IN THE SUPERIOR COURT OF MUSCOGEE COUNTY STATE OF GEORGIA. Phone Number Bar # Civil Action No. SU- - CV-

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Address E-Mail Address Phone Number Bar # Vs Garnishment Court Information: Clerk of Superior Court Muscogee County Address P.O. Box 2145 100 10 th Street Columbus, GA 31902 Garnishee (706) 653-4372 Address SUMMONS OF GARNISHMENT ON A FINANCIAL INSTITUTION DO NOT USE THIS FORM IF THIS IS A CONTINUING GARNISHMENT (SEE O.C.G.A. 18-4-72 and 18-4-78) OR CONTINUING GARNISHMENT FOR CHILD SUPPORT OR ALIMONY (SEE O.C.G.A. 18-4-73 and 18-4-80) Check this box if other allegations are made against a nonjudgment pursuant to O.C.G.A. 18-4-23. Check this box if this is a garnishment for child support or alimony. TO THE ABOVE-NAMED GARNISHEE: Total amount claimed due by the...$ Plus court cost due on this summons...$ Total garnishment claim...$ Court of Judgment Judgment Case No. 1

YOU ARE HEREBY COMMANDED to immediately hold all money, including wages, and other property, except what is known to be exempt, including property in safe-deposit boxes or similar property that you hold, belonging to the named above beginning on the day of service of this summons and including the next five days. You are FURTHER COMMANDED to file your answer, in writing, not sooner than five days and not later than 15 days after the date you were served with this summons, with the Clerk of this Court and serve a copy of your answer upon the or 's Attorney named above and the named above, or the 's Attorney, if known, at the time of making such answer. Your answer shall state what money, including wages, or other property, except what is known to be exempt, belonging to the you hold beginning on the day of service of this summons and including the next five days. Money, including wages, or other property admitted in an answer to be subject to garnishment must be paid or delivered to the Court concurrently with your answer. If, in answering this summons, you state that the property of the includes property in a safe-deposit box or similar property, you shall answer to the Court issuing this summons as to the existence of such safe-deposit box or similar property and shall restrict access to any contents of such safe-deposit box or similar property until further order of such Court regarding the disposition of such contents or 120 days from the date of filing your answer to this summons unless such time has been extended by the Court, whichever is sooner. Should you fail to file a Garnishee Answer as required by this summons, a judgment by default will be rendered against you for the amount remaining due on the judgment as shown in the 's Affidavit of Garnishment. WITNESS the HONORABLE Judge of said Court, This day of, 2016., Clerk, Deputy Clerk 2

VS Garnishee ATTACHMENT FOR SUMMONS OF GARNISHMENT ON A FINANCIAL INSTITUTION Other known names of the : Current and past addresses of the : Social security number or federal tax identification number of the : Account or identification numbers of accounts of the used by the Garnishee: Other allegations pursuant to O.C.G.A. 18-4-23: THIS PLEADING SHALL NOT BE FILED WITH THE COURT 3

Address E-Mail Address Phone Number Bar # Vs Physical Address Garnishment Court Information: Clerk of Superior Court Muscogee County P.O. Box 2145 100 10 th Street Columbus, GA 31902 Garnishee (706) 653-4372 Address AFFIDAVIT OF GARNISHMENT Check if the Garnishee is a financial institution. Check if garnishment is for the collection of child support or alimony. See OCGA. 18-4-50. et seq. Personally appeared (Print Name) who on oath says: 1. I am the Attorney for Agent for. 2. The obtained a judgment against the in Case Number, in the, Court of MUSCOGEE, County, Georgia State, and no agreement requires forbearance from garnishment which is applied for currently. 3. $ is the balance due, which consists of the sum of $ Principal, $ Post Judgment interest, and $ Other (e.g., prejudgment 4

interest, attorney s fees, costs [exclusive of the cost of this action]). 4. Upon the Affiant s personal knowledge or belief, the sum stated herein is unpaid. This. Affiant Sworn to and Subscribed Before Me, This. Notary Public 5

VS Garnishee CERTIFICATE OF SERVICE OF NOTICE TO DEFENDANT OF RIGHT AGAINST GARNISHMENT OF MONEY, INCLUDING WAGES, AND OTHER PROPERTY This is to certify that I have this day served the in the foregoing matter with a copy of the garnishment summons and affidavit, together with Notice to of Right Against Garnishment of Money, Including Wages and Other Property, and a copy of the s Claim Form as required in Georgia Code Annotated, Section 18-4-8(a), by: or depositing in the United States Mail pursuant to OCGA 18-4-8(b)(1)(A) or (C) personal service pursuant to OCGA 18-4-8(b)(1)(B). 2016. This day of, (Agent for) Sworn to and Subscribed Before Me, This day of, 2016. Notary Public 6

