Illinois > Local County > Kane > Garnishment
Affidavit For Wage Deduction Order P1-WD-03 - Illinois
| Affidavit For Wage Deduction Order Form. This is a Illinois form and can be used in Garnishment Kane Local County . |
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IN THE CIRCUIT COURT OF THE SIXTEENTH JUDICIAL CIRCUIT KANE COUNTY, ILLINOIS Case No. Plaintiff(s) Defendant(s) Plaintiff(s) Atty. Employer: Name: Address: City, State and Zip: Defendant(s) Atty. File Stamp AFFIDAVIT FOR WAGE DEDUCTION ORDER on oath states: 1. I believe employer is indebted to the Judgment Debtor for wages due or to become due. Employer's address is stated above. 2. The last known address of the Judgment Debtor is I request that a summons issue directed to employer and I certify that a copy of the attached Wage Deduction Notice was mailed to Judgment Debtor, by first class mail, at his/her last known address prior to filing this wage deduction proceeding. Name: Atty. for Judgment Creditor: Atty. Registration No.: Address: City, State and Zip: Phone: Affiant: Under penalty of perjury as provided by law pursuant to 735 ILCS 5/1-109 the affiant certifies that the statements set forth herein are true and correct. CERTIFICATE OF ATTORNEY OR JUDGMENT CREDITOR Note: Non-Attorneys must also submit a copy of the underlying judgment or a certification by the Clerk of the Court that entered the judgment. I, the undersigned certify under penalties as provided by law pursuant to 735 ILCS 5/1-109 that the following information is true: 1. 2. 3. Judgment in the above captioned case was entered on The amount of Judgment was Allowable costs previously expended: A. Initial Filng Fees B. Original and alias summons C. 4. 5. Filing and summons costs of prior supplementary proceedings Filing and summons cost for this proceedings Statutory interest due on Judgment from date above TOTAL Deduct:Total amount paid by or on behalf of the Judgment Debtor prior to this proceeding BALANCE DUE JUDGMENT CREDITOR Attorney or Judgment Creditor P1-WD-03 (01/08) Page 1 of 2 American LegalNet, Inc. www.FormsWorkflow.com . IN THE CIRCUIT COURT OF THE SIXTEENTH JUDICIAL CIRCUIT KANE COUNTY, ILLINOIS Case No. Plaintiff(s) Defendant(s) Plaintiff(s) Atty. Employer: Name: Address: City, State and Zip: Defendant(s) Atty. File Stamp INTERROGATORIES/ANSWER TO WAGE DEDUCTION PROCEEDINGS Employer/Agent: , the undersigned, certifies under penalty of perjury that the following Answer is true and correct to the best of her/his knowledge and belief concerning the property of the Judgment Debtor. Debtor Name: Do you pay monies to the Judgment Debtor above? Yes Social Security No.: No If answer to preceding question is "No," state date Debtor was last employed: State whether any funds paid to the Debtor are for disability, retirement or are in any other way exempt or subject to other Court Order: One pay period equals: day(s) week(s) month(s) other CALCULATION TO DETERMINE AMOUNT OF WITHHOLDING: (A) Gross Wages minus mandatory contributions to pension or retirement plans is (B) METHOD I- 15% OF (A) (C) Enter Total FICA, State and Federal Tax and Medicare (D) Subtract (C) from (A)= (E) Enter Minimum wage per pay period (45 X federal minimum wage or the Illinois minimum hourly wage, whichever is greater) (F) Subtract (E) from (D) (G) Enter Lesser of line (B) or (F) (H) Enter Child Support of other Court Ordered Deduction, including current wage deduction, if any (I) Subtract (H) from (G) (J) Subtract Employer's Statutory Fee (735 ILCS 5/12-814) (Optional: A fee of $12.00 or 2% of the amount to deducted, whichever is greater, Employer keeps this fee.) (K) Amount to be applied to judgment INSTRUCTIONS 1. Mail a copy of this Answer to the Court and mail to attorney for Plaintiff and give a copy to the Defendant. 2. You will receive a copy of a Court Order by fax or mail instructing you how to proceed and where to send deducted funds. Signature of Employer or Agent (Affiant) Subscribed and Sworn to before me on Print Name: Notary Public - Circuit Clerk P1-WD-03 (01/08) Page 2 of 2 American LegalNet, Inc. www.FormsWorkflow.com $.00 $12.00 $-12.00 (Date)
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