Reserved for Court Use Civil No. Defendant(s) Filing Party/Attorney Name, Attorney Number (if applicable), Address, Telephone and Fax Numbers
Garnishee(s) Name(s) and Address(es):
NOTICE TO RECIPIENTS OF TEMPORARY AID TO NEEDY FAMILIES - FEDERAL AND STATE [TANF] A judgment has been entered against you which says that you owe $ _______________________________________________________ to _________________________________________________________________________________________ (Judgment Creditor). Because of that judgment, this Court has ordered _______________________________________________________________________ ____________________________________________________________________________________________________ (Garnishee) to pay money from your checking and/or savings account to Judgment Creditor. But, if any money in this account is payments from the Welfare Department under the Temporary Aid to Needy Families - Federal and State [TANF] Program, you can have this Order canceled or changed. Your creditors cannot take any money you received under the TANF Program. If the money in your checking and/or savings account with the Garnishee named above was received by you under the TANF Program, you may wish to consult an attorney. NOTICE OF FUNDS EXEMPT FROM GARNISHMENT UNDER LAW Your creditors cannot garnish funds you receive as unemployment or workers' compensation benefits or social security payments or pension and retirement plans. If the money in your checking and/or savings account with the Garnishee named above is from any of these sources, you can stop garnishment of the funds in your account. You should contact your own attorney to advise and/or represent you, or you can contact the Judgment Creditor to find out when this matter is set for a court hearing so that you can appear at that hearing to explain to the Judge that some or all of the funds are exempt from garnishment. Signature of Filing Party/Attorney:
Date:
Print/Type Name:
In accordance with state and federal disability laws, if you require an accommodation for a disability when working with a court program, service, or activity, please contact the District Court Administration Office at PHONE NO. 538-5121, FAX 538-5233, or TTY 539-4853 at least ten (10) working days before your proceeding, hearing, or appointment date.
For all Civil related matters, please call 538-5151 or visit the District Court Service Center at 1111 Alakea Street, Third (3rd) Floor.
(Rev. 31 M ay 2006)
1D-P-764
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Form#1D C01
Reprographics (2/07)
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