Address E-Mail Address Phone Number Bar # Vs Garnishment Court Information: Clerk of Superior Court Muscogee County Address P.O. Box 2145 100 10 th Street Columbus, GA 31902 Garnishee (706) 653-4372 Address NOTICE TO DEFENDANT OF RIGHT AGAINST GARNISHMENT OF MONEY, INCLUDING WAGES, AND OTHER PROPERTY You received this notice because money, including wages, and other property belonging to you have been garnished to pay a court judgment against you. HOWEVER, YOU MAY BE ABLE TO KEEP YOUR MONEY, INCLUDING WAGES, OR OTHER PROPERTY. READ THIS NOTICE CAREFULLY. State and federal law protects some money, including wages, from garnishment even if it is in a bank. Some common exemptions are benefits from social security, supplemental security income, unemployment, workers' compensation, the Veterans' Administration, state pension, retirement funds, and disability income. This list of exemptions does not include all possible exemptions. A more detailed list of exemptions is available at the Clerk of Court's office located at the above address, and on the website for the Attorney General (www.law.ga.gov). Garnishment of your earnings from your employment is limited to the lesser of 25 percent of your disposable earnings for a week or the amount by which your disposable earnings for a week 7

exceed $217.00. More than 25 percent of your disposable earnings may be taken from your earnings for the payment of child support or alimony or if a Chapter 13 bankruptcy allows a higher amount. TO PROTECT YOUR MONEY, INCLUDING WAGES, AND OTHER PROPERTY FROM BEING GARNISHED, YOU MUST: 1. Complete the 's Claim Form as set forth below; and 2. File this completed claim form with the Clerk of Court's office located at the above address. FILE YOUR COMPLETED CLAIM FORM AS SOON AS POSSIBLE. You may lose your right to claim an exemption if you do not file your claim form within 20 days after the Garnishee's Answer is filed or if you do not mail or deliver a copy of your completed claim form to the and the Garnishee at the addresses listed on this notice. The Court will schedule a hearing within ten days from when it receives your claim form. The Court will mail you the time and date of the hearing at the address that you provide on your claim form. You may go to the hearing with or without an attorney. You will need to give the Court documents or other proof that your money is exempt. The Clerk of Court cannot give you legal advice. IF YOU NEED LEGAL ASSISTANCE, YOU SHOULD SEE AN ATTORNEY. If you cannot afford a private attorney, legal services may be available. 8

DEFENDANT'S CLAIM FORM Case No. SU- - CV- I CLAIM EXEMPTION from garnishment. Some of my money or property held by the garnishee is exempt because it is: (check all that apply) 1. Social security benefits. 2. Supplemental security income benefits. 3. Unemployment benefits. 4. Workers' compensation. 5. Veterans' benefits. 6. State pension benefits. 7. Disability income benefits. 8. Money that belongs to a joint account holder. 9. Child support or alimony. 10. Exempt wages, retirement, or pension benefits. 11. Other exemptions as provided by law. Explain: I further state: (check all that apply) 1. The does not have a judgment against me. 2. The amount shown due on the 's Affidavit of Garnishment is incorrect. 3. The 's Affidavit of Garnishment is untrue or legally insufficient. Send the notice of the hearing on my claim to me at: Address: Phone Number: E-mail Address: The statements made in this claim form are true to the best of my knowledge and belief. 's signature,20 Date Print name of CERTIFICATE OF SERVICE 9

This is to certify that I have this day served the or s Attorney and the Garnishee in the foregoing matter with a copy of this pleading by depositing it in the United States Mail in a properly addressed envelope with adequate postage thereon. This day of, 20. or s Attorney 10

VS Garnishee FINANCIAL INSTITUTION GARNISHEE ANSWER 1. At the time of service of the Summons of Garnishment on a Financial Institution and including the next five days, the Garnishee had in its possession the following described money and property of the : 2. $ is the amount herewith paid into court. 3. Check if the is not presently an account holder of the Garnishee. 4. The Garnishee further states: _ Signed _ Garnishee, Garnishee s Attorney, or Officer or Employee of Garnishee 11

CERTIFICATE OF SERVICE This is to certify that I have this day served the or 's Attorney and the or 's Attorney in the foregoing matter with a copy of this pleading by depositing it in the United States Mail in a properly addressed envelope with adequate postage thereon. This day of,. Signed _ Garnishee, Garnishee s Attorney, or Officer or Employee of Garnishee 12

VS Garnishee REQUEST FOR PAYMENT OF FUNDS Now comes the in the above and foregoing case and states that no claim has been filed and no traverse has been filed within 20 days of the funds being delivered by the above Garnishee and request that the funds in the amount of ($ ) paid into the court on and now held by the Court, be paid to _ in accordance with O.C.G.A. 18-4-20(1). x Title _ Address: 13