Free Garnishee by Affidavit - Hawaii

AFFIDAVIT OF JUDGMENT CREDITOR(S) FOR GARNISHMENT OF WAGES; EXHIBIT(S); NOTICE TO EMPLOYER OF JUDGMENT DEBTOR; GARNISHEE INFORMATION IN THE DISTRICT COURT OF THE THIRD CIRCUIT ______________________________ DIVISION STATE OF HAWAI`I
Plaintiff(s)

TWO-SIDED FORM Form #3DC25

Defendant(s)

Reserved for Court Use

Civil No. Filing Party(ies)/Filing Party(ies)' Attorney (Name, Attorney Number, Firm Name (if applicable), Address, Telephone and Facsimile Numbers) Garnishee (Name and Address)

Certified copy of the Judgment attached as Exhibit A Current Amount Due: (If this amount is different from Judgment Amount, please attach separate sheet showing calculations as Exhibit B) Judgment Debtor(s): Current Place of Employment:

AFFIDAVIT OF JUDGMENT CREDITOR(S) FOR GARNISHMENT OF WAGES
STATE OF ) ) ) SS.

Affiant, being first duly sworn on oath, deposes and says: 1. I am the Judgment Creditor(s) or Judgment Creditor(s)' attorney; (continued on reverse side)
GARNAFFJ.2XX (Amended 4/18/97)v
3D-P-276

SEE REVERSE SIDE

SEE FEDERAL WAGE GARNISHMENT LAW FOR APPLICABLE RESTRICTIONS.
(Attached form entitled "Garnishee Information")

Reprographics (11/06)

AFFIDAVIT OF JUDGMENT CREDITOR(S) (continued)
2. The Judgment (a certified copy of which is attached as Exhibit A) was entered on the date shown on said Judgment for Judgment Creditor(s) and against Judgment Debtor(s). There is still due and owing the sum of G as shown in the certified copy of the Judgment attached as Exhibit A or G Current Amount Due as evidenced by attached Exhibit B; The Judgment has not been appealed (or if appealed, no bond has been filed), reversed, modified, set aside or satisfied except as aforesaid and otherwise remains in full force and effect; and The Judgment Creditor(s) is still the owner and holder of said Judgment. Judgment Debtor(s) above named is presently believed to be employed at the Current Place of Employment listed on the reverse side. The Judgment has been in effect for at least 10 days.

3.

4. 5. 6. 7.

Subscribed and sworn to before me this day of

Signature of Affiant: , 20 .

Notary Public, State of My commission expires: Print/Type Name:

NOTICE TO EMPLOYER OF JUDGMENT DEBTOR
The applicable law found in Hawai`i Revised Statutes §652-1(b) provides as follows: ". . . the employer shall thereupon either file a disclosure within one week or shall withhold from the wages of the judgment debtor the amounts as [provided by this law] and pay the same to the judgment creditor." If you file a disclosure, send it to G 75 Aupuni Street, Room 205, Hilo, Hawai`i 96720 G 79-1020 Haukapila Street, Kealakekua, Hawai`i 96750 G 67-5187 Kamamalu Street, Kamuela, Hawai`i 96743 In accordance with the Americans with Disabilities Act if you require an accommodation or assistance, please contact the ADA Coordinator at PHONE NO. 934-5788, FAX 935-1959, or TTY 961-7525 at least ten (10) working days in advance of your hearing or appointment date.
3D-P-276

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