STATE OF MAINE DISTRICT COURT Location Docket No.
Judgment Creditor v. MOTION AND AFFIDAVIT FOR ORDER TO WITHHOLD AND DELIVER
Judgment Debtor
The undersigned Judgment Creditor moves the Court to issue an Order to Withhold and Answer pursuant to 14 M.R.S.A., ยง 3127-B to be served on , for the following reason(s): The above-named Judgment Debtor has failed to timely make two or more payments required by this Court's installment order dated that the judgment debtor pay per . The above-named Judgment Debtor failed to appear before this Court on as ordered to do so by a disclosure subpoena or a notice of disclosure hearing. The judgment debtor currently owes the judgment creditor (plus interest of ) plus costs of .
, for a total of
Judgment Creditor
Personally appeared the above-named and made oath that the foregoing statements are true.
Date: Notary Public / Attorney at Law
MJ-009, Rev. 02/99