Hamilton County Municipal Court Affidavit & Order & Notice of Garnishment of Personal Earnings & Answer of Employer Hamilton County Municipal Court Civil Div. Rm. 115, 1000 Main St. Cincinnati Ohio 45202 (513) 946-5722. Web Address: www.courtclerk.org _______________________________________________CREDITOR WAGE Page 1 of 2 _______________________________________________ Case No. ________________________________ _______________________________________________ THIS COMMUNICATION IS FROM A DEBT COLLECTOR VS. _______________________________________________DEBTOR _______________________________________________ _______________________________________________ (SS# OPTIONAL) ____________-____________-____________ STATE OF OHIO, HAMILTON COUNTY, SS: The undersigned, being first duly cautioned, sworn or affirmed according to law, says that I am attorney/judgment creditor who recovered or certified a judgment in this court against above named judgment debtor. I have good reason to believe and do believe that the garnishee named below may have personal earnings owing to the judgment debtor that are not exempt under section 2329.66 Ohio Revised Code (ORC). Written demand on judgment debtor, per 2716.02 ORC, has been made at least 15 and not more than 45 days before this date. Payment demanded in the written demand has not been made, nor a sufficient portion been made to prevent the garnishment of personal earnings described in such section. Affiant has no knowledge if the judgment debtor has applied for trusteeship or is the subject of a debt scheduling agreement, either of which precludes the garnishment of judgment debtor’s personal earnings. __________________________________________________________ SIGNATURE: JUDGMENT CREDITOR/ATTORNEY (SIGNATURE ON ORIGINAL ONLY) Sworn to & Subscribed before me on ___________________________________ __________________________________________________________ NOTARY PUBLIC (SIGNATURE ON ORIGINAL ONLY) __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Garnishee: SECTION A: COURT ORDER AND NOTICE OF GARNISHMENT The judgment creditor in this case has filed an affidavit, satisfactory with this court, stating that you may owe the judgment debtor money for personal earnings and that some of that money may not be exempt from garnishment under Ohio or U.S. law. ___________________________________________________________________________________ You are ordered to file a completed and signed copy of the Answer of Employer (Garnishee) , Section B page 2 of this form, with the clerk of this court within 5 ___________________________________________________________________________________ business days upon receipt of this garnishment order. Deliver a completed and signed copy & accompanying document entitled Notice to the Judgment Debtor & Request for Hearing to the debtor. Keep a completed and signed copy for your files. __________________________________________________________________________________ 1. The unpaid portion of the judgment is: $___________________________________ 2. Pre Judgment Interest (if applicable) in the amount of: $ ___________________________________ 3. Judgment Interest and, if applicable, Pre-Judgment Interest relative to the judgment at: _____________% per annum payable until judgment is satisfied 4. Court Costs in the amount of: $___________________________________ Total Probable Amount Now Due On Judgment is (1+2+4) $___________________________________ This garnishment order of personal earnings is a continuous order requiring you to withhold a specified amount, calculated during each pay period at the statutory percentage, of the debtor’s personal disposable earnings as determined in accordance with the Interim/Final Report & Answer of Garnishee, from the debtors personal, disposable earnings during each pay period beginning with the first full pay period after you receive the order, until the judgment, court costs, and all applicable interest has been paid in full. You must pay that specified amount, calculated each pay period at the statutory percentage, to the clerk of this court within 30 days after the end of each pay period of the debtor. You must include with that specified amount an Interim/Final Report & Answer of Garnishee in the form set forth in 2716.07 ORC (form enclosed). Use a new photocopy with each payment. You are permitted to deduct a processing fee (not part of the court costs) of up to $3.00 from the debtor’s personal, disposable earnings for any pay period of the debtor where an amount was withheld. You are not required to file with the court the Interim/Final Report and Answer of Garnishee for any pay period in which an amount from the debtor’s personal, disposable earnings was not withheld. This garnishment of personal earnings will remain in effect until one of the following occur: (1) The total probable amount due on the judgment is paid in full due to your withholding of the specified amount. (2) The creditor/attorney files with this court a written notice that the total probable amount due on the judgment has been satisfied; or files a written request to terminate and release this garnishment order, releasing you from the mandate of this garnishment. (3) A municipal or county court appoints a trustee for the debtor and issues to you an order that stays this garnishment order. (4) A federal bankruptcy court issues to you an order that stays this garnishment order of personal earnings. (5) A municipal, county, or a common pleas court issues to you a garnishment order of personal earnings that relates to the debtor and a different creditor, and Ohio or federal law provides