Justice Court, Henderson Township CLARK COUNTY, NEVADA Name: Address: Plaintiff, CASE NO. B vs B Name: WRIT OF GARNISHMENT Address: Defendant. THE STATE OF NEVADA TO: Garnishee You are hereby notified that you are attached as garnishee in the above entitled action and you are commanded not to pay any debt due from yourself to (defendants) and that you must retain possession and control of all personal property, money, credits, debts, effects and choses in action of said defendant(s) in order that the same may be dealt with according to law; where such property consists of wages, salaries, commissions or bonuses the amount you shall retain shall be in accordance with 15 U.S. Code 1673 and Nevada Revised Statutes 31.295; Plaintiff believes that you have property, money, credits, debts, effects and choses in action in your hands and under your custody and control belonging to said defendant(s) described as: . YOU ARE REQUIRED TO forward all monies due or owing in your possession or under your control for wages, salaries, commissions, bonuses or other reasons belonging to the defendant(s) named in this Writ of Garnishment, subject to the exemptions indicated above, to the Henderson Constable at the address below . YOU ARE REQUIRED within 20 days from the date of service of this Writ of Garnishment to answer the interrogatories set forth herein and to return your answers to the officer of the Constable which has issued this Writ of Garnishment. Your failure to answer the interrogatories within 20 days, a Judgment by Default in the amount due the Plaintiff may be entered against you. IF YOUR ANSWERS TO the Interrogatories indicate that you are the employer of the defendant(s), this Writ of Garnishment shall be deemed to continue for 120 days or until the amount demanded in the attached Writ of Execution is satisfied. YOU ARE FURTHER DIRECTED to forward all funds due to the defendant(s) each payday in the future, up to 120 days, less any amount which is exempt and less $3.00 per pay period not to exceed $12.00 per month which you may retain as a fee for compliance. The $3.00 fee does not apply to the first pay period covered by this Writ. YOU ARE FURTHER REQUIRED to serve a copy of your answers to the Writ of Garnishment on Plaintiff=s attorney, if any, whose address appears below. Issued at the direction of: CONSTABLE - HENDERSON TOWNSHIP By: ATTORNEY FOR PLAINTIFF Constable/Deputy Constable Date Please furnish a statement and Case #. Address MAKE CHECK PAYABLE TO: HENDERSON CONSTABLE AND MAIL TO: 243 WATER STREET HENDERSON, NEVADA 89015 JC Henderson Rev. 02/02 American LegalNet, Inc. www.FormsWorkflow.com STATE OF NEVADA COUNTY OF CLARK ) ) ss: ) The undersigned, being duly sown, states that I received the within WRIT OF GARNISHMENT on the of , 20 , and personally served copies of the same on the day of , 20 by showing the original WRIT OF GARNISHMENT, informing of the contents and delivering and leaving a copy, along with the statutory fee of $5.00 with (name) at County of Clark, State of Nevada. By: Constable / Deputy Constable INTERROGATORIES TO BE ANSWERED BY THE GARNISHEE UNDER OATH 1. Are you in any manner indebted to the defendant(s) or either of them, either in property or money, and is the debt now due? If not due, when is the debt to become due? State fully all particulars. ANSWER 2. Are you an employer of one or all of the defendants? If so, state the length of your pay period and the amount each defendant presently earns during a pay period. ANSWER 3. Did you have in your possession, in your charge or under your control, on the date of the WRIT OF GARNISHMENT was served upon you any money, property, effects, goods, chattels, rights, credits or choses in action of the defendant(s) or either of them, or in which defendant(s) is (are) interested? If so, state in full its value and state full all particulars. ANSWER 4. Do you know of any debts owing to the defendant(s), whether due or not due, or any money, property, effects, goods, chattels, rights, credits or choses in action, belonging to the defendant(s) or either of them, or in which defendant(s) is (are) interested, and now in the possession or under the control of others? If so state particulars. ANSWER 5. State your correct name and address, or the name and address of your attorney upon whom written notice of further proceedings in this action may be served. ANSWER 6. NOTE: If any employer, without legal justification, refuses to withhold the earnings of a defendant demanded in a Writ of Garnishment or knowingly misrepresents the earnings of the defendant, the court shall order the employer to pay the Plaintiff the amount of arrearages caused by the employer=s refusal to withhold or his misrepresentation of the defendant=s earnings. In addition, the court may order the employer to pay the plaintiff punitive damages in an amount not to exceed $1,000 for each pay period in which the employer has, without legal justification, refused to withhold the defendant=s earnings or has misrepresented the earnings. NRS Chapter 31. I, interrogatories subscribed by me are true. , do solemnly swear (or affirm) that the answers to the foregoing SUBSCRIBED AND SWORN to before me this date Garnishee B Affiant NOTARY PUBLIC, Clark County, Nevada Garnishee Company Name My Commission Expires: American LegalNet, Inc. www.FormsWorkflow.com