Date of notice to Plaintiff: 	
Date of notice to Garnishee: 	
Clerk/Deputy: 		Hearing:		
		Reset for:		

Comes the Defendant(s) pursuant to Tennessee Code Annotated §26-2-216 and would move this Honorable Court to reduce the judgment heretofore entered in this cause in the amount of  ___________________to installment payments in the amount of _________________ per _____________.  In support of this motion the Defendant(s) would offer the Affidavit of Income and Property attached hereto. Defendant(s) would further allege that the payment schedule is the maximum payment Defendant(s) can reasonably make on said judgment.  Defendant(s) would allege there are no other sources of income other than the wages from the employer set forth in said Affidavit.  Defendant(s) further acknowledges that if a previous agreement to pay the judgment by installment payments has been entered, the filing of this motion does not stay the issuance, execution or return of any writ of garnishment against wages or salary due to the Plaintiff or any satisfaction or payment of or upon such judgment.

Date:			
	Defendant signature
JUDGMENT
This cause came to be heard upon Defendant's Motion for Installment Payments on the judgment entered in this cause, and upon
    	  	Agreement of the parties            Hearing            Default
    	  	Defendant(s) having shown good cause that they are entitled to the relief sought, the judgment in this cause is commuted to installment payments in the sum of $			 to be paid each 	 , beginning 			, and further execution by garnishment is hereby stayed.
    	  	Payments to be made directly to Plaintiff or Plaintiff’s attorney/agent
 	Payments to be made through the Clerk of the Court
 	Defendant’s Petition is hereby dismissed:
     	  	Defendant(s) having failed to show good cause for the Petition;
    	  	Defendant(s) having failed to appear and support the Petition
  	Costs are taxed to Defendant(s).

Date:			
	Judge
Attorney for Plaintiff:					Attorney for Defendant:

Name:			Name: 	
Address:			Address: 	
									
Telephone:		Telephone: 	

Comes now the Defendant(s) and, subject to the penalty of perjury, makes oath and says that the following facts are true and that there is NO OTHER source of income or property other than that described below:

1. Full name:						
Address: 			 			
Phone #  						
Soc. Sec. No. 						 
Employer: 						
Phone # 							

2.   List all dependents:
Name			Age		Relationship

										

3.   List all income from any source:   
$ 			 	per/wk  /mo  ,
from 										:
$ 			 	per/wk  /mo  ,
from 										:
$ 			 	per/wk  /mo  ,
from 										:

I receive CHILD SUPPORT in the sum of 
$ 			  per 							.

4.   List all bank accounts:
ACCOUNT   	BANK/SOURCE      		BALANCE
Checking				$ 								
Savings  				$ 				 				
Other:   				  	$ 							
Other:       				$ 								

5.   List all debts:
CREDITOR/ADDRESS              	BALANCE
					  	$ 			
						$ 			
						$ 			
						$ 			
					 	$ 			

6.   List all monthly household expenses:
Rent/Mortgage:    				$ 		
Utilities:         	 			$ 		
Health Insurance:  				$ 		
Transportation Cost:				$ 		
Food:             				$ 		
Clothing:          				$ 		
Other:             				$ 		
					$ 			
					$ 			
					$ 			

	TOTAL				$ 					

7.   List all land/house/real estate/property you own:
DESCRIBE                  				VALUE
				  		$ 		
						$ 		
				 		$ 		
				 		$ 		
8.   List all personal property/cars/trucks/ furniture/stocks/bonds/tools/equipment you own and its total value:
DESCRIBE                   				VALUE
Cars 					$ 	
Trucks 					$  	
Other 					$  	
					$  	
					$  	
					$  	

9.   List all assets/property sold or transferred in the last six months:
DESCRIBE                    				VALUE
				 	$ 	 	
					$ 		
					$ 		
				 	$ 		
					$ 		

10.  The last income tax I filed was for 	 and it reflected an income of $ 		 and I attach a copy hereto or will file the same within seven days.

LIST ALL PROPERTY YOU CLAIM TO BE EXEMPT PURSUANT TO LAW:
All clothing for myself and my family; all receptacles for said clothing; family portraits; family Bible; school books; and 

																

VERIFICATION AND OATH:  Comes now the Petitioner(s) / Defendant(s) and makes oath, subject to the penalty of perjury, that the information in this Motion for Installment Payment is true to the best of Petitioner's knowledge, information and belief.
Defendant(s) 							 							

Sworn to and subscribed before me 
on ____________________
						
Clerk/Deputy Clerk/Notary Public

Commission Expires: