REQUEST FOR HEARING ON CURRENT BALANCE DUE Personal Earnings ELYRIA MUNICIPAL COURT 601 Broad Street Elyria, OH 44035 ATTN: Clerk of Courts - Civil Division Phone: (440) 326-1800 Clerk's Received Stamp CASE NO: __________________________ ______________________________________ VS ____________________________________ Judgment Creditor Judgment Debtor I dispute the Judgment Creditor's determination of current balance due on garnishment order in the above case and request that a hearing in this matter be held not later than twelve 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 Creditor's determination for the following reasons: Optional: _______________________________________________________________ _____________________________________________________________________________ I UNDERSTAND THAT NO OBJECTIONS TO THE JUDGMENT ITSELF WILL BE CONSIDERED AT THE HEARING. ____________________________________ (print name of judgment debtor) ____________________________________ (signature of judgment debtor) ____________________________________ (date) WARNING: IF YOU DO NOT DELIVER THIS REQUEST FOR HEARING OR A REQUEST IN A SUBSTANTIALLY SIMILAR FORM TO THE OFFICE OF THE CLERK OF ELYRIA MUNICIPAL COURT WITHIN FIVE (5) BUSINESS DAYS OF YOUR RECEIPT OF IT, YOU WAIVE YOUR RIGHT TO A HEARING, AND SOME OF YOUR PERSONAL EARNINGS WILL CONTINUE TO BE PAID TO____________________________________ IN SATISFACTION OF YOUR Judgment Creditor's name DEBT TO THE JUDGMENT CREDITOR. EMC 111G1 rev. 8/00 American LegalNet, Inc. www.FormsWorkFlow.com