Fill and Sign the Order Interrogatories Form

 Small Claims Court ▲COURT USE ONLY▲_______________________________ County, Colorado Court Address: PLAINTIFF(S): Address: City/State/Zip: Phone (Home/Work): DEFENDANT(S): Case Number: Division CourtroomAddress: City/State/Zip: Phone (Home/Work): MOTION AND ORDER FOR INTERROGATORIES The judgment creditor, ____________________________________________________, requests this court to issue an order requiring the judgment debtor, ___________________________________________________________, to answer completely all of the INTERROGATORIES attached within ten (10) days after receipt, because: 1. On (date )_________________________, judgment was entered in favor of the ___________________________. and against the ________________________________________________ in the amount of $ ________________, with court costs in the amount of $ _____________________, for a total award of $ _________________________; 2. There remains due on this judgment the amount of $ ____________________, interest to date of $ __________________, additional costs of $ _______________________, for a balance of $ __________________; 3. Execution may presently issue on this judgment; and 4. Pursuant to Rules 517 and 518, C.R.C.P., the judgment creditor is entitled to an order requiring the judgment debtor to appear and answer these interrogatories concerning the debtor’s financial condition. DATE: _________________________________ ________________________________________ Judgment Creditor Subscribed under oath before me on: DATE: _________________________________ ________________________________________ Clerk/Deputy IT IS ORDERED: 1. That the judgment debtor, ________________________________________________________, APPEAR and ANSWER completely all of the INTERROGATORIES attached, pursuant to Rules 517 and 518 C.R.C.P.. 2. That these INTERROGATORIES be signed by the judgment debtor in full legal name, under penalty of perjury, in the presence of a notary public or clerk of court. 3. That these INTERROGATORIES be filed with the Clerk, and that the judgment debtor appear on (date and time) ___________________________________ at (location) ____________________________________________________. 4. That service of these INTERROGATORIES and this order be made by mailing copies to the judgment debtor, by certified mail, or as provided by Rule 304, C.R.C.P.. DATE: ___________________________________ ________________________________________ Judge/Magistrate I certify that a copy of this form and interrogatories were mailed to the judgment debtor on: DATE: ___________________________________ ________________________________________ Clerk/Deputy JDF 252 R7/00 MOTION AND ORDER FOR INTERROGATORIES 1 INTERROGATORIES TO JUDGMENT DEBTOR Name of Judgment Debtor: ________________________________________________________________ THESE INTERROGATORIES MUST BE COMPLETELY ANSWERED AND FILED WITH THE CLERK OF THE _____________________________________ COUNTY COURT AT THE ADDRESS BELOW ON (DATE AND TIME) _______________________________. YOU MUST APPEAR ON THIS DATE. COURT ADDRESS: ____________________________________________________________________________________ WARNING : FAILURE TO TRUTHFULLY AND COMPLETELY ANSWER ALL OF THESE QUESTIONS AND RETURN THEM WITHIN TEN (10) DAYS TO THE CLERK OF COUNTY COURT, SMALL CLAIMS DIVISION, SHALL CAUSE A CITATION TO BE ISSUED FOR CONTEMPT OF COURT. A FINDING OF CONTEMPT MAY BE CAUSE FOR A FINE OR JAIL SENTENCE. NOTE : YOU MAY PAY $__________________ (THE AMOUNT OF THE JUDGMENT TOGETHER WITH ANY INTEREST AND COSTS) TO THE CLERK OF THE COURT WITHIN TEN (10) DAYS INSTEAD OF ANSWERING THESE QUESTIONS. IF YOU MAKE THE PAYMENT, THIS CASE WILL BE CLOSED. 1. State your full and correct name and any business or trade names. 2. State your full and correct business address. a. Do you rent or own the premises? b. State the full and correct name and address of your landlord. c. On what day of the month do you pay your rent? d. What is the amount of the deposit with your landlord? 3. State your full and correct home address. a. Do you own or rent the premises? b. State the full and correct name and address of your landlord. c. On what day of the month do you pay your rent? d. What is the amount of the deposit with your landlord? 4. State the full and correct address of all real estate you own or have an interest in. 5. State the book and page number and other recording numbers of the deed or other instruments of such property. 