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Plaintiff
V. Civil Action File No.
Defendant
St A Sa a a Sa a Sa a
Garnishee
To:
Garnishee
This is to notify you that the undersigned Plaintiff and Defendant have agreed to a modification of the above-styled garnishment action. Upon receipt of service of a legible copy of this document, stamped by the garnishment court, with the signatures of both Plaintiff and Defendant affixed and fully notarized, the Summons of Garnishment served upon you in this action is superseded as follows: you are commanded instead to make the following deduction from all obligations owed to the Defendant during the remaining garnishment period of the abovestyled garnishment action:
1) The sum of $ per week/two weeks/month/paycheck (circle one);
2) % of the disposable income of Defendant; or
3) ______% of the gross amount due the Defendant for
__s (state payment basis, e.g., invoice, monthly draw, all goods and services, etc.).
You are authorized and instructed to deliver such amount(s) to Plaintiff directly, by any electronic or other mechanism provided to you by Plaintiff if acceptable to you, or payable and addressed to:
(Plaintiff or attorney/firm name) (Plaintiff or attorney street address) (Plaintiff or attorney city, state, ZIP Code)
This Modification does not terminate the garnishment action, nor does it relieve you of the obligation to file answers of garnishment with the garnishment court and to serve such answers on the Plaintiff and Defendant within the times and in the manner prescribed by law.
This Modification is effective only upon service on you of a file-stamped copy of same.
Agreed to by: Sign: Sign: Print: Print: Title (if any) Title (if any) Plaintiff Defendant or Representative/ Attorney Executed before me by i Executed before me by , this day of ____, 20 ____ this ______—s day of , 20 Notary Public/Clerk Notary Public/Clerk”