Colorado Garnishment

WRIT OF GARNISHMENT WITH NOTICE OF EXEMPTION AND PENDING LEVY

County Court District Court

Court Address:

Plaintiff(s)/Petitioner(s):

v.

Defendant(s)/Respondent(s):

COURT USE ONLY

WRIT OF GARNISHMENT WITH NOTICE OF EXEMPTION AND PENDING LEVY

The Judgment creditor is (check one): a licensed collection agency pursuant to §12-14-101, et. seq., C.R.S.;
represented by an attorney; not represented by an attorney and is not a licensed collection agency pursuant to §12-14-101, et. seq., C.R.S.

Judgment Debtor’s name, last known address, other identifying information:

1. Original Amount of Judgment Entered $

2. Plus any Interest Due on Judgment (currently % per annum) + $

3. Taxable Costs (including estimated cost of service of this Writ) + $

4. Less any Amount Paid - $

5. Principal Balance/Total Amount Due and Owing = $

By checking this box, I am acknowledging I am filling in the blanks and not changing anything else on the form.

By checking this box, I am acknowledging that I have made a change to the original content of this form.

VERIFICATION

I declare under penalty of perjury under the law of Colorado that the foregoing is true and correct and I am authorized to act for the Judgment Creditor.

Printed name of Judgment Creditor

Address City State Zip Code

Executed on the day of , , at

Address City State Zip Code

THE PEOPLE OF THE STATE OF COLORADO to the Sheriff of any Colorado County, or to any person 18 years or older and who is not a party to this action:

You are directed to serve a copy of this Writ of Garnishment upon , Garnishee, with proper return of service to be made to the Court.

TO THE GARNISHEE:

YOU ARE HEREBY SUMMONED AS GARNISHEE IN THIS ACTION AND ORDERED:

a. To answer the following questions under oath and file your answers with the Clerk of the Court within days following service of this Writ upon you.

b. To hold pending court order the personal property of any kind (other than earnings of a natural person) in your possession or control.

QUESTIONS TO BE ANSWERED BY GARNISHEE

Judgment Debtor’s Name: Case Number:

a. On the date and time this Writ was served upon you, did you possess or control any personal property of the Judgment Debtor or did you owe any rents, payments, obligations, debts or moneys other than earnings to the Judgment Debtor?

YES NO

b. If YES, list all items of personal property and their location(s) and/or describe the nature and amount of the debt or obligation:

c. Do you claim any setoff against any property, debt or obligation listed above?

YES NO

d. If you answered YES to question c, describe the nature and amount of the setoff claimed:

VERIFICATION

I declare under penalty of perjury under the law of Colorado that I am authorized to act for the Garnishee and the foregoing is true and correct.

Name of Garnishee (Print)

Executed on the day of , , at

NOTICE TO JUDGMENT DEBTOR OF EXEMPTION AND PENDING LEVY

This Writ with Notice is a Court order which may cause your property or money to be held and taken to pay a judgment entered against you. You have legal rights which may prevent all or part of your money or property from being taken.

PARTIAL LIST OF EXEMPT PROPERTY

1. All or part of your property listed in Sections 13-54-101 and 102, C.R.S., including clothing, jewelry, books, burial sites, household goods, food and fuel, farm animals, seed, tools, equipment and implements, military allowances, stock-in-trade and certain items used in your occupation, bicycles, motor vehicles, life insurance, income tax refunds, money received because of loss of property or for personal injury, equipment that you need because of your health, or money received because you were a victim of a crime.

2. All or part of your earnings under Section 13-54-104, C.R.S.

3. Worker’s compensation benefits under Section 8-42-124, C.R.S.

4. Unemployment compensation benefits under Section 8-80-103, C.R.S.

5. Group life insurance benefits under Section 10-7-205, C.R.S.

6. Health insurance benefits under Section 10-16-212, C.R.S.

7. Fraternal society benefits under Section 10-14-403, C.R.S.

8. Family allowances under Section 15-11-404, C.R.S.

9. Teachers’ retirement fund benefits under Section 22-64-120, C.R.S.

10. Public employees’ retirement benefits (PERA) under Sections 24-51-212 and 24-54-111, C.R.S.

11. Social security benefits (OASDI, SSI) under 42 U.S.C. §407.

12. Railroad employee retirement benefits under 45 U.S.C. §231m.

13. Public assistance benefits (OAP, AFDC, TANF, AND, AB, LEAP) under Section 26-2-131, C.R.S.

14. Police Officer’s and Firefighter’s pension fund payments under Sections 31-30-1117 & 31-30.5-208 and 31-31-203, C.R.S.

15. Utility and security deposits under Section 13-54-102(1)(r), C.R.S.

16. Proceeds of the sale of homestead property under Section 38-41-207, C.R.S.

17. Veteran’s Administration benefits under 38 U.S.C. §5301.

18. Civil service retirement benefits under 5 U.S.C. §8346.

19. Mobile homes and trailers under Section 38-41-201.6, C.R.S.

20. Certain retirement and pension funds and benefits under Section 13-54-102(1)(s), C.R.S.

21. A Court-ordered child support or maintenance obligation or payment under Section 13-54-102(1)(u), C.R.S.

22. Public or private disability benefits under Section 13-54-102(1)(v), C.R.S.

If the money or property which is being withheld from you includes any “exempt property,” you must file within 14 days of receiving this notice a written Claim of Exemption with the Clerk of the Court.