Free Garnishee by Affidavit - Hawaii

DECLARATION OF JUDGMENT CREDITOR FOR GARNISHMENT OF W AGES; EXHIBIT(S); NOTICE TO EMPLOYER OF JUDGMENT DEBTOR; GARNISHEE INFORMATION IN THE DISTRICT COURT OF THE FIFTH CIRCUIT STATE OF HAW AI`I Plaintiff(s)

Reserved for Court use

Civil No.:

Defendant(s)

Filing Party/Attorney Name, Attorney number, Address, Telephone, and Fax numbers

Garnishee (Name and Address)

Certified copy of the Judgment attached as Exhibit Current Amount Due: $_______________________
(If this amount is different from the Judgment Amount, please attach separate sheet showing calculations as Exhibit B

Judgment Debtor(s):

Current Place of Employment:

DECLARATION 1. I am the Judgment Creditor of Judgment Creditor's Attorney; 2. Judgment(a copy of which is attached as Exhibit A) was entered on the date shown on the Judgment for Judgment Creditor and against Judgment Debtor(s); 3. There is still due and owing [ as evidenced by Exhibit B; ] the Judgment amount shown in Exhibit A or [ ] the Current Amount Due

4. The Judgment has not been appealed (or if appealed, no bond has been filed), reversed, modified, set aside or satisfied except as stated above, and otherwise remains in full force and effect; 5. The Judgment Creditor is still the owner and holder of the Judgment; 6. 7. Judgment Debtor is presently believed to be employed at the Current Place of Employment listed above; and The Judgment has been in effect for at least 10 days.
I DECLARE UNDER PENALTY OF LAW THAT EVERYTHING IN THIS DECLARATION IS TRUE AND CORRECT.

Signature of Declarant: Date:
Reprographics (06/07) 5DC

Print/Type Name:
5D-P-187

CLEAR FORM

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Declaration of Judgment Creditors - Garnishment of Wages Form #DC25

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." Prior to making the final payment, you should contact the Judgment Creditor or the Judgment Creditor's attorney to obtain the final payoff amount, that may include additional interest as allowed by law. If you file a disclosure, send it to: District Court of the Fifth Circuit Small Claims Division 3970 Ka`ana Street, Suite 207 Lihu`e, Hawai`i 96766

For additional information, please refer to Garnishee Information (Form #DC27)
In accordance with state and federal disability laws, if you require an accommodation for a disability when working with a court program, service, or activity, please contact the Administration office at PHONE NO. 482-2347, FAX 482-2309, OR TTY 482-2533 at least ten(10) working days before your proceeding, hearing, or appointment date. FOR ALL CIVIL RELATED M ATTERS, PLEASE CALL 482-2303 OR VISIT DISTRICT COURT, SM ALL CLAIM S DIVISION AT 3970 KA`ANA STREET, LIHU`E, HAW AI`I.
Reprographics (06/07) 5DC 5D-P-187

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