Fill and Sign the Colorado Garnishment 497300127 Form

 County Court  District Court ___________________________ County, Colorado Court Address: Plaintiff(s)/Petitioner(s): v. Defendant(s)/Respondent(s): COURT USE ONLY Judgment Creditor’s Attorney or Judgment Creditor (Name and Address): Phone Number: E-mail: FAX Number: Atty. Reg. #: Case Number: Division Courtroom 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; or  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 ___________________________(date) $ ___________________ 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 ______________________________________________ (date) (month) (year) (city or other location, and state OR country _________________________________________ _______________________________________________________ Printed name of Authorized Party Signature of Authorized Party (Title,and Phone No.) ____________________________________________________________________________________________________ Address City State Zip Code FORM 29SC R8/18 WRIT OF GARNISHMENT WITH NOTICE OF EXEMPTION AND PENDING LEVY Page 1 of 3 WRIT OF GARNISHMENT WITH NOTICE OF EXEMPTION AND PENDING LEVY 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 (AND to mail a completed copy with your answers to the Judgment Creditor or attorney when a stamped envelope is attached) within 14 days following service of this Writ upon you. YOUR FAILURE TO ANSWER THIS WRIT WITH NOTICE MAY RESULT IN THE ENTRY OF A DEFAULT AGAINST 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, including the debts, credits, choses in action or money owed to the Judgment Debtor whether they are due at the time of the service of the writ or are to become due thereafter. YOU ARE NOTIFIED : a. T his Writ with Notice applies to all personal property (other than earnings) owed to or owned by the Judgment Debtor and in your possession or control as of the date and time this Writ was served upon you. b. In no case may you withhold any personal property greater than the amount on Line 5 on the front of this Writ unless the personal property is incapable of being divided. c. After you file your answers to the following questions, and after receiving a separate notice or order from the court, MAKE CHECKS PAYABLE AND MAIL TO:  the Judgment Creditor named above (May select only if the Judgment Creditor is a licensed collection agency pursuant to 12-14-101, et. seq., C.R.S.);  the Judgment Creditor’s Attorney (if applicable); or to the  Clerk of the County Court or District Court in ______________________ (city), Colorado (Must select if the Judgment Creditor is not represented by an attorney AND is not a licensed collection agency pursuant to 12- 14-101, et. seq., C.R.S.) at the address below: Name: __________________________________________________________________________________________ Address: ________________________________________________________________________________________ PLEASE PUT THE CASE NUMBER (above) ON THE FRONT OF THE CHECK. CLERK OF THE COURT By Deputy Clerk: ___________________________________ Date: _____________________________________________ QUESTIONS TO BE ANSWERED BY GARNISHEE Judgment Debtor’s Name: ___________________________________ Case Number: ___________________ T he following questions MUST be answered by you under oath: 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: (Attach additional pages if necessary): _________________________________________________________ _______________________________________________________________________________________________ c . Do you claim any setoff against any property, debt or obligation listed above?  YES  NO d. I f you answered YES to question c, describe the nature and amount of the setoff claimed: (Attach additional pages if necessary): _______________________________________________________________ ______________________________________________________________________________________________ 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 ________________________________________________ (date) (month) (year) (city or other location, and state OR country __________________________________________ ________________________________________________ (Printed name of Person Answering) Signature of Person Answering NOTICE TO JUDGMENT DEBTOR OF EXEMPTION AND PENDING LEVY FORM 29SC R8/18 WRIT OF GARNISHMENT WITH NOTICE OF EXEMPTION AND PENDING LEVY Page 2 of 3 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. That part of the money or property which may not be taken is called “exempt property”. A partial list of “exempt property” is shown below, along with the law which may make all or part of your money or property exempt. The purpose of this notice is to tell you about these rights. 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 (greater for disabled persons), life insurance, income tax refunds, attributed to an earned income tax credit or child tax credit, 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 describing what money or property you think is “exempt property” and the reason that it is exempt. YOU MUST USE THE APPROVED FORM attached to this Writ or a copy of it. When you file the claim, you must immediately deliver, by certified mail, return receipt requested, a copy of your claim to the Garnishee (person/place that was garnished) and to the Judgment Creditor’s attorney, or if none, to the Judgment Creditor at the address shown on this Writ with Notice. Notwithstanding your right to claim the property as “exempt,” no exemption other than the exemptions set forth in Section 13-54-104(3), C.R.S., may be claimed for a Writ which is the result of a judgment taken for arrearages for child support or for child support debt. Once you have properly filed your claim, the court will schedule a hearing within 14 days. The Clerk of the Court will notify you and the Judgment Creditor or attorney of the date and time of the hearing, by telephone, by mail or in person. When you come to your hearing, you should be ready to explain why you believe your money or property is “exempt property”. If you do not appear at the scheduled time, your money or property may be taken by the Court to pay the judgment entered against you. REMEMBER THAT THIS IS ONLY A PARTIAL LIST OF “EXEMPT PROPERTY”; you may wish to consult with a lawyer who can advise you of your rights. If you cannot afford one, there are listings of legal assistance and legal aid offices in the yellow pages of the telephone book. You must act quickly to protect your rights. Remember, you only have 14 days after receiving this notice to file your claim of exemption with the Clerk of the Court. FORM 29SC R8/18 WRIT OF GARNISHMENT WITH NOTICE OF EXEMPTION AND PENDING LEVY Page 3 of 3