Fill and Sign the Nonearning Disclosure Minnesota Form

STATE OF MINNESOTA IN COUNTY COURT COUNTY OF             JUDICIAL DISTRICT FAMILY COURT DIVISION In Re the Marriage of: Court File No.             , Petitioner, NONEARNING AND DISCLOSURE       , Respondent/Judgment Debtor,       , Law Offices, LTD. Judgment Creditor. On the _____ day of _____________ , 20 ___ , the time of service of garnishment summons herein, there was due and owing the debtor from the garnishee the following: (1) Money . Enter on the line below any amounts due and owing the debtor, except earnings, from the garnishee. __________________________________________________________________ (2) Property . Describe on the line below any personal property, instruments, or papers belonging to the debtor and in the possession of the garnishee. __________________________________________________________________ (3) Setoff . Enter on the line below the amount of any setoff, defense, lien, or claim which the garnishee claims against the amount set forth on lines (1) and (2) above. State the facts by which the setoff, defense, lien, or claim is claimed. (Any indebtedness to a garnishee incurred by the debtor within the ten days before the receipt of the first garnishment on a debt may not be set off against amounts otherwise subject to the garnishment.) __________________________________________________________________ (4) Exemption . Enter on the line below any amounts claimed by other persons by reason of - 1 - ownership or interest in the debtor's property. __________________________________________________________________ (5) Adverse Interest . Enter on the line below any amounts claimed by other persons by reason of ownership or interest in the debtor's property. __________________________________________________________________ (6) Enter on the line below the total of lines (3), (4), and (5). __________________________________________________________________ (7) Enter on the line below the difference obtained (never less than zero) when line (6) is subtracted from the sum of lines (1) and (2). __________________________________________________________________ (8) Enter on the line below 110 percent of the amount of the creditor's claim which remains unpaid. __________________________________________________________________ (9) Enter on the line below the lesser of line (7) and (8). Retain this amount only if it is $10 or more. __________________________________________________________________ AFFIRMATION I, _________________________ , ( person signing Affirmation) am the garnishee or I am authorized by the garnishee to complete this nonearnings garnishment disclosure, and have done so truthfully and to the best of my knowledge. DATED: __________________ _________________________ (Signature) - 2 - _________________________ (Title) _________________________ Telephone Number - 3 -