ORDER AND NOTICE OF GARNISHMENT AND ANSWER OF EMPLOYER – SECTION CLEVELAND MUNICIPAL COURT 1200 ONTARIO STREET CLEVELAND, OH 44113 ATTN: CLERK OF COURTS-GARNISHMENT DEPT PHONE: (216) 664-4859 B CASE NO. ______CV___-______________ ____________________________________________ vs. ____________________________________________ Judgment Creditor Judgment Debtor _________________________________________________________________________ Identification for Judgment Debtor SECTION B: ANSWER OF EMPLOYER (GARNISHEE). (An employer is one who is required to withhold payroll taxes out of payments of personal earnings made to the judgment debtor) GARNISHEE: answer all pertinent questions. Now comes ___________________________________________________, the employer (garnishee) herein, who says: 1. This order of garnishment of personal earnings was received on:…………… 1. 2. The judgment debtor is in my/our employ…………………………………. _______________________________ 2. Yes ___________ NO _____________ If answer is NO, please give date of last employment __________________. If never employed check here _____. 3(A) Is the debt to which this order of garnishment of personal earnings pertains the subject of an existing agreement for debt scheduling between the judgment debtor and a budget and debt counseling service and has the judgment debtor made every payment that was due under the agreement for debt scheduling no later than forty-five (45) days after the date on which the payment was due? ………………...…………………… 3(A). Yes___________ NO ____________ If the answer to both parts of this question is “YES”, give all available details of the agreement, sign this form and return it to the court. Details of Agreement:____________________________________________________________________________ _______________________________________________________________________________________________. 3(B) Were you, on the date that you received this order of garnishment of personal earnings, withholding moneys from the judgment debtor’s personal earnings pursuant to another order of garnishment personal earnings that Ohio or Federal Law provides with a higher priority than this order of garnishment of personal earnings (such as a support order or Internal Revenue Service levy)?…………………………………………… 3(B). Yes ____________ No ____________. Name of Court _________________________________________________________________ Associated Case Number ________________________________________________________ Date Received ____________________________________ Balance Due__________________ Return one COMPLETED and SIGNED copy of this form to the clerk of this court with or without payment within five (5) business days after you receive this order of garnishment. (Rev 2008 10 01) American LegalNet, Inc. www.FormsWorkflow.com 3 (C) Did you receive prior to the date that you received this order of garnishment of personal earnings one or more other orders of garnishment of personal earnings that are not described in question 3 (B), and are you currently processing one or more of those orders for the statutorily required 182-day period or holding one or more of those orders for processing for a 182-day period in the sequence of their receipt by you? . 3(C). Yes ___________ No _____________. If the answer to this question is “YES”, give the name of the court that issued each of those orders and the balance due to the relevant judgment creditor under each of those orders. List first the previously received order(s) that you are currently processing, and list each of the other previously received orders in the sequence that you are required to process them. (Attach additional paper if needed). Name of Court __________________________________________________________________ Associated Case Number _______________________________________________________________ Date Received ____________________________________ Balance Due___________________ I certify that the statements above are true. _____________________________________________ (PRINT the name of EMPLOYER) Signed: ___________________________________________ (Signature of Person Completing Form) _____________________________________________ (PRINT Name and Title of Person Completing Form) Date: _____________________________________________ (area code) (phone number) ___________________________________________ (Date this form was completed) Return one COMPLETED and SIGNED copy of this form to the clerk of this court with or without payment within five (5) business days after you receive this order of garnishment. (Rev 2008 10 01) American LegalNet, Inc. www.FormsWorkflow.com