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Approved, SCAO
•
STATE OF MICHIGAN
JUDICIAL DISTRICT
JUDICIAL CIRCUIT
Court address
Original - State Treasurer (Part 1)
1st copy - Court (Part 2)
2nd copy - Defendant (Part 2)
REQUEST AND WRIT FOR GARNISHMENT
(INCOME TAX REFUND/CREDIT)
3rd copy - Return (proof of service) (Part 2)
4th copy - Plaintiff/Attorney (proof) (Part 2)
•
CASE NO.
•
Zip code
Court telephone no.
Plaintiff's name and address (judgment creditor)
Defendant's name and address (judgment debtor)
v
•
•
Social security no.
Garnishee
Third Party Withholding Unit
Michigan Department of Treasury
PO Box 30785
Lansing, Michigan 48909
Plaintiff attorney FE no.
Plaintiff attorney telephone no.
•
REQUEST NOTE for item 2: If a civil judgment includes judgment interest in the “total judgment” field (as in the forms in use before the 5/07 revisions),
the interest amount reported in item 2 should not include any postfiling interest already included in the judgment.
, the plaintiff received judgment against the defendant for:
1. On
2. The total amount of judgment interest accrued to date is:
.
.
.
.
.
3. Plaintiff knows or with good reason believes the garnishee is indebted to or possesses or controls property belonging to defendant.
4. Plaintiff requests a writ of income tax garnishment be paid to
The total amount of postjudgment costs accrued to date is:
The total amount of postjudgment payments made and credits to date is:
The amount of the unsatisfied judgment now due (including interest and costs) is:
plaintiff's attorney,
$
$
$
$
$
the court,
plaintiff,
and mailed to
plaintiff.
plaintiff's attorney.
the court.
I declare under the penalties of perjury that this request has been examined by me and that its contents are true to the best of my
information, knowledge, and belief.
To be completed by the court.
Plaintiff/Agent/Attorney signature
Date
WRIT OF GARNISHMENT
TO THE PLAINTIFF:
this garnishment.
1. The social security number field is blacked out for security reasons on all parts except the garnishee copy.
2. You must serve this writ on the state treasurer along with a $6.00 fee and any discovery request for information related to
3. You must serve a copy of this writ on the defendant within 7 days after serving the writ on the state treasurer.
4. You are responsible for paying to the state treasurer any reasonable costs incurred by the state treasurer in providing
information in response to your discovery request.
5. If a state tax refund or credit is not intercepted before October 31 of the year during which this writ of garnishment is to be
processed, you will not receive a disclosure unless you file a written request with the state treasurer between November 1 and
December 31 of the tax year following the tax year for which this writ was filed.
TO THE DEFENDANT: See separate instructions.
1. If a state tax refund or credit is intercepted pursuant to this writ, the state treasurer will notify you on a disclosure form.
2. You have 14 days after being notified of an intercept to file objections to the writ of garnishment with the court. If you do
not object within this time, the intercepted tax refund or credit held under this writ will be applied to the judgment 28 days
after the disclosure was filed with the court.
TO THE GARNISHEE:
1. Upon intercepting a state tax refund or credit, calculate the amount available to satisfy all or part of the garnishment.
2. Within 90 days after establishing any other liability for which the state tax refund or credit may be applied under MCL 205.30a,
file with the court a verified disclosure identifying the intercepted amount, less any setoff, counterclaim, or other demand
of the state against the defendant.
3. Unless notified by the court that objections to the writ of garnishment have been filed, payment of the intercepted amount
must be made not less than 28 days after filing the disclosure.
4. You are ordered to pay the amount intercepted under this writ as specified in the request.
Date of issue
MC 52 (10/19) REQUEST AND WRIT FOR GARNISHMENT (INCOME TAX REFUND/CREDIT) (Part 1) MCL 600.4061, MCL 600.4061a
Deputy court clerk
Plaintiff FE no. / Social security no.
Plaintiff's attorney, address
•
•
•••
•
•
•
Approved, SCAO
•
STATE OF MICHIGAN
JUDICIAL DISTRICT
JUDICIAL CIRCUIT
Court address
Original - State Treasurer (Part 1)
1st copy - Court (Part 2)
2nd copy - Defendant (Part 2)
REQUEST AND WRIT FOR GARNISHMENT
(INCOME TAX REFUND/CREDIT)
3rd copy - Return (proof of service) (Part 2)
4th copy - Plaintiff/Attorney (proof) (Part 2)
•
CASE NO.
•
Zip code
Court telephone no.
Plaintiff's name and address (judgment creditor)
Defendant's name and address (judgment debtor)
v
•
•
Plaintiff FE no. / Social security no.
Plaintiff's attorney, address
Garnishee
Third Party Withholding Unit
Michigan Department of Treasury
PO Box 30785
Lansing, Michigan 48909
Plaintiff attorney FE no.
Plaintiff attorney telephone no.
•
REQUEST
NOTE for item 2: If a civil judgment includes judgment interest in the “total judgment” field (as in the forms in use before the 5/07 revisions),
the interest amount reported in item 2 should not include any postfiling interest already included in the judgment.
, the plaintiff received judgment against the defendant for:
1. On
2. The total amount of judgment interest accrued to date is:
.
.
.
.
.
3. Plaintiff knows or with good reason believes the garnishee is indebted to or possesses or controls property belonging to defendant.
