Oregon Revised Statutes Procedure in Civil Proceedings § 18.832

____________ COURT

COUNTY OF ____________

____________

)

Plaintiff,

)

DEBT

)

CALCULATION

)

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