NOTICE AND AFFIDAVIT TO THE JUDGMENT DEBTOR OF CURRENT BALANCE DUE ON GARNISHMENT ORDER COURT, OHIO. JUDGMENT CREDITOR VS CASE NO. (MUST BE ON ALL REFERENCES) DOCKET NO. PA GE THIS COMMUNICATION IS FROM A DEBT COLLECTOR JUDGMENT DEBTOR (SS# OPTIONAL) You are hereby notified that the judgment creditor in this proceeding has issued an affidavit of current balance due on garnishment order in the above case. The Affidavit of Current Balance Due on Garnishment Order, below, shows the original amount of the judgment that was the basis of the garnishment order, the accrued interest to date, the court costs assessed to date, all moneys paid to the judgment creditor and the judgment creditors attorney on the judgment balance to date, and the current balance due on the judgment. If you dispute the judgment creditors determination of these amounts or if you believe that this affidavit is improper for any other reason, you may request a hearing before this Court disputing the affidavit in the request for hearing form, attached or in a substantially similar form, and delivering the request for hearing to this th Court at the above address, at the office of the Clerk of Court, no late r than the end of the 5 business day after you receivethis notice. You may state your reasons for disputing the judgment creditors determination of the amounts shown in the Affidavit of Current Balance Due on Garnishment Order in the space provided on the form; however, you are not required to do so. If you state your reasons for disputing the judgment cr editors determination, you are not prohibited from stating any other reason at the hearing. If you do not state your reasons, the Court will not hold it against you, you can state your reasonsat the hearing. No objections to the judgment itself will be heard or considered at the hearing. The hearing will be limitedto a consideration of the amount currently due on the judgment you owe to the judgment creditor. If you request a hearing by th delivering your request for hearing not later than the end of the 5 business day after you receive this notice, the Court willconduct the hearing no later than 12 days after your request is received by the Court, and the Court will send you notice of the date, time, and place. You may indicate in the form that you believe that the need for the hearing is an emergency and that it should be given priority by the Court. If you do so, the Court will schedule the hearing as soon as practical after your re questis received and will send you notice of the date, time, and place. If you do not request a hearing by delivering your request th for hearing not later than the end of the 5 business day after you receive this notice, some of your personal earnings will continue to be paid to the judgment creditor until the judgment is satisfied. If you have any questions concerning this matter, you may contact the office of the Clerk of this Court. If you want legal representation, you should contact your lawyer immediately. If you need the name of a lawyer, you should contact the local bar association. State of Ohio, County:ss Now comes the judgment creditor/attorney and states:The original amount of the judgment that is the basis of the garnishment order is: $ The accrued interest to date is: $ ; The court costs assess to date are: $ All moneys paid to the judgment creditor/attorney on the judgment to dat e are: $ Current Balance Due is: $ Judgment Creditor/Attorney Supreme Court ID Number Address City, State, Zip Code Judgment Creditor/Attorney Sworn to and subscribed before me on Notary Public American LegalNet, Inc. Revised January 27, 2004 www.USCourtForms.com