4. Plaintiff requests a writ of income tax garnishment be paid to
The total amount of postjudgment costs accrued to date is:
The total amount of postjudgment payments made and credits to date is:
The amount of the unsatisfied judgment now due (including interest and costs) is:
plaintiff's attorney,
$
$
$
$
$
the court,
plaintiff,
and mailed to
plaintiff.
plaintiff's attorney.
the court.
I declare under the penalties of perjury that this request has been examined by me and that its contents are true to the best of my
information, knowledge, and belief.
To be completed by the court.
Plaintiff/Agent/Attorney signature
Date
WRIT OF GARNISHMENT
TO THE PLAINTIFF:
this garnishment.
1. The social security number field is blacked out for security reasons on all parts except the garnishee copy.
2. You must serve this writ on the state treasurer along with a $6.00 fee and any discovery request for information related to
3. You must serve a copy of this writ on the defendant within 7 days after serving the writ on the state treasurer.
4. You are responsible for paying to the state treasurer any reasonable costs incurred by the state treasurer in providing
information in response to your discovery request.
5. If a state tax refund or credit is not intercepted before October 31 of the year during which this writ of garnishment is to be
processed, you will not receive a disclosure unless you file a written request with the state treasurer between November 1 and
December 31 of the tax year following the tax year for which this writ was filed.
TO THE DEFENDANT: See separate instructions.
1. If a state tax refund or credit is intercepted pursuant to this writ, the state treasurer will notify you on a disclosure form.
2. You have 14 days after being notified of an intercept to file objections to the writ of garnishment with the court. If you do
not object within this time, the intercepted tax refund or credit held under this writ will be applied to the judgment 28 days
after the disclosure was filed with the court.
TO THE GARNISHEE:
1. Upon intercepting a state tax refund or credit, calculate the amount available to satisfy all or part of the garnishment.
2. Within 90 days after establishing any other liability for which the state tax refund or credit may be applied under MCL 205.30a,
file with the court a verified disclosure identifying the intercepted amount, less any setoff, counterclaim, or other demand
of the state against the defendant.
3. Unless notified by the court that objections to the writ of garnishment have been filed, payment of the intercepted amount
must be made not less than 28 days after filing the disclosure.
4. You are ordered to pay the amount intercepted under this writ as specified in the request.
Date of issue
MC 52 (10/19) REQUEST AND WRIT FOR GARNISHMENT (INCOME TAX REFUND/CREDIT) (Part 2)
Deputy court clerk
MCL 600.4061, MCL 600.4061a
•
•••
•
•
•
1. This writ has been issued because there is a judgment against you that you have not paid. In order to collect on this judgment,
income owed to you may be withheld or property belonging to you may be taken from you and sold.
Instructions for the Defendant
2. You may object to this garnishment if:
a. your income is exempt from garnishment by law,
b. you have a pending bankruptcy proceeding,
c. the maximum withheld exceeds the amount allowed by law,
d. you have paid the judgment in full,
e. the garnishment was not properly issued or is otherwise invalid.
3. Except for tax garnishments issued in criminal cases, you may send the plaintiff a written request to review postjudgment costs
and fees listed in item 2 of the request. Within 28 days after receiving your request, the plaintiff must send an itemized list
of the postjudgment costs and fees to you and the court. Within 28 days after receiving the itemized list, you may file a motion
with the court to review the postjudgment costs and fees if you believe they are wrong. If the judge rules in your favor, the judge
may order the motion fee to be deducted from the judgment balance.
REQUEST AND WRIT FOR GARNISHMENT
(INCOME TAX REFUND/CREDIT)
Case No.
TO PROCESS SERVER: You must serve the garnishee with this request and writ of garnishment, the $6.00 fee, and any
attachments, and file proof of service with the court clerk as directed by the plaintiff. If you are unable to complete service, you must
return this original and all copies to the court clerk.
PROOF OF SERVICE
CERTIFICATE / AFFIDAVIT OF SERVICE / NONSERVICE
OFFICER CERTIFICATE
OR
I certify that I am a sheriff, deputy sheriff, bailiff, appointed
court officer, or attorney for a party [MCR 2.104(A)(2)], and
that:
(notarization not required)
AFFIDAVIT OF PROCESS SERVER
Being first duly sworn, I state that I am a legally competent
adult who is not a party or an officer of a corporate party, and
that:
(notarization required)
I served the request and writ of garnishment, the $6.00 fee, and any attachments by:
personal service
registered or certified mail (copy of return receipt attached) on:
Garnishee name
Michigan Department of Treasury
Third Party Withholding Unit
Complete address of service
PO Box 30785
Lansing, Michigan 48909
Day, date, time
I served a copy of the request and writ of garnishment by
personal service
first-class mail on:
Defendant name
Complete address of service
Day, date, time
I have personally attempted to serve the request and writ of garnishment on the defendant and have been unable to complete service.
Defendant name
Complete address(es) of service
Day, date, time
I declare under the penalties of perjury that this certificate has been examined by me and that its contents are true to the best of my
information, knowledge, and belief.
Miles traveled Fee
Service fee
$
Incorrect address fee Miles traveled Fee
$
$
$
TOTAL FEE
$
Subscribed and sworn to before me on
Date
Signature
Name (type or print)
Title
.
My commission expires:
Date
Deputy clerk/Notary public signature
Name (type or print)
Notary public, State of Michigan, County of .
This notarial act was performed using an electronic notarization system or a remote electronic notarization platform
Acting in the County of .
I acknowledge that I have received the request and writ of garnishment (and the $6.00 fee and attachments if applicable) on
Day, date, time
Signature
ACKNOWLEDGMENT OF SERVICE
.
on behalf of
MCR 2.105