6. Are there any liens, mortgages, or encumbrances against any of the property referred to in No. 4? If so, give the full and correct name and address of the creditor of, and balance due on each. 7. What do you do for a living and by whom are you employed? Give your employer’s full and correct name and address. a. How much are you paid? Indicate whether full or part-time. b. On what days of the month are you paid? c. By whom are you paid? d. If you are paid on a commission basis, on what days of the month are you paid? JDF 252 R7/00 MOTION AND ORDER FOR INTERROGATORIES 2 8. If self-employed, do you own or have any interest in any inventory, supplies, machinery, equipment, or tools? If so, list each of them and whether they are paid for. If you owe money for any item, indicate how much for each item. 9. List the full and correct name and address of all banks and savings institutions you have: a. Savings account: Account No.: b. Checking account Account No.: 10. Do you have any life, health, or other insurance with a cash surrender value or from which money is or will be due to you? If so, state the name and number of the policy and full and correct name and address of the insuring company. 11. Have you received any money judgments from any court within the past twelve (12) months? If so, state the nature of the action and the amount and date received. Also state the case number and the court. 12. Are you entitled to any refund on either or both of your last federal or Colorado state income tax returns? a. If so, what is the amount of the refund on each? b. Have you received any of this money as of this date? 13. State the description, amount, and location of any and all stocks, bonds, U.S. Savings Bonds, debentures, or other securities which you own or in which you have an interest. 14. State the amount and location of any cash you have on hand. 15. List and describe any and all automobiles, trucks or other motor vehicles owned by you, or vehicles in which you have an interest. a. Are any of these vehicles used daily in your work? If so, identify b. What is the value of each? c. Are any of these vehicles mortgaged? If so, state for what amount and the full and correct name and address of the mortgagee. 16. List and describe any and all livestock and crops you own or have an interest in, giving the location and present market value of each. 17. State the amount, description, and location of any and all other personal property you own or have an interest in, including household furniture and fixtures, motorcycles, boats, photographic and electronic equipment, jewelry, and any other moveable property. If any of this property is mortgaged, state for what amount and the full and correct name and address of the mortgagee(s). (Use last page if necessary.) 18. State the full and correct name and address of any and all persons, firms, and/or corporations to whom you owe any money. 19. List and describe any and all rents, notes receivable, and accounts receivable, on open account or otherwise, due or payable to you or in which you have an interest. 20. For each item listed in No. 19, state the full and correct name and address of the debtor and the amount due as of this date. 21. State the full and correct address of the location of your financial books and records and, if you employ the services of a bookkeeper or accountant, the full correct name and address of such person. 22. What is the amount of your deposit with any utility company (gas, electric, water and sewer)? 23. What is the amount of your deposit with any telephone company? JDF 252 R7/00 MOTION AND ORDER FOR INTERROGATORIES 3 24. For a period of one full year prior to the commencement of this legal action against you until the present, have you or your agents or employees, if any, closed out any savings, commercial, or other financial account which was in your name, individually or together with other people or business, in any bank or other financial institution? If so, for each of such closed accounts, state: a. The full and correct name and address of the bank or institution. b. The names on the account. c. The account number. d. The date on which the account was opened. e. The date on which the account was closed. 25. Supply a copy of your last federal income tax return. I affirm/swear under the penalty of perjury that the above answers to these INTERROGATORIES are true, complete, and correct. PERJURY IS A FALSE STATEMENT AND A PERSON WHO COMMITS PERJURY IS GUILTY OF A FELONY. _____________________________________________ Judgment Debtor Subscribed under oath before me on (date): ___________________________________ ____________________________________________ Notary Public/Deputy Clerk My commission expires: ____________________ JDF 252 R7/00 MOTION AND ORDER FOR INTERROGATORIES 4