3. A garnishment disclosure form must be served upon the garnishee. The disclosure must be substantially in the following form, subject to subsection 3 of section 32-09.1-03: State of North Dakota ) In ___________ Court )
ss.
County of __________ ) ____________________
______________________________ Plaintiff vs. ______________________________ Defendant and Garnishment Disclosure ______________________________ Garnishee
I am the __________________ of the garnishee and duly authorized to disclose for the garnishee.
On ______________, ______, the time of service of garnishee summons on the garnishee, there was due and owing the defendant from the garnishee the following:
1. Earnings. For the purposes of garnishment, "earnings" means compensation payable for personal service whether called wages, salary, commission, bonus, or otherwise, and includes periodic payments under a pension or retirement program. "Earnings" does not include social security benefits or veterans' disability pension benefits, except when the benefits are subject to garnishment to enforce any order for the support of a dependent child. "Earnings" includes military retirement pay. "Disposable earnings" means that part of the earnings of an individual remaining after the deduction from those earnings of amounts required by law to be withheld. If the garnishee summons was served upon you at a time when earnings from a prior completed pay period were owing but not paid, complete the following disclosure for earnings from both the past pay period and the current pay period.2. Money. Any amounts due and owing to defendant from the garnishee, except for earnings. (amount and facts)3. Property. Any personal property, instruments, or papers belonging to the defendant and in the possession of the garnishee. (description, estimated value, and facts)4. Adverse interest and setoff. Any setoff, defense, lien, or claim by the garnishee or other persons by reason of ownership or interest in the defendant's property. You must state the name and address and the nature of that person's claim if known. (Any assignment of wages made by the defendant or any indebtedness to a garnishee within ten days before the receipt of the first garnishment on a debt is void and should be disregarded.)5. Dependent. Any family member of the defendant who is residing in the defendant's residence. (If properly claimed after receipt of the garnishee summons.)6. Earnings worksheet: a. Total earnings in pay period ________d. FICA (social security/Medicare) ________e. Total deductions (lines b+c+d) ________f. Disposable earnings (line a less line e) ________g. Twenty-five percent of line f ________h. Minimum wage exemption (minimum wage times forty hours times number of weeks in pay period) ________i. Line f less line h ________j. Line g or line i (whichever is less) ________k. Dependent exemption (twenty dollars per dependent per week, if claimed) ________l. Adverse interest or setoff ________m. Total of lines k and l ________n. Line j less line m (the amount of earnings subject to garnishment) ________7. Total of property, earnings, and money. The garnishee shall add the total of property, earnings, and money and if this sum is ten dollars or more, the garnishee shall retain this amount, not to exceed the retention amount identified by the plaintiff in the garnishee summons. Signature ___________________________ Garnishee or Authorized Representative of Garnishee
__________________________ Title Subscribed and sworn to before me on ______________, _____.
_____________________________________ Notary Public