STATE OF NEBRASKA FORM NO. 3:6 Rev. 1/1/94 §25-1056 CASE NUMBER GARNISHMENT AFFIDAVIT IN THE ____________COURT OF __________________________________COUNTY, NEBRASKA _________________________________ Affidavit and Praecipe for Summons in Garnishment [In Aid of Execution] Plaintiff vs. _________________________________ Defendant ___________________________________________, being duly sworn says; the creditor in this action, ___________________________________________, recovered a judgment against the debtor, ___________________________________________, on ____________________, _______; that the debtor’s last known address is ______________________________________; that there is now due on the judgment the sum of $_____________, plus $____________ interest, and $__________ costs, for a total of $_________________. I have good reason to and do believe that this sum is based upon a judgment that: (check one.) _____ A. _____ B. _____ C. _____ D. _____ E. _____ F. is not for the support of a person, and the judgment debtor is the head of a family.* is not for the support of a person, and the judgment debtor is not the head of a family.* is for the support of a person, the judgment debtor is supporting a spouse or dependent child, and this support order is not for payments more than 12 weeks in arrears.** is for the support of a person, the judgment debtor is supporting a spouse or dependent child, and this support order is for payments more than 12 weeks in arrears.** is for the support of a person, the judgment debtor is not supporting any other spouse or dependent child, and this support order is not for payments more than 12 weeks in arrears.** is for the support of a person, the judgment debtor is not supporting any other spouse or dependent child, and this support order is for payments more than 12 weeks in arrears.** I further say that I have a good reason to and do believe that the garnishee, _______________ _________________________________, has property of and is indebted to the judgment debtor. Further Affiant says not. _______________________________________________ Judgment Creditor/Attorney Phone Signed and sworn to before me on ________________________, ______. ___________________________ Notary Public (Seal) FORM NO. 3:6 Page 1 of 2 American LegalNet, Inc. www.FormsWorkflow.com PRAECIPE To the Clerk of Court: Please issue Summons in Garnishment upon the following garnishee: ________________________ __________________________________________, at ___________________________________ ________________________________________________________________________________ in the aforementioned entitled case. __________________________________________ Judgment Creditor/Attorney Phone __________________________________________ Address _____ Service by certified mail. _____ Service by sheriff, constable, or authorized person. * Section 25-1558(4)(d), N.R.S.: Head of a family shall mean an individual who actually supports and maintains one or more individuals who are closely connected with him [or her] by blood relationship, relationship by marriage, by adoption, or by guardianship, and whose right to exercise family control and provide for the dependent individuals is based upon some moral or legal obligation. Restrictions defined in 15 U.S.C., Section 1673(a). See Instructions. ** Restrictions defined in 15 U.S.C., Section 1673(b). See Instructions. This form is provided as a public service but should be reviewed by your attorney. Effective January 1, 1994. FORM NO. 3:6 Page 2 of 2 American LegalNet, Inc. www.FormsWorkflow.com