IN THE SUMMIT COUNTY COURT OF COMMON PLEAS GENERAL DIVISION 205 S. HIGH STREET, AKRON, OHIO AFFIDAVIT; ORDER AND NOTICE OF GARNISHMENT OF PROPERTY OTHER THAN PERSONAL EARNINGS AND ANSWER OF GARNISHEE (R.C. 2716.11 and 2716.13) _____________________________________________________ _____________________________________________________ JUDGMENT CREDITOR Case No. ______________________________________ Exec. No.______________________________________ -vs_____________________________________________________ _____________________________________________________ JUDGMENT DEBTOR LAST FOUR DIGITS OF DEBTOR'S SS# ______________________ (The debt collector is attempting to collect a debt and any information obtained will be used for that purpose). ======================================================================================================== AFFIDAVIT STATE OF OHIO, COUNTY OF SUMMIT, SS.: I, the Affiant, first duly cautioned and sworn, deposes that I am the Judgment Creditor and, on the ______ day of _______________________________ 20_____, I duly recovered a judgment against the Judgment Debtor named above in the Court of____________________________________________________________________ and that the Garnishee Named ________________________________________________________________________________________________________________ Whose Address is: _________________________________________________________________________________________________________________________ may have in the Garnishee's hands or control money, property, or credits, other than personal earnings, of the Judgment Debtor. Said property is described as follows: _______________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ ATTORNEY FOR JUDGMENT CREDITOR AFFIANT _____________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ Sworn to and subscribed before me this______day of ___________________________________, 20___ . _______________________________________________________ NOTARY PUBLIC ===================================================================================================================== SECTION A. COURT ORDER AND NOTICE OF GARNISHMENT TO______________________________________________________________________________GARNISHEE The judgment creditor in the above case has filed an Affidavit, satisfactory to the undersigned, in this Court stating that you may have money, property, or credits, other than personal earnings, in your hands or under your control that belong to the Judgment Debtor. You are therefore ordered to complete the "ANSWER OF GARNISHEE" in section (B) on the back of this form. Return one completed and signed copy of this form to the clerk of this court together with the amount determined in accordance with the "ANSWER OF GARNISHEE" within five (5) business days after you receive this Order of Garnishment. Deliver one completed and signed copy of this form to the Judgment Debtor. Keep the other completed and signed copy of this form for your files. The total probable amount now due on this judgment is $____________. (The total probable amount due includes the unpaid portion of the judgment in favor of the Judgment Creditor, which is $__________________; interest on that judgment and, if applicable, prejudgment interest at the rate of _______% per annum payable until that judgment is satisfied in full; and court costs in the amount of $____________________) You also are ordered to hold safely anything of value that belongs to the Judgment Debtor and that has to be paid to the court, as determined under the "ANSWER OF GARNISHEE" in section (B) of this form, but that is of such a nature that it cannot be so delivered, until further order of the court. ________________________ DATE CIV009 ____________________________________________________________________________ JUDGE or MAGISTRATE Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Rev 1.1 110131 SECTION B. ANSWER OF GARNISHEE Now comes __________________________________________________________ the GARNISHEE, who says: 1. That the Garnishee has more than $425 in money, property, or credits, other than personal earnings, of the judgment debtor under the Garnishee's control and in the Garnishee's possession. _______________________________________________ $ :524 $ REVO UOMA ,SEY FI TN No Yes 2. That property is described as: 3. If the answer to line 1 is "yes" and the amount is less than the probable amount now due on the judgment, as indicated in section (A) of this form, sign and return this form and pay the amount of line 1 to Daniel M. Horrigan, Summit County Clerk of Courts, 205 S. High Street, Akron, Ohio 44308 4. If the answer to line 1 is "yes" and the amount is greater than that probable amount now due on the judgment, as indicated in section (A) of this form, sign and return this form and pay that probable amount now due to Daniel M. Horrigan, Summit County Clerk of Courts, 205 S. High Street, Akron, Ohio 44308 5. If the answer to line 1 is "yes" but the money, property, or credits are of such a nature that they cannot be delivered to the Clerk of Court, indicate that by placing an "X" in this Box: Do not dispose of that money, property, or credits or give them to anyone else until further order of the Court. 6. If the answer to line 1 is "no," sign and return this form to the Daniel M. Horrigan, Summit County Clerk of Courts, Akron, Ohio 44308 I certify that the statements above are true. _________________________________________________ (Print Name of Garnishee) ________________________________________________________ (Print Name and Title of Person Who Completed Form) SIGNED ________________________________________________ (Signature of Person Completing Form) ____________________ Date _______________________ Phone Three copies of the Affidavit, Garnishment Order, and Answer of Garnishee were served pursuant to R.C. 2716.13 upon the Garnishee or an officer or managing or general agent of the Garnishee. CIV009 Page 2 of 2 Rev 1.1 110131 American LegalNet, Inc. www.FormsWorkFlow.com