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Motion For Installment Payments - Tennessee

Motion For Installment Payments Form. This is a Tennessee form and can be used in Civil Sessions Knox Local County .
 Fillable pdf Last Modified 4/2/2014
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State of Tennessee Court (Must Be Completed) - General Sessions Civil Division County (Must Be Completed) KNOX File No. __________________ (Must Be Completed) Request to Make Payments (Motion and Affidavit for Installment Payments and Order) Division __________________ (Large Counties Only) Plaintiff/Creditor ________________________________________________________ (Name: First, Middle, Last of person/company that filed lawsuit) Defendant/Debtor _______________________________________________________ (Name: First, Middle, Last of the other person) You must go to Court on (Court Date): _______________________ at_______ G a.m. G p.m. Courtroom: ________________________________________________________________ (Court, Address, Zip) Reset Date: _______________________________ Review Date: __________________________ Time: ___________________ G a.m. G p.m. Time: _________________ G a.m. G p.m. To ask the court to allow you to make payments on this case, you must: · Send a copy of your completed form to the Plaintiff/Creditor or his/her lawyer, and · Go to a court on the date listed above that the clerk's office gave you. · Do not agree to pay more than you can afford. At this time, the law allows you to keep at least $217.50 of your weekly paycheck. If your weekly pay is more than $217.50, the amount that can be taken (garnished) is the difference between your net weekly pay and $217.50 or 25% of your net wage, whichever is greater. You may have to pay a filing fee. Can't afford the fee? Ask the court clerk for a paper called a Request to Postpone Filing Fees and Order (Uniform Civil Affidavit of Indigency). Or go on the internet to www.tncourts.gov or www.justiceforalltn.com to get the form. I ask the court to allow me to make payments of (amount): This amount will be paid (check one): W eekly $ beginning ___________________ (date) toward this judgment, pursuant to Tennessee Code Annotated 26-2-216. Bi-weekly Monthly Your Information Full Name: Address: street address Tel. (home): Birth date (mm/dd/yy): city (work): state (cell): zip Dependents Relationship Name Age Relationship List your dependents below. Name Age Request to Make Payments Page 1 of 4 American LegalNet, Inc. www.FormsWorkFlow.com 1. 4. 2. 5. 3. 6. Employment: If you are working now, fill out below. If not working now, check here: Employer's name: Employer's address and tel. #: street address city state zip tel # How much do you earn after taxes are deducted? $ each (check one): week month Other: Other Income: List any other income that you get now or expect to get. How much do you get? $ $ $ $ / month / month / month / month Source of Income Unemployment Worker's Comp. Other* SSI $ $ $ $ How much do you get? / month / month / month / month Source of Income AFDC Social Security Retirement Disability __________________________________________________________ __________________________________________________________ Assets: List all assets that you own separately, with your spouse or with someone else: Fair Market Value 1. Car, truck, or other vehicle 2. Other car, truck, or other vehicle 3. House, condominium, land 4. Other house, condominium, land List all bank/financial accounts below: Request to Make Payments Page 2 of 4 American LegalNet, Inc. www.FormsWorkFlow.com * Explain source of Other income here. Other: _______________________________________________________________________________________________ Money still owed = $ $ $ $ Bank name 5. 6. 7. Cash Total: Other: $ $ $ $ Balance Expenses How much each month? Rent/House Payment $ Phone $ Groceries $ School Supplies $ Electricity $ Clothing $ Water $ Gas Child Care Court-ordered Child Support Transportation Medical/Dental Other Other How much each month? $ $ $ $ $ $ $ Debts: Who do you owe? 1. 2. 3. $ $ $ How much do you owe? 4. 5. 6. Who do you owe? $ $ $ How much do you owe? List any other facts you want the court to know, such as unusual medical expenses, family emergencies, etc. I declare under penalty of perjury under the laws of the State of Tennessee that: · The information I have provided is true, correct, and complete. Sign here: Date: Sworn and subscribed before me this _______ day of _____________________, 20________. Bring the original and 2 copies of this form to the Court Clerk to be date stamped. ______________________________________ Deputy Clerk or Notary Public Give the original to the Court Clerk. Bring a stamped envelope addressed for each plaintiff to the Court Clerk. Mail one copy to the lawyer or if there is no lawyer, mail it to the plaintiff or company that sued you. Keep one copy for yourself. Request to Make Payments Page 3 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Certificate of Service: (How I gave this paper to the Plaintiff/Creditor) I certify that I (check one box) hand delivered or mailed by first-class mail, properly addressed, a true and correct copy of this paper to the person listed below at the address below: Name of Who You Are Giving This To (The creditor's lawyer or the plaintiff/creditor if no lawyer) Address of the Lawyer or the Creditor (Include City, State and Zip Code) on ___________________________________. (Date you mailed/hand-delivered the copy) ______________________________________ Sign Your Name IMPORTANT! Take any proof that supports your case to the hearing, including: witnesses, photos, papers, receipts, etc. The court will not accept written statements from witnesses. The person must go to court in person. If you think a witness may not want to go to court, ask the clerk for subpoena forms. Complete the subpoena as soon as possible so the sheriff can serve them before court. The court and clerks are not allowed to give you legal advice, even if you don't have a lawyer. This form is a public record. It is not legal advice. The law may change and it is best to consult with a lawyer if possible. DO NOT FILL OUT THIS SECTION BELOW. THE JUDGE WILL FILL THIS SECTION OUT AT COURT. The court denies this Request because (judge will check all that apply): The defendant did not prove s/he has the right to make payments. The defendant did not go to the court hearing for this case. This Request is dismissed. The defendant must pay court costs of: $ The court approves this Request because the defendant proved s/he has the right to make payments. Garnishment will end, and the defendant will pay as follows: Payments of: $ , on the day of each (month, week, other): starting (date): until (date of final payment
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