CV-421, 05/16 Earnings Garnishment Notice 247247812.35 and 812.44, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. STATE OF WISCONSIN, CIRCUIT COURT, COUNTY Earnings Garnishment Notice Case No. Creditor: Debtor: and Garnishee: To the Clerk of Court: The creditor has commenced an earnings garnishment action against the debtor and the garnishee to collect the following unsatisfied civil judgment: Name of Debtor(s) County of Original Judgment Original Case Number Date of Original Judgment Amoun t of Original Judgment Transcript of Judgment filed in This County on: Case Number of Transcript Amount of Judgment Unpaid This is a garnishment action to satisfy an order for victim restitution under 247973.20(1r), Wis. Stats., and there is no filing fee. Name of Debtor being garnished: Name Address Garnishee: Name Address Creditor: Name Phone Number Address Creditor's Attorney: Name Phone Number Address State Bar Number Name Printed or Typed Date American LegalNet, Inc. www.FormsWorkFlow.com