REQUEST FOR HEARING ­ DETERMINATION OF CURRENT BALANCE DUE ON GARNISHMENT ORDER Case No. Judgment Creditor vs. Judgment Debtor I dispute the judgment creditor's determination of current balance due on the garnishment order in the above case and request that a hearing in this matter be held no later than twelve days (12) after delivery of this request to the court. I do/do not (circle one) feel that the need for the hearing is an emergency. I dispute the judgment creditor's determination for the following reason: NEW PHILADELPHIA MUNICIPAL COURT 166 East High Avenue New Philadelphia, Ohio 44663 (330)343-6797 TIME STAMP I UNDERSTAND THAT NO OBJECTIONS TO THE JUDGMENT ITSELF WILL BE CONSIDERED AT THE HEARING. (Name of Judgment Debtor - Print) (Signature of Judgment Debtor - Print) (Date) (Address & Street) (City, State & Zip Code) (Area Code) (Phone Number) 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 THIS 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 THE JUDGMENT CREDITOR IN SATISFACTION OF YOUR DEBT TO THE JUDGMENT CREDITOR. REQUEST FOR HEARING ON CURRENT BALANCE DUE American LegalNet, Inc. www.FormsWorkFlow.com 11/2015 JAS