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1 IN THE MAGISTRATE COURT OF DOUGLAS COUNTY STATE OF GEORGIA ( Plaintiff ( Current Civil Action File Number ( ( Street Address ( ( City, State and Zip Code ( Original Civil Action File Number ( ( VS ( ( ( Court Where Original Judgment Entered ( Defendant ( ( ( Street Address ( ( City, State and Zip Code ( INTERROGATORIES TO: Defendant, in the above-styled action: The plaintiff in the above-styled action demands that you answer the following interrogatories separately, fully, and under oath and serve such answers on said plaintiff at plaintiff’s address shown above by mail or hand delivery within 30 days after the service of these interrogatories. 1. List you full name, home phone number, and address, including apartment number and ZIP code. 2. List the name, address, and phone number of your employer(s). If self-employed, give name, address, and phone number of your business. 3. Describe and state the location of each piece of real estate in which you own any interest. 4. Give the name, address, phone number, and a description of the nature of any business venture in which you own any interest. 5. List the names, addresses, and phone numbers of all persons who owe money to you and specify the amounts owed. ---PAGE BREAK--- 2 6. List the names and addresses of all banks or savings institutions where you have any sums of money deposited and identify the accounts by number. 7. List and give the present location of all items of personal property owned by you that have a value of more than one hundred dollars. VERIFICATION STATE OF GEORGIA, COUNTY OF DOUGLAS being first duly sworn on oath, says the foregoing are true and complete answers to the interrogatories propounded by plaintiff to defendant. Sworn to and subscribed before me, this of Defendant Notary Public, Georgia or attesting official. My commission expires: NOTICE YOU ARE REQUIRED TO PROVIDE COMPLETE ANSWERS TO THE ABOVE-STATED QUESTIONS TO THE PLAINTIFF WITHIN 30 DAYS AFTER SERVICE OF THESE INTERROGATORIES UPON YOU. IF YOU DO NOT ANSWER, OR DO NOT ANSWER COMPLETELY, YOU MAY BECOME SUBJECT TO THE SANCTIONS PROVIDED BY LAW FOR CONTEMPT OF COURT. IF YOU NEED FURTHER INSTRUCTION OR IF YOU NEED ASSISTANCE IN ANSWERING THE QUESTIONS, PLEASE CONTACT THE COURT AT ONCE. ***You must mail your completed Answers to the Court and to the Plaintiff/Plaintiff’s Attorney.***