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Wage Deduction Summons - Notice - Interrogatories - Affidavit - Illinois
| Wage Deduction Summons - Notice - Interrogatories - Affidavit Form. This is a Illinois form and can be used in General St. Clair Local County . |
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IN THE CIRCUIT COURT OF THE TWENTIETH JUDICIAL CIRCUIT ST. CLAIR COUNTY, ILLINOIS _______________________________ Plaintiff vs. _______________________________ Defendant ) ) ) ) ) ) Case No.:______________________ WAGE DEDUCTION SUMMONS To the employer: __________________________Address: ______________________ YOU ARE SUMMONED and required to file answers to the judgment creditor's interrogatories, in the Office of the Clerk of the Circuit Court, #10 Public Square, Belleville, IL 62220 on or before _______________________________(21 to 40 days after issuance of summons). However, if this summons is served on you less than 3 days before that date, you must file answers to the interrogatories on or before a new return date, to be set by the court, no less than 21 days after you were served with this summons. This proceeding applies to non-exempt wages due at the time you were served with this summons and to wages which become due thereafter until the balance due on the judgment is paid. IF YOU FAIL TO ANSWER, A CONDITIONAL JUDGMENT BY DEFAULT MAY BE TAKEN AGAINST YOU FOR THE AMOUNT OF THE JUDGMENT UNPAID. FEDERL AGENCY EMPLOYERS: Effective upon service of this summons and pursuant to 5 USC 552(a), you are to commence to pay over deducted wages to the attorney for the judgment creditor in accordance with 735 ILCS 5/12-808. To the Officer: This summons must be returned by the officer or other person to whom it was given for service, with endorsement of service and fees, if any, immediately after service. If service cannot be made, this summons shall be returned so endorsed. This summons may not be served later than the above date. WITNESS______________________________ _______________________________________ Clerk of the Circuit Court (Seal of Court) By: ___________________________________ Deputy Clerk (Plaintiff's Attorney or Plaintiff if not represented by an Attorney) Name: ________________________________ Attorney for: ___________________________ Address: ______________________________ City: _________________________________ Telephone: ____________________________ E-mail Address: ________________________ American LegalNet, Inc. www.FormsWorkFlow.com INTERROGATORIES/ ANSWER TO WAGE DEDUCTION PROCEEDINGS Employer/Agent: ___________________________________ Return Date: _________________ Defendant's Name: ____________________ S.S. No. XXX-XX-_____ Case No.: ___________ Defendant's Address: ____________________________________________________________ Do you pay money to the Defendant listed above? ____ Yes ____ No IF YOUR ANSWER IS "NO," GO TO "INSTRUCTIONS" BELOW. Are any funds paid to the debtor: ___Subject to prior court ordered deduction ___For Disability ___For Retirement ___Otherwise exempt (Describe ___________). CALCULATION TO DETERMINE AMOUNT OF WITHHOLDING (Note: Withholding must be recalculated for every pay period if income varies.) Do you pay debtor: (A) (B) (C) (D) (E) ___ Every Week ___Every Two Weeks ___Semi-Monthly ___ Monthly ___ Other _______ (A) (B) (C) (D) Gross wages per paycheck minus mandatory contributions to pension or retirement plan. 15% of (A)= Enter total FICA, State Tax, Federal Tax and Medicare Subtract (C) from (A)= If debtor is paid every week, enter $371.25 If debtor is paid every two weeks, enter $742.50 If debtor is paid semi-monthly, enter $804.37 If debtor is paid monthly, enter $1,608.75 If other, multiply 45 times state minimum wage (currently $8.25) times number of weeks in a pay period ___________ ___________ ___________ ___________ (E) ___________ ___________ (F) Subtract (E) from (D) (Enclose a negative number in parentheses, e.g., ($50.00)) (F) IF LINE "F" IS ZERO OR A NEGATIVE NUMBER, WITHHOLD NO WAGES, GO TO "INSTRUCTIONS" BELOW (G) (H) (I) Enter the lesser of Line (B) or (F) Enter Child Support or other Court Ordered Deduction Subtract (H) from (G) (Enclose a negative number in parentheses, e.g., ($50.00)) (G) (H) (I) ___________ ___________ ___________ IF LINE "I" IS ZERO OR A NEGATIVE NUMBER, WITHHOLD NO WAGES, GO TO "INSTRUCTIONS" BELOW (J) (K) Subtract Employer's One-Time Amount to be applies to Judgment (J) (K) ___________ ___________ LINE "I" MUST BE WITHHELD AS OF THE DATE OF SERVICE AND HELD UNTIL FURTHER ORDER OF THE COURT INSTRUCTIONS 1. 2. Fill out and sign the certification below. Mail a copy of this Answer to the Court and Plaintiff's Attorney and give a copy to the Defendant Mail it to the Clerk of the Court, #10 Public Square, Belleville, IL 62220 DO NOT MAIL CHECK TO THE CLERK'S OFFICE. You will receive a copy of a Court Order instructing you how to proceed and where to send any withheld funds. 3. THIRD PARTY EMPLOYER CERTIFICATION Under the penalties as provided by law pursuant to Section 1-109 of the Code of Civil Procedure (735 ILCS 5/1-109), the under-signed certifies that the statements set forth in this instrument are true and correct and that I have either mailed or hand delivered a copy of this completed Interrogatories/ Answer to the Defendant. Date: _____________________________________ Signature of Employer/ Agent: _______________________________________ Fax: _______________________ Print full name clearly: _____________________________________________ Telephone: __________________ KAHALAH A. DIXON, CLERK OF THE CIRCUIT COURT, ST. CLAIR COUNTY, ILLINOIS American LegalNet, Inc. www.FormsWorkFlow.com IN THE CIRCUIT COURT OF THE TWENTIETH JUDICIAL CIRCUIT ST. CLAIR COUNTY, ILLINOIS ________________________________ Plaintiff- Judgment Creditor vs. (Summons Return Date)_____________ _________________________________ Defendant- Judgment Debtor Judgment Debtor's Name: _____________________________ Address: ___________________________ City: ______________________________ Phone: _____________________________ Attorney No.: ________________________ Judgment in the amount of $_____________ Judgment Creditor/Creditors Atty Name: __________________________ Address: _________________________ City: ____________________________ Phone: __________________________ Attorney No.: _____________________ BALANCE DUE: $________________ Case No.: ________________________ Employer Name: _____________________________________________________________ NOTICE: The Court has issued a wage deduction summons against the employer names above for wages due or about to become due to the judgment creditor. The wage deduction summons was issued on the basis of a judgment against the judgment debtor in favor of the judgment creditor in the amount s
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