SUGGESTION FOR SUMMONS IN GARNISHMENT ______________________________________________ v. ____________________________________________ Plaintiff's Address _____________________________________________________________________________ Defendant's Address ___________________________________________________________________________ Defendant's Last Four Digits of Social Security No. XXX-XX___________________________________________________ Date of Judgment _________________________________ Date Execution Ordered ________________________ Suggested Garnishee (if defendant's employer, furnish employer's name and state whether it is a corporation or one or more persons trading under a fictitious or trade name) ____________________________________________________________________________________________ Suggested Garnishee's Address ________________________________________________________________ Return Date ______________________________________ Judgment Principal Interest to Return Date Judgment Costs Garnishment Costs Attorney's Fees Credits TOTAL DUE $ __________________ $ __________________ $ __________________ $ __________________ $ __________________ $ __________________ $ __________________ Basis for Judgment: q Support q State Taxes q Other
The exemption set out in ยง 34-29(a) does/does not (strike one) apply to this garnishment. I request the Clerk to summon the Suggested Garnishee to answer this suggestion. I further certify that: q q q (1) The summons is based upon a judgment upon which a prior summons has been issued but not fully satisfied; or (2) No summons has been issued upon this judgment creditor's suggestion against the same judgment debtor within a period of eighteen months, other than a summons which was based upon a judgment upon which a prior summons has been issued but not fully satisfied; or (3) The summons is based upon a judgment granted against a debtor upon a debt due or made for necessary food, rent or shelter, public utilities including telephone service, drugs, or medical care supplied the debtor by the judgment creditor or one of his lawful dependents, and that it was not for luxuries or nonessentials; or (4) The summons is based upon a judgment for a debt due the judgment creditor to refinance a lawful loan made by an authorized lending institution; or (5) The summons is based upon a judgment on an obligation incurred as an endorser or comaker upon a lawful note; or (6) The summons is based upon a judgment for a debt or debts reaffirmed after bankruptcy.
q q q
My authorization to suggest is based on the following: I am the q Plaintiff q Agent for the Plaintiff q Attorney for the Plaintiff
WARNING
Any judgment creditor who knowingly gives false information in a Suggestion for Summons in Garnishment shall be guilty of a Class I misdemeanor.
___________________________________ Date Submitted
________________________________________ Signature of Affiant