FO RM H-6 Page 1 of 2 UNITED STATES DISTRICT COURT UNITED STATES BANKRUPTCY COURT SOUTHERN DISTRICT OF WEST VIRGINIA In re Case Number _______________________ Debtor Chapter ___________________________ Plaintiff v. Adv. Proc. No. ______________________ Defendant SUGGESTEE EXECUTION To the United States Marshal for the Southern District of West Virginia: WHE REAS in an adversary proceeding in the United States Bankruptcy Court for the Southern D istrict of West Virginia, on the _____ day of ________________, 20___, _____________________________________ ___ recovered a judgement against ________ _____ _____ _____ _____ _____ _____ _____ for the sum of $_______ _____ ___ and $______________ costs, with interest on the principal sum at the rate of ____________________% per annum from the said ____ day of ____________________, 20___, until paid; AND WH EREA S it appears that a writ of execution against the said Defendant has been issued on the _________ day of ______________, 20___; AN D W HE RE AS satisfactory proof has b een filed in this office that weekly disposable earnings are now, or will hereafter, within one year from this date, become due to the judgment debtor from __________________________, his or her employer, after the deduction of State and federal taxes in excess in any week of thirty time the federal minimum ho urly wage now in effect; THEREFORE, you are commanded in the name of the United States of America to levy for the amount due on said judgment upon twenty percent (20% ) of the wages and salary of the judgment debtor now due or to become d ue within one year from this date from the said employer, provided such levy will not reduce the amount payable to the judgment debtor to an amount per week that is less than thirty times the federal minimum hourly wage now in effect, and receive and collect from the above-named employer for the benefit of the judgment creditor the percent aforesaid of the said wages and salary, and make return of your proceedings hereunder at the office of the United States Bankruptcy Clerk on the first Mo nday of the month following the exp iration o f one year from the date hereof. A certified copy of this Suggestee Execution is being mailed concurrently with issuance to the judgment debtor. (Continued on Next Page) American LegalNet, Inc. www.USCourtForms.com FO RM H-6 Page 2 of 2 WITN ESS, the UNITED STATES BANKRU PTCY CLERK for the Southern D istrict of W est Virginia, this ___ __ d ay of ____ ___ ___ ___ ___ ___ __, 2 0__ _, at __ ___ ___ ___ o'clock ___ .M. UNITED STATES BANK RUPTCY CLERK by _____________________________________________ Deputy Clerk (SEAL OF THE COURT) TABULATION OF JUDGMENT AND PAYMENTS RECEIVED ON ACCO UNT THERE OF: Amount o f Judgment: $_________________________________ Payment Received $_________________________________ Make Remittance To: __________________________________ Mail To: __________________________________ __________________________________ __________________________________ __________________________________ American LegalNet, Inc. www.USCourtForms.com