COC-CV-05 REVISED O8/29/00 IN THE COURT OF COMMON PLEAS FRANKLIN COUNTY, OHIO Case No. JUDGMENT CREDITOR AGAINST (THIS NUMBER MUST BE USED ON ALL REFERENCES) JUDGMENT DEBTOR SECTION B. ANSWER OF THE EMPLOYER (GARNISHEE) (AN EMPLOYER IS ONE WHO IS REQUIRED TO WITHHOLD PAYROLL TAXES OUT OF THE PERSONAL EARNINGS MADE TO THE JUDGMENT DEBTOR) (ANSWER ALL PERTINENT QUESTIONS) Now comes 1. This order of garnishment of personal earnings was received on 2. This judgment debtor is in my/our employ: YES If the answer is "NO" give the date of the last employment 3. (A) Is this debt to which this order of garnishment of personal earnings pertains the subject of an existing agreement for debt scheduling between the judgment debtor and a budget and debt counseling service and has the judgment debtor made every payment that was due under the agreement for debt scheduling no later than forty-five days after the date on which the payment NO was due? YES If the answer to both parts of this question is "YES" give all available details of the agreement, sign this form, and return it to court. 3(A) Details: NO , the employer (garnishee) herein, who says: (DATE) (B) Were you, on the date that your received this order of garnishment of personal earnings, withholding moneys from the judgment debtor's personal disposal earnings pursuant to another order of garnishment of personal earnings that Ohio or federal law provides with a higher priority than this order of garnishment of personal earnings (such as a support order or NO Internal Revenue Service levy )? YES If the answer to this question is "YES" give the name of the court that issued the higher priority order, the associated case number, the date upon which you received that order, and the balance due to the relevant judgment creditor under that order. 3(B) Details: (C) Did you receive, prior to the date that you received this order of garnishment of personal earnings, one or more other orders of garnishment of personal earnings that are not described in question 3(B), and are your currently processing one or more of those orders for the statutorily required time period or holding one or more of those orders for processing for a statutorily NO required period in the sequence of their receipt by you? YES If the answer to this question is "YES" give the name of the court that issued each of those previously received orders, the associated case numbers, the date upon which you received each of those orders, and the balance due to the relevant judgment creditors under each of those orders. List first the previously received order(s) that your are currently processing, and list each each of the previously received orders in the sequence you received them. 3(C) Details: (Answer of the Employer(Garnishee) Continued on Reverse Side) American LegalNet, Inc. www.FormsWorkFlow.com I certify that all statements answered on the front of this form are true, and a completed and signed copy of this form, along with two (2) copies of the Notice to the Judgment Debtor form, the Court Order and Notice of Garnishment form, and a Request for Hearing form, have been delivered to the judgment debtor. Each subsequent deduction from the employee's pay will be the result of a continuous garnishment. Franklin County Clerk of Courts First Floor-Civil Division 345 S. High St. Columbus, OH 43215-4579 Note: This form must be completed, signed and returned to this court regardless of any payments due. (Print Name of Employer) (Print Name and Title of Person Who Completed Form) Signed: (Signature of Person Completing Form) American LegalNet, Inc. www.FormsWorkFlow.com