FINAL REPORT AND ANSWER OF GARNISHEE CASE NO. CV I- CLEVELAND MUNICIPAL COURT 1200 ONTARIO STREET CLEVELAND, OH 44113 Clerks Filed Date Stamp ATTN: Clerk of Courts-Cashiers Dept. Phone: (216) 664-4859 Judgment Creditor: VS. Judgment Debtor: The garnishee, _________________________________________________________ _____ in the above case states as follows: 1. The date that the garnishee received the order of garnishment of the judgment deb tors personal earnings was _______________________________________. 2. The total probable amount on the judgment, including court costs, ju dgment interest, and, if applicable, prejudgment interest, as stated in Section A of the order of garnishment of the judgment debtors personal earnings, is $________________________________. 3. The total amount that has been withheld from the judgment debtor s personal earnings and paid to the court while the order of garnishment of the judgment debtors perso nal earnings remained in effect is $_______________________________________. 4. (When applicable) the total probable amount due on the judgment ( as stated in 2 above) is not equal to the total amount that has been withheld (as stated in 3 above), and the reason for that difference is that the order of garnishment of the judgment debtors personal earnings ceased to be in effect for the following statutorily prescribed reason(s) (check whichever apply): (a) _______ A municipal or county court appointed a trustee for the judgment debtor and issued an order that stays the order of garnishment of the judgment debt ors personal earnings. (b) _______ A federal bankruptcy court issued an order that stays the order of garnishment of the judgment debtors personal earnings. (c) _______ A municipal or county court or a court of common pleas iss ued another order of personal earnings that relates to the judgment debtor and a different ju dgment creditor, and Ohio or federal law provides the other order a higher priority. (Set forth the name of the court that issued the higher priority order, the associated case number, the date that the higher priority order was received and the balance due to the relevant judgment creditor under that order): (OVER) American LegalNet, Inc. www.USCourtForms.com>>>> 2 Court __________________________________ Case Number ____________________________ (Name of Court that issued higher priority order) (Associated Case Number) Date Received __________________________ Balance Due $___________________________ (Date that higher priority order was received) (Balance Due to the Judgment Creditor under that Order). (d) _______ A municipal or county court or a court of common pleas issued another order of garnishment of personal earnings that relates to the judgment debtor and a different judgment creditor and that is not described in 4(c) above. (Set forth the nam e of the court that issued the subsequently received order, the associated case number, the date that the subsequent order was received and the balance due to the relevant judgment creditor under tha t order). Court __________________________________ Case Number ____________________________ (Name of Court that issued subsequently received order) (Associated Case Number) Date Received __________________________ Balance Due $___________________________ (Date that subsequent order was received) Ba(lance Due to the Judgment Creditor under that Order). (e) _______ The judgment creditor or judgment creditors attorney h as issued a request that the order of garnishment be terminated and the garnishee released from t he mandates of the order of garnishment. (f) _______ Judgment debtors employment terminated on _________________ _________. (date) (g) _______ Other: __________________________________________________ ________. I certify that the statements above are true. _______________________________________ (PRINT Name of Employer) Signed________________________________ _____________________________ __________ (Signature of Person Completing Form) (PRIZNT Name of Person Who Completed This Form) (Employer or EmployersAgen t) Dated_________________________________ _____________________________ __________ (Date This Form Was Completed) (PRINT Title of Person Who Completed This Form) Telephone No. ___________________________ Note: After completing this FINAL REPORT AND ANSWER OF GARNISHEE, you must send one copy to the Clerk of Cleveland Municipal Court at the address printed on this form by regular U. S. Mail. One copy to employee. Retain one copy for your records. Garnishment Form Final Report (Revised 08/2000) O. R. C. 2716.08 American LegalNet, Inc. www.USCourtForms.com