(A) Subject to division (D) of section 2716.041 of the Revised Code, if a continuous order of garnishment of personal earnings ceases to remain in effect because of the operation of division (C)(1) of that section, the garnishee shall file with the municipal or county court or court of common pleas that issued the order the garnishee's final report and answer that shall be substantially in the following form: "FINAL REPORT AND ANSWER OF GARNISHEE Case No. ______________________ In the __________________ Court _________________________, Ohio ___________ Judgment Creditor vs. ___________ Judgment Debtor The garnishee, _______________, in the above case states as follows: 1. The date that the garnishee received the order of garnishment of the judgment debtor's personal earnings was _________________________ 2. The total probable amount due on the judgment, including court costs, judgment interest, and, if applicable, prejudgment interest, as stated in section A of the order of garnishment of the judgment debtor's personal earnings, is $_____________________ 3. The total amount that has been withheld from the judgment debtor's personal disposable earnings and paid to the court while the order of garnishment of the judgment debtor's personal earnings remained in effect is $______________________ 4. (When applicable) the total probable amount due on the judgment (as stated in 2 above) is not equal to the total amount that has been withheld (as stated in 3 above), and the reason for that difference is that the order of garnishment of the judgment debtor's personal earnings ceased to be in effect for the following statutorily prescribed reason(s) (check whichever apply):

1. (a) _____ A municipal or county court appointed a trustee for the judgment debtor and issued an order that stays the order of garnishment of the judgment debtor's personal earnings.
2. (b) _____ A federal bankruptcy court issued an order that stays the order of garnishment of the judgment debtor's personal earnings.
3. (c) _____ A municipal or county court or a court of common pleas issued another order of garnishment of personal earnings that relates to the judgment debtor and a different judgment creditor, and Ohio or federal law provides the other order a higher priority. (Set forth the name of the court that issued the higher priority order, the associated case number, the date that the higher priority order was received, and the balance due to the relevant judgment creditor under that order): ________________________________________________________________
4. (d) _____ A municipal or county court or a court of common pleas issued another order of garnishment of personal earnings that relates to the judgment debtor and a different judgment creditor and that is not described in 4(c) above. (Set forth the name of the court that issued the subsequently received order, the associated case number, the date that the subsequent order was received, and the balance due to the relevant judgment creditor under that order):
5. (e) _____ The judgment creditor or judgment creditor's attorney has issued a request that the order of garnishment be terminated and the garnishee released from the mandates of the order of garnishment.
6. (f) _____ Judgment debtor's employment terminated on: ________________________________________________________________
7. (g) _____ Other: ________________________________________________________________ I certify that the statements above are true. ___________________________________(Print Name of Employer) ___________________________________(Print Name and Title of Person Who Completed Form on behalf of theEmployer) Signed _________________________________________________________ (Signature of Employer or Employer's Agent) Dated this ___________ day of __________________, _______"