Barberton Municipal Court 576 West Park Avenue, Room 205 Barberton, Ohio 44203 (330) 861-7192 www.cityofbarberton.com/clerkofcourts REQUEST FOR HEARING Case No. Date: I dispute the Judgment Creditors determination of CURRENT BALANCE DUE on garnishm ent order in the above case and request that a hearing in this matter be held not later than twelve (12) days after delivery of this request to the court. I believe that the need for the hearing is an emergency. (Insert Do or Do Not) I dispute the Judgment Creditors determination for the following reasons : (optional) I understand that no objections to the judgment itself will be considered at the hearing. _______________________________ ____________________________________ Date Name of Judgment Debtor (Print) ____________________________________ Signature ===================================================================== Warning: If you do not deliver this request for hearing or a request in a substa ntially similar form to the office of the Clerk of this Court within five (5) business days of your receipt of it, you waive your right to a hearing, and some of your person al earnings will continue to be paid to__________________________________, in satisfactio n of your debt (Judgment Creditors Name) to the Judgment Creditor. American LegalNet, Inc. www.USCourtForms.com