ORS 18.832: Debt calculation form.

(1) A debt calculation form shall be prepared for each writ of garnishment issued. A copy of the form need not be served on the garnishee, but a copy must be delivered to the debtor along with a copy of the writ in the manner required by ORS 18.658.

      (2) A debt calculation form must be in substantially the following form:

________ COURT

COUNTY OF ________

______            )

Plaintiff,         )           DEBT

                        )           CALCULATION

            vs.       )           Case No. _____

                        )

______            )

Defendant.      )

      TO: ________ (Debtor).

      The following amounts have been calculated to be owing from you to ________ (Creditor). The amounts are owed by reason of:

      __  A judgment entered against you dated _____, 2__, in Case No. _____, ______ Court, ______ County.

      __  Other debt subject to garnishment under the law (provide details):

      THE COURT ADMINISTRATOR HAS NOT CALCULATED ANY AMOUNTS FOR THE PURPOSE OF THIS FORM AND IS NOT LIABLE FOR ERRORS IN THIS FORM OR IN THE WRIT OF GARNISHMENT MADE BY THE CREDITOR OR GARNISHOR.

Original Debt Amount            $______

+    Pre-adjudication Interest  $______

+    Attorney Fees       $______

+    Cost Bill   $______

+    Post-adjudication Interest $______

+    Delivery Fee for Writ       $______

+    Sheriff’s Fees other

      than Delivery Fees            $______

+    Other (Explain. Attach

      additional sheets

      if necessary.)

      ______      $______

      ______      $______

      ______      $______

      ______      $______

      Total “Other”

      from additional

      sheets (if used)

+    Past Writ Issuance Fees    $______

+    Past Delivery Fees            $______

+    Transcript and Filing

      Fees for Other Counties   $______

=    Subtotal    $______

LESS Payments Made on Debt          $(______)

=    Total Amount Required to

      Satisfy Debt in Full          $______

      NOTE: INSERTING ITEMS AND AMOUNTS NOT LAWFULLY SUBJECT TO COLLECTION BY GARNISHMENT MAY RESULT IN LIABILITY FOR WRONGFUL EXECUTION.

      I certify that I have read this Debt Calculation form and to the best of my knowledge, information and belief the amount shown as owing is correct.

Creditor (Creditor must sign if writ issued by court administrator.)

Garnishor (Attorney for Creditor or other person authorized by law to issue writ.)

Address

Telephone Number

Oregon State Bar Number (if attorney)

, 2__

Date of Calculation