IN THE CHANCERY COURT OF SHELBY COUNTY, TENNESSEE FOR THE THIRTIETH JUDICIAL DISTRICT AT MEMPHIS _________________________ Plaintiff vs. Docket No. ___________________ _________________________ Defendant ORDER ON MOTION FOR INSTALLMENT PAYMENTS Whereas, Petitioner___________________, appeared in this Court on the _____ day of ________________, 20____ pursuant to Section 35 of Chapter 915 of Public Acts of 1978, and moved by appropriate written motion and affidavit that the Court permit said Petitioner to make __________________ (weekly, bi-weekly, monthly, bi-monthly) payments in the amount of $____________ and whereas after due notice and a hearing on said motion, it was the decision of this Court to enter an order requiring said Petitioner to pay to the Chancery Court Clerk a certain sum of money, being $________________, to be paid __________________ (weekly, biweekly, monthly, bi-monthly) beginning ________________, 20____. IT IS THEREFORE ORDERED, ADJUDGED AND DECREED; That the Petitioner be ordered to pay to the Chancery Court Clerk $__________________ to be paid _______________________ (weekly, bi-weekly, monthly, bi-monthly) beginning ___________________, 20____ and that the issuance, execution or return of any writ of garnishment against wages or salary due the judgment debtor during the period that such judgment debtor complies with this order, pursuant to the provisions of Chapter 915 of the Public 1 American LegalNet, Inc. www.USCourtForms.com Acts of 1978 is stayed. Any funds being held by the Clerk’s office are hereby released to ___________________________________________. ____________________________________ Chancellor ____________________________________ Date Certificate of Service I hereby certify that a copy of the foregoing order has been mailed postage prepaid to all interested parties, this ______ day of ______________, 20____. ____________________________________ Deputy Clerk 2 American LegalNet, Inc. www.USCourtForms.com