Fill and Sign the Creditors Garnishment Report Earnings Form

PLAINTIFF/CREDITOR:DEFENDANT/JUDGMENT DEBTORStreet: ____________________________________ Street: ____________________________________City/State/Zip: _____________________________ City/State/Zip: _____________________________Phone: ___________________________________ Phone: ___________________________________GARNISHEE: ATTORNEY OR REPRESENTATIVE:Street: ____________________________________ Street: ____________________________________City/State/Zip: _____________________________ City/State/Zip: _____________________________Phone:___________________________________ Phone: ___________________________________CASE NUMBER: _____________________________________________ CREDITOR'S GARNISHMENT REPORT (EARNINGS) Instructions: Creditor is required to complete this report and send it to the judgment debtor and garnishee within 21 days after the end of each calendar quarter and when the balance due is less than double the amount of nonexempt earnings received in the last two pay periods. Creditor should also issue a report within 21 days after the balance is reduced to $500.00 or less and, after that, before the 10th of each month as long as the Order of Continuing Lien is in effect.1. This report covers the period from _______________________ to ___________________________.2. I received these payments during this period (ATTACH A LIST IF NECESSARY) DATE AMOUNT_____________________________________ 3.Judgment balance at beginning of period ….................................................... $____________________4.Total credited to the judgment balance ............................................................ $____________________ 5.Interest accrued during this period ................................................................... $____________________6.Total outstanding balance on the judgment ...................................................... $____________________ FILED BY: ______________________________________________________________FIRM: __________________________________________________________________BAR NUMBER (IF APPLICABLE): __________________________________________ADDRESS: ______________________________________________________________PHONE: _________________________________________________________________REPRESENTING: _________________________________________________________ CREDITOR'S GARNISHMENT REPORT (EARNINGS) 7.The following statements apply if checked: [ ] Balance due is $500.00 or less.[ ] Balance due is less than double the amount received it the last two pay periods.[ ] Garnishee should stop withholding earnings. DELIVERED TO JUDGMENT DEBTOR DELIVERED TO CREDITORDATE:____________________________________ DATE:____________________________________ TIME: ____________________________________ TIME: ____________________________________ [ ] MAIL [ ] PERSONAL SERVICE [ ] MAIL[ ] PERSONAL SERVICEDate: ______________________________ ____________________________________________ Creditor