IN THE MAGISTRATE COURT OF
COUNTY, WEST VIRGINIA
Case No.
Address v. Defendant Judgment Debtor s Social Security No.
Address
Judgment Debtor s Date of Birth
AFFIDAVIT FOR SUGGESTEE EXECUTION
The judgment creditor, , being duly sworn, states that in the above case on , he or she was awarded a money judgment against hereinafter referred to as the judgment debtor, in the amount of $ from the date of judgment at the rate of percent per year, plus $ in costs. with interest
The current unpaid balance of the judgment, with any partial payments applied to reduce accrued interest, then to reduce the judgment principal, is:
Unpaid Principal Unpaid Interest Unpaid Costs Costs of this Execution (if costs awarded in judgment)
$
TOTAL
$
The judgment creditor further states the belief that the judgment debtor is employed by the employer identified below and the weekly disposable income or wages of the judgment debtor exceeds or will exceed 30 times the federal minimum hourly wage. Employer: Employer address:
Signature of Judgment Creditor Taken, subscribed and sworn or affirmed before me this My commission expires on: Signature of Notary/Magistrate Court Clerk
W. Va. Code §§ 38-5A-2 & 3, § 38-5B-2 SCA-M640NP / 10-00
day of