Defendants Claim Form

STATE OF GEORGIA STATE COURT OF GWINNETT COUNTY DEFENDANT'S CLAIM FORM I CLAIM EXEMPTION from garnishment. Some of my money or property held by the garnishee is exempt because it is: (check all that apply) ( ) 1. Social Security benefits. ( ) 2. Supplemental security income benefits. ( ) 3. Unemployment benefits. ( ) 4. Workers' compensation. ( ) 5. Veterans' benefits. ( ) 6. State pension benefits. ( ) 7. Disability income benefits. ( ) 8. Money that belongs to a joint account holder. ( ) 9. Child support or alimony. ( ) 10. Exempt wages, retirement, or pension benefits. ( ) 11. Other exemptions as provided by law. Explain: DEFENDANT'S CLAIM FORM State Court Garnishment Case No.: _____________________ I further state: (check all that apply) ( ) 1. The Plaintiff does not have a judgment against me. ( ) 2. The amount shown due on the Plaintiff's Affidavit of Garnishment is incorrect. ( ) 3. The Plaintiff's Affidavit of Garnishment is untrue or legally insufficient. Send the notice of the hearing on my claim to me at: Address: Phone Number: E-mail Address: The statements made in this claim form are true to the best of my knowledge and belief. , 20 Defendant's signature Date Print name of Defendant CERTIFICATE OF SERVICE This is to certify that I have this day served the Plaintiff or Plaintiff's Attorney and the Garnishee in the foregoing matter with a copy of this pleading by depositing it in the United States Mail in a properly addressed envelope with adequate postage thereon. This day of , 20 . Defendant or Defendant's Attorney American LegalNet, Inc. www.FormsWorkFlow.com