Payment To Avoid Garnishment Form

Download a blank fillable Payment To Avoid Garnishment Form in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Payment To Avoid Garnishment Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

PAYMENT TO AVOID GARNISHMENT
To: __________________________________________________________
Date of Mailing:____________________________
(
Name of Judgment Creditor)
______CV
___________________________________________________________
CASE NO. __
___-___________________
(Address of Judgment Creditor)
___________________________________________________________
CLEVELAND MUNICIPAL COURT
City
State
Zip Code
To avoid garnishment of PERSONAL EARNINGS of which you have given me notice I enclose $____________________
to apply toward my indebtedness to you. The amount of the payment was computed as follows:
1.
Total amount of indebtedness demanded…………………………………………………. 1. $__________________________
2.
Enter the amount of your personal earnings after deductions required by law earned by you
during the current pay period (that is, the pay period in which this demand is received by
you)……………………………………………………………………………………….. 2. $__________________________
Enter your pay period (weekly, bi-weekly, semi-monthly, monthly):…………………
3(A). _________________________
3(A).
3(B). _______________________
3(B). Enter the date when your present pay period ends:……………………………………………..
4.
Enter an amount equal to 25% of the amount on line (2):……………………………….. 4. $__________________________
5(A). The current federal minimum hourly wage is $________________________(to be filled in by Judgment Creditor).
(You should use the above figure to complete this portion of the form). If you are paid weekly, enter thirty (30) times the
current federal minimum hourly wage; if paid bi-weekly enter sixty (60) times the current federal minimum hourly wage; if
paid semimonthly, enter sixty-five (65) times the current federal minimum hourly wage; if paid monthly, enter one hundred
thirty (130) times the current federal minimum hourly wage…………………………. 5(A). $________________________
5(B). Enter the amount by which the amount online (2) exceeds the amount on
line 5(A)……………………………………………………………………………….
5 (B). $________________________
6.
Enter the smallest of the amounts on lines 1, 4 or 5(B). Send this amount to the
judgment creditor along with this form after you have signed it………………………. 6.
$_______________________
I CERTIFY THAT THE STATEMENTS CONTAINED ABOVE
ARE TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF: X___________________________________________
(Signature of Judgment Debtor)
_________________________________________________
_____________________________________________________
City
State
Zip Code
(Print name and RESIDENCE address of Judgment Debtor)
(To verify that the amount shown on line (2) is a true statement of your earnings, you must either have your employer certify below that the amount
shown on line (2) is a true statement of your earnings or you may submit copies of your pay stubs for the two pay periods immediately prior to your
receiving this notice.)
I CERTIFY THAT THE AMOUNT SHOWN ON LINE (2) IS A TRUE STATEMENT OF THE JUDGMENT DEBTOR’S EARNINGS:
______________________________________________
_____________________________________________
(
(Name of person Certifying this document)
Print Name of Employee)
___________________________________________________
__________________________________________________
(TITLE of person Certifying this document)
(Address of Employer or Agent)
__________________________
_________________
X___________________________________________
City
State
Zip Code
(area code)(phone number)
(Signature of Employer or Agent)
I CERTIFY THAT I HAVE ATTACHED COPIES OF MY PAY STUBS FOR THE TWO PAY PERIODS IMMEDIATELY PRIOR TO MY
RECEIVING THIS NOTICE.
X______________________________________________
(Signature of Judgment Debtor)
Garn Form -Payment to Avoid garnishment (O.R.C. 2716.02)

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Legal
Go