the other order with a higher priority than this order. (6) A municipal, county, or a common pleas court issues to you a garnishment order of personal earnings that relates to the debtor and a different creditor that does not have a higher priority than this order. Under any of the circumstances listed, you are required to file with this court an Interim/Final Report & Answer of Garnishee per 2716.08 ORC. Under the circumstances listed in 5 & 6 above, you must cease processing this garnishment after the expiration of the full pay period within which the 182nd day after you began processing it falls. Special stacking, priority of payment, and manner of payment rules apply when a garnishee receives multiple garnishment orders with respect to the same debtor. Familiarize yourself with the rules are set forth in 2716.041 ORC. ________________________________________________________ Witness My Hand & Seal of This Court This__________ Day of ____________________, 20______________ JUDGE HAMILTON COUNTY MUNICIPAL COURT ( JUDGE’S SIGNATURE ON ORIGINAL ONLY) __________________________________________________________________ JUDGMENT CREDITOR/ATTORNEY ATTY. I.D. __________________________________________________________________ ADDRESS __________________________________________________________________ CITY, STATE, ZIP CODE Revised 02/2005 FILE DATE ___________________________________________________________________________ PHONE NUMBER PAGE 1 American LegalNet, Inc. www.FormsWorkflow.com Gregory Hartmann, Clerk of Courts Copyright 2005 all rights reserrved Hamilton County Municipal Court Affidavit & Order & Notice of Garnishment of Personal Earnings & Answer of Employer Hamilton County Municipal Court Civil Div. Rm. 115, 1000 Main St. Cincinnati Ohio 45202 (513) 946-5722. Web Address: www.courtclerk.org _______________________________________________CREDITOR WAGE Page 2 of 2 Case No. ________________________________ THIS COMMUNICATION IS FROM A DEBT COLLECTOR VS. _______________________________________________DEBTOR SECTION B: ANSWER OF EMPLOYER (GARNISHEE). ANSWER ALL PERTINENT QUESTIONS. An employer is one who is required to withhold payroll taxes out of payments of personal earnings made to the judgment debtor. Complete and return a signed copy of this page to the above listed address. Now comes _______________________________________________________________________________________the employer herein who says: 1. This garnishment order of personal earnings was received on _________________________________________________________________________ 2. The judgment debtor is in my employ: Yes__________ No_________(IF “YES” COMPLETE REMAINDER OF SECTION B AND THE INTERIM/FINAL REPORT FORM) If the answer is “no” give date of last employment___________________________________________________________________________________________________ . 3. (A) Is the debt to which this garnishment order 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 45 days after the date on which the payment was due? YES_________NO__________ 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 the court. _____________________________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________________________ (B) Were you, on the date that you received this garnishment order of personal earnings, withholding moneys from the judgment debtor’s personal disposable earnings pursuant to another garnishment order of personal earnings that Ohio or federal law provides with a higher priority than this garnishment order of personal earnings (such as a support order, or internal revenue service levy)? YES_________NO__________ 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. _____________________________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________________________ (C) Did you receive prior to the date that you received this garnishment order of personal earnings one or more other garnishment orders of personal earnings that are not described in question 3(B), and are you currently processing one or more of those orders of the statutorily required time period, or holding one or more of those orders for processing for a statutorily required period in the sequence of their receipt by you? YES_________NO__________ 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 creditor under each of those orders. List first the previously received order(s) that you are currently processing, and list each of the other previously received orders in the sequence that you are required to process them. _____________________________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ I certify that the statements above are true, and that a completed and signed copy of this form, along with 2 copies of the Notice to the Judgment Debtor form, and a Request for Hearing form have been delivered to the judgment debtor. Each deduction from the employee’s pay will be the result of a continuous garnishment HOLDING (CLERK USE ONLY) $____________________ CASH CHECK ______________________________________________________________ JUDGMENT CREDITOR/ATTORNEY ________________________________________________________ ATTY. I.D. EMPLOYER ______________________________________________________________ ________________________________________________________ ADDRESS NAME AND TITLE OF PERSON COMPLETING FORM ______________________________________________________________ CITY, STATE, ZIP CODE ________________________________________________________ PHONE NUMBER SIGNATURE OF PERSON COMPLETING FORM ________________________________________________________ PAGE 2 DATE American LegalNet, Inc. www.FormsWorkflow.com