AFFIDAVIT OF CURRENT BALANCE DUE ON GARNISHMENT ORDER THE STATE OF OHIO COUNTY OF LORAIN, ss __________________________________________ Judgment Creditor Elyria Municipal Court 601 Broad Street Elyria, OH 44035 Case No. ______________________ vs __________________________________________ Judgment Debtor Before me, the undersigned Notary Public or Deputy Clerk of Elyria Municipal Court personally appeared: _______________________________________________, who being first duly sworn according to law, says that he/she is the JUDGMENT CREDITOR or ATTORNEY FOR JUDGMENT CREDITOR in the above-captioned matter and received a judgment against JUDGMENT DEBTOR on (judgment entry date) _______________________ in the Elyria Municipal Court. Original amount of Judgment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $_______________________ Accrued interest to date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $_______________________ Court Costs assessed to date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $_______________________ All moneys paid to the Judgment Creditor and the Judgment Creditor's Attorney on the judgment to date . . . . . . . . . . . . . . . . . $_______________________ Current Balance Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $_______________________ Name of Judgment Creditor: Address of Judgment Creditor: Phone No. of Judgment Creditor: Name of Judgment Creditor Attorney: Address of Judgment Creditor Attorney: Phone No. Judgment Creditor Attorney: __________________________________________________ __________________________________________________ _________________________________________________ __________________________________________________ __________________________________________________ __________________________________________________ __________________________________________________ __________________________________________________ Sworn to and subscribed before me this _______day of _____________________, 20_____. CERTIFICATE OF SERVICE A copy of the foregoing AFFIDAVIT OF CURRENT BALANCE DUE ON GARNISHMENT ORDER was sent via Regular U.S. Mail to the judgment debtor(s) at the judgment debtor(s) last known address as evidenced by the stamped certificate of mailing; and by regular mail to the garnishee: ________________________________________________________________________________. _______________________________________________ Affiant _______________________________________________ Deputy Clerk or Notary Public EMC 01 rev 4/02 American LegalNet, Inc. www.FormsWorkFlow.com