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CommonwealthofKentucky CourtofJusticewww.courts.ky.gov CR28.01;CR33.01
Small Claims Post-Judgment Interrogatories
Plaintiff: Address: Defendant: Address:
____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________
TO THE PLAINTIFF DEFENDANT: Asaresultofthejudgmentissuedintheabove-styledcase,youwereorderedbytheCourttopaythe Plaintiff Defendant a specified amount. In an attempt to collect on that judgment, the PlaintiffDefendant,asallowedbylaw,isrequestingthatyouanswerthefollowingquestions fullyinwritingunderoath.Youmustanswerthesequestionswithin30daysfromthedayyoureceive them.Additionalsheetsofpapermaybeusedifnecessary.Afteryouhaveansweredallthequestions, take your answers to a notary or to the circuit clerk's office to be notarized. You must sign this forminfrontofanotaryorcircuitcourtclerk.Onceyouhavesignedyouranswers,youmustmailor personallydeliveracopyoftheanswerstothePlaintiffDefendantattheaboveaddress. DO NOT FILE YOUR ANSWERS IN THE CIRCUIT CLERK'S OFFICE.
Stateyourfullname:___________________________________________________DOB:_______________ Yourhomeaddress:_______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________
Stateyouremployer'sname:________________________________________________________________ Employer'saddress:_______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________
Whoissuesyourpaycheck?_________________________________________________________________ Areyoupaid: []hourly[]weekly[]monthly[]other____________________________________ Listthenameandaddressofeachbankorcreditunionwhereyouhaveapersonalorbusinessaccountand thenameandnumberofeachaccount:_________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ Listanystocks,bonds,orothersecuritiesyoumayownandtheamountofeachone: ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ Listthelicensenumberofeachvehicleregisteredinyournameandthevalueofeach: ________________________________________________________________________________________
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CaseNo.__________________ DistrictSmallClaims Court_____________________ County ____________________
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Ifthesevehiclesaremortgaged,listthenameandaddressofthemortgageholderandtheamountyouowe: ________________________________________________________________________________________ Doyouownrealestate?[]Yes[]NoIfyouansweredyes,listtheaddressorlocationandvalueof eachparcel: ________________________________________________________________________________________ ________________________________________________________________________________________ Ifthepropertyismortgaged,listthenameandaddressofthemortgageholderandtheamountyouowe: ________________________________________________________________________________________ ________________________________________________________________________________________ Ifthepropertyisownedjointlywithanyoneelse,listtheirnamesandaddressesandpercentageofownership: ________________________________________________________________________________________ ________________________________________________________________________________________ Listanyothersourcesofincomenotalreadymentioned:___________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ TO THE PLAINTIFF DEFENDANT: Pursuanttocourtrule,youmayaskupto15additionalquestions.Thequestionsshouldbelistedinthespace below.Additionalsheetsofpapermaybeusedifnecessary.DO NOT FILE THIS FORM IN THE CIRCUIT CLERK'S OFFICE. ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ I, _________________________________________, the above-named Defendant Plaintiff, after being duly sworn under oath by ________________________________, state that the answers I have given to the questions are true and correct. _______________________________________________ Signature of Plaintiff Defendant
Subscribedandsworntobeforemeby_______________________________________________ thisdayof_______________________,2________. Mycommissionexpires:____________,2________.___________________________________ Clerk/NotaryPublic
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