identify the entity electronically depositing those funds which are not attachable pursuant to section 513.430.1(10)(a), (b), or (c), RSMo, or subject to the exemptions under Title 31 C.F.R. Part 12. Answer: I swear/affirm under the penalty of perjury that I have read the foregoing interrogatories and the answers given are true to the best of my knowledge and belief, and that no exempt funds have been or will be attached. Signature of Garnishee 2 of 2 Rules 90.07, 90.13; Sections 525.130, 525.140 RSMo OSCA (10-16) CV110 CCCDT67-WS Rev. 0/1 American LegalNet, Inc. www.FormsWorkFlow.com