WESTERN AUSTRALIA / Court
Civil Judgments Enforcement Act 2004
Part 4 Division 2 / Location:
FORM 11 – MEANS INQUIRY SUMMONS / Court ref number:

Judgment creditor

Lawyer
File ref number
Contact/address details

METHOD OF SERVICE:

Judgment debtor

PERSON TO BE SUMMONED:

Name:
Address:
Complete one of the three options below and delete the remaining two:
On ………………..20...... the court ordered you (or the corporation) to pay the judgment sum below.
OR
On ………………..20...... the court ordered the judgment debtor to pay the judgment sum below.
OR
On ………………..20...... the court made an Earnings/Debt Appropriation Order against you, which the judgment creditor claims you have failed to comply with.
You are summoned to (delete one):
Attend a means inquiry and give verbal evidence
Attend court and produce (complete details below)
………………………………………………......
You must complete the attached statement of financial affairs and produce it at the hearing. If you fail to comply, you will be in contempt of court.
You must attend ______Court held at ______
on ______day, the ______day of ______20______at ______am/pm
IF YOU DO NOT ATTEND IN ANSWER TO THIS SUMMONS, A WARRANT MAY BE ISSUED BY THE COURT FOR YOUR ARREST. IF YOU ARE UNSURE ABOUT THE PROCEDURES RELATING TO THIS HEARING YOU SHOULD CONTACT THE COURT ON______OR SEEK LEGAL ADVICE.
AMOUNT
OWED /

Judgment sum

/ $
Less paid/credit amount / $

Balance judgment sum

/ $
Interest / $
Previous enforcement costs / $
ENFORCEMENT
COSTS / Application fee / $
Sheriff’s fees/CS fees/re-issue …/…/20...... / $
Travelling fee / $
Lawyer’s costs / $

Judgment debt

/ $

Date of issue: ...... Court Seal

Judgment creditor / Name: / Court ref number:
Judgment debtor / Name: / Court ref number:
I ………………………………………………………….hereby certify that I did on the ………….dayof ……………….
20…... duly serve …………………………………… with a true copy of this summons by:
handing the document to the individual.
Other - describe here any other authorised means of service pursuant to Part 6 Division 2 of the Civil Judgments Enforcement Regulations 2005.
………………………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………………………….
Date: …………………. Sheriff/Bailiff/Assistant Bailiff ………………………………………………..……..

Form 11 version 3December 2007

I…...... of………………………………………………...... having been duly sworn/affirmed(delete one)say on oath/affirm (delete one) the following that I did on the
………….day of……………….20….... with authority, duly serve …………………………………… with a true copy of this summons by:
handing the document to the individual.
Other - describe here any other authorised means of service pursuant to Part 6 Division 2 of the Civil Judgments Enforcement Regulations 2005.
SWORN/AFFIRMED
at………………………...... this ………...... day of………...... …20......
In the presence of:
…………………………………......
(Deponent)
…………………………………......
Registrar/Justice of the Peace/other authorised witness