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 FOR SUPPORT Personally appeared _______________________________________________________, who on oathsays:

(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. The Affiant states that the Defendant is in arrears on the obligation for support in an amount equal to or in excess of one month's obligation as decreed in the judgment for support and provides the following information:

$______________ is the amount of arrearage which exists under the judgment as of the execution of this affidavit.

Check one of the boxes below and complete the requested information:

A. [] Periodic support is owed for one obligee, or the judgment sets forth a total amount of periodic support for multiple obligees as follows:

$____________ is the total amount of periodic support duefor

____________________________, ____________________________,and

Name of obligee Name of obligee

____________________________. Such periodic support ispayable

Name of obligee

on a ________________________ basis.

E.g., weekly, monthly

The termination date of the obligation for periodic support is ______________.

Date

B. [] Periodic support is owed for multiple obligees, and the judgment sets forth a different amount of periodic support for each obligee as follows:

$ ____________ is the total amount of periodic support duefor

__________________, payable on a____________________________

Name of obligee E.g., weekly, monthly

basis, and the termination date of such obligationis

______________________________.

Date

$ ____________ is the total amount of periodic support duefor

__________________, payable on a____________________________

Name of obligee E.g., weekly, monthly

basis, and the termination date of such obligationis

______________________________.

Date

$ ____________ is the total amount of periodic support duefor

__________________, payable on a____________________________

Name of obligee E.g., weekly, monthly

basis, and the termination date of such obligationis

______________________________.

Date

4. [] Check this box and attach a certified copy of the judgment for support hereto.

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

6. 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, §18-4-73, enacted by Ga. L. 2016, p. 8, § 1/SB 255.)