INTERIM REPORT AND ANSWER OF GARNISHEE CASE NO:______________________________ IN THE ELYRIA MUNICIPAL COURT 601 Broad Street Elyria, OH 44035 ATTN: Clerk of Courts-Civil Division Phone: (440) 326-1800 Clerk's Received Stamp ________________________________________ vs ___________________________________ Judgment Creditor 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 debtor's personal earnings was: _____________________ The total probable amount due on the judgment, including court costs, judgment interest, and, if applicable, prejudgment interest, as stated in either Section A of the order of garnishment of the judgment debtor's personal earnings or in the affidavit of current balance due on garnishment order if that affidavit has been received subsequent to the order of garnishment, is: $____________________ The pay period of the judgment debtor is (enter weekly, biweekly, semimonthly, or monthly. Do not enter a pay period of more than one month) $____________________ The disposable earnings of the judgment debtor earned during the judgment debtor's present pay period is ("disposable earnings" means earnings after deductions required by law. "Present pay period" means the pay period for which you are completing this Interim Report and Answer of Garnishee). $____________________ The amount equal to twenty-five per cent (25%) of the judgment debtor's disposable earnings set forth in section 4 of this form is: $____________________ ______times the current federal minimum hourly wage is (if the judgment debtor is paid weekly, enter thirty above, if paid biweekly, enter sixty, if paid semimonthly, enter sixty-five, if paid monthly, enter one hundred thirty, then calculate the amount). $____________________ The amount by which the amount in section 4 of this form exceeds the amount in section 6 of this form is: $____________________ 2. 3. 4. 5. 6. 7. (OVER) EMC 111B rev 8/00 American LegalNet, Inc. www.FormsWorkFlow.com 8. The smallest of either the amount entered in section 5 of this form, the amount entered in section 7 of this form, or the amount entered in section 2 of this form, is: $____________________ 9. The amount entered in section 8 of this form, plus or minus (as appropriate) the garnishee's processing fee is: $____________________ (If the amount entered in section 8 of this form equals the amount entered in section 2 of this form, then add up to three dollars ($3); otherwise subtract up to three dollars ($3)). Other deductions: $____________________ 10. 11. The calculated amount that has been withheld from the judgment debtor's personal earnings during the judgment debtor's present pay period and that is submitted with this "Interim Report and Answer of Garnishee" is: $____________________ I certify that the statements above are true. ________________________________________________ (print name of employer) ________________________________________________ (print name and title of person who completed this form) Signed _________________________________________ (signature of person who completed this form) Dated this _____day of _______________, 20____ PLEASE NOTE: You must make multiple copies of this form, as a newly completed copy of this form must be sent with each payment. 1 copy to the Court with each payment submitted - - 2 copies to Judgment Debtor/Employee - - 1 copy for Garnishee/Employer file. American LegalNet, Inc. www.FormsWorkFlow.com