Indiana

Indiana Interrogatory

Firm File Number(Required)

Printed or Typed Name(Required)

Title/Position(Required)

Phone Number(Required)

Email Address:(Required)

County(Required)

Cause No.(Required)

Court #

Hearing Date

Interrogatories

1. State the correct name, address and telephone number of your company or partnership.

2. Is the judgment defendant, an employee of your company and if not considered an employee, please describe your relationship to this individual and the nature of the individual’s compensation?

3. What is the Defendant's position or title? What is their date of hire?

4. If yes, what is the individual’s residence address and social security number ?

5. State the average weekly gross amount paid by your company to this individual.

6. This individual on any type of leave and if so, please describe the circumstances and duration of such leave?

7. To the best of your knowledge, state whether or not there are any garnishment orders at this time in effect against this individual, and, if so, state the cause numbers and amounts

8. Does this individual own any interest in your company or are there any debts due to this individual from your company? If so, please describe.

I(we) affirm under penalties for perjury that the foregoing representations are true

Date

Signature(Required)

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Blitt and Gaines, P.C. is a debt collector. This is an attempt to collect a debt and any information obtained will be used for that purpose.

Indiana

Indiana Interrogatory

Interrogatories

Company

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