Free STATE OF NEBRASKA - Nebraska

STATE OF NEBRASKA FORM NO. CC 3:6 Rev. 1/94 25-1056 IN THE

CASE NUMBER

GARNISHMENT AFFIDAVIT
COURT OF COUNTY, NEBRASKA

Plaintiff vs.

AFFIDAVIT AND PRAECIPE FOR SUMMONS IN GARNISHMENT [IN AID OF EXECUTION]

Defendant
, being duly sworn says: the creditor in this action, , recovered a judgment against the debtor, , on the debtor's last known address is due on the judgment the sum of $ a total of $ that: (Check one.) ___A. ___B. ___C. ___D. ___E. ___F. is not for the support of a person, and the judgment debtor is the head of a family.* is not for the support of a person, and the judgment debtor is not the head of a family.* is for the support of a person, the judgment debtor is supporting a spouse or dependent child, and this support order is not for payments more than 12 weeks in arrears.** is for the support of a person, the judgment debtor is supporting a spouse or dependent child, and this support order is for payments more than 12 weeks in arrears.** is for the support of a person, the judgment debtor is not supporting any other spouse or dependent child, and this support order is not for payments more than 12 weeks in arrears.** is for the support of a person, the judgment debtor is not supporting any other spouse or dependent child, and this support order is for payments more than 12 weeks in arrears.** , plus $ interest, and $ , ; that

; that there is now costs, for

. I have good reason to and do believe that this sum is based upon a judgment

I further say that I have good reason to and do believe that the garnishee, property of and is indebted to the judgment debtor. Further Affiant says not. Judgment Creditor/Attorney

, has

Phone Number Signed and sworn to before me on Notary Public: (Seal) (Over) , .

PRAECIPE
To the Clerk of Court: Please issue Summons in Garnishment upon the following garnishee: , at

in the aforementioned entitled case.

Judgment Creditor/Attorney

Phone Number

Address Service by certified mail.

Service by sheriff, constable, or authorized person.

*

Section 25-1558(4)(d), N.R.S.: Head of a family shall mean an individual who actually supports and maintains one or more individuals who are closely connected with him [or her] by blood relationship, relationship by marriage, by adoption, or by guardianship, and whose right to exercise family control and provide for the dependent individuals is based upon some moral or legal obligation.

Restrictions defined in 15 U.S.C., Section 1673(a). See Instructions.

**

Restrictions defined in 15 U.S.C., Section 1673(b). See Instructions.

This form is provided as a public service but should be reviewed by your attorney. Effective January 1, 1994.