Fill and Sign the Financial Institution Garnishee Form

JGM403 State ENG Rev 7/15 www.mncourts.gov/forms Page 1 of 2 State of Minnesota District Court County Judicial District: Court File Number: Case Type: Civil Creditor Creditor’s Notice of Objection And vs Notice of Hearing on Exemption Claim (Minn. Stat. §§550.143, subd. 7; 551.05, subd. 5; 571.914, subd. 2) Debtor Financial Institution / Garnishee ______________________________________________________________________________________ ________________ Debtor Name: Debtor Address: NOTICE OF HEARING The Cred itor objects to your exemption claim. The hearing is to resolve your exemption claim. Hearing Date: Time: Hearing Place: The Creditor objects to your claim of exemption from (levy of execution / garnishment ) for the following reason(s): Note: Bring with you to the hearing all documents and materials supporting your exemption claim. Failure to do so could delay the court’s decision. If the Creditor receives all documen ts and materials supporting your exemption claim before the hearing date, the Creditor may agree with your exemption claim and you might be able to avoid a hearing. JGM403 State ENG Rev 7/15 www.mncourts.gov/forms Page 2 of 2 Because a court hearing will be held on your claim that your funds are protected , your fi nancial institution will retain the funds until it receives an order from the court or upon mutual agreement between you and your Creditor . Dated: Signature of Creditor or Creditor’s Attorney Name: Address: City/ State/Zip: Telephone: ( ) E-mail address: