STATE OF GEORGIA Plaintiff: )

__________________________________ )

Name)

Plaintiff's contact information: )

__________________________________)

Name )

__________________________________) Civil Action File No.

Street Address )

__________________________________ ) ________________________

City State ZIP Code )

__________________________________ )

E-mail Address )

__________________________________)

Phone Number )

__________________________________)

Bar Number )

v. )

Defendant: )

__________________________________ )

Name )

__________________________________ )

Street Address )

__________________________________ )

City State ZIP Code )

Garnishee: )

__________________________________ )

Name )

__________________________________ )

Street Address )

__________________________________ )

City State ZIP Code )

AFFIDAVIT OF CONTINUING GARNISHMENT DO NOT USE THIS FORM FOR A CONTINUING GARNISHMENT

FOR CHILD SUPPORT OR ALIMONY. SEE O.C.G.A. § 18-4-73.

Personally appeared __________________, who on oath says:

(Print name)

1. I am the (Plaintiff) (Attorney at Law for Plaintiff) (Agent for Plaintiff). [Circle one]

2. The Plaintiff obtained a judgment against the Defendant in Case Number ____________ in the ______________ Court of ______________ County, __________________, and noagreement

State

requires forbearance from the garnishment which is applied for currently.

3. $______________ is the balance due, which consists of the sum of $____________ Principal, $____________ Postjudgment interest, and $____________ Other (e.g., prejudgment interest, attorney's fees, costs [exclusive of the cost of this action]).

4. Upon the Affiant's personal knowledge or belief, the sum stated herein is unpaid.

5. The Affiant believes that the Garnishee is an employer of the Defendant.

This __________ day of __________________, 20____.

_______________________________________________________________________________

Affiant

_______________________________________________________________________________

Print name of Affiant

Sworn to and subscribed before me this __________ day

of __________________, 20____.

________________________________________________

Notary Public or Deputy Clerk of Court"

(Code 1981, §18-4-72, enacted by Ga. L. 2016, p. 8, § 1/SB 255.)