Reserved for Court Use Defendant(s) Civil No. Filing Party/Attorney Name, Attorney Number (if applicable), Address, Telephone and Fax Numbers
Garnishee(s) (Name and Address)
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/savings account(s) to Judgment Creditor. But, if any money in this account is payment 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. 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/savings account(s) with the Garnishee named above is from any of these sources, you can stop garnishment of the funds in your account(s). 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. 244-2800, FAX 244-2849, or TTY 244-2865 at least ten (10) working days before your proceeding, hearing, or appointment date.
For all Civil related matters, please call 244-2706 or visit the Service Center at 2145 Main Street, Rm. 141A, Wailuku, HI 96793
(Rev. 1 December 2006)
2D-P-214
Clear form
Reprographics (12/06)
Form#2DC01
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