IN THE COURT OF GENERAL SESSIONS SHELBY COUNTY, TENNESSEE REQUEST FOR ISSUANCE OF AN EXECUTION OR GARNISHMENT ____________________________________ ______________________________ Defendants Social Security No. Docket N o. ___________________________________________ ____________________________________ Defendants Full Name Plaintiffs Name ___________________________________________ Name of Garnishee or Property Levied On $__________________________________ ___________________________________________ Deposit Amount Address CREDITORS STATEMENT OF JUDGME NT DEBTORS LAST KNOW ADDRESS Pursuant to TCA 26-2-402, I, _________________________________________________, judgment creditor, creditors agent or attorney, state that the last know address of the defendant, judgment debtor is: ______________________________________________ ______________________________________________ ______________________________________________ The judgment cerditors address for mailing any notice under this act is: _____________________________________________ _____________________________________________ _____________________________________________ Judgment ____________________________________ Interest ____________________________________ Direct Payments ____________________________________ Payments to G.S. ____________________________________ Court Cost ____________________________________ Balance ____________________________________ ________________________________________________________ _____________________________ Attorney, Judgment Creditor or Agents Signature Phone No. Todays Date ____________________________