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Notice And Order For Income Assignment - Tennessee
| Notice And Order For Income Assignment Form. This is a Tennessee form and can be used in Trial And General Sessions Courts Statewide . |
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____________ Court ______________County NOTICE AND ORDER FOR Case Number INCOME ASSIGNMENT ________________Tennessee Page 1 of 1 _____________________________________ vs. ______________________________ ___ Garnishee:__________________________ Employer:___________________________ address:_____________________________________________________ Notice is hereby given that you are ordered to deduct from the income of ______________________________, Social Security # ___________________ restitution and court costs due in the above referenced case in the amount of $__________ per _________. Payments are to be forwarded to this office after each pay period. Checks should be made payable to CourtName and mailed to: CourtName CourtAddress1 CourtAddress2 CourtCity, TN CourtZ ip . Withholding of restitution and court costs is binding upon you until the total amount listed below is paid or you are notified by this court. Withholding of restitution and court costs in accordance with this notice shall have priority over any other process under state law against the same wages or other income for debts, other than assignments for Child Support. It is your responsibility to notify this office if _______________ terminates employment with you and to provide this office the last known address and the name and address of the new employer if it is known. It is unlawful under TCA 35-5-501 for you to discharge any employee from employment, refuse to employ or take disciplinary action against any employee because of income assignment. The total amount of restitution and court costs due as of this date is _____________ __________. When this amount has been withheld, this income assignment will cease. Issued: ______________________ _______________________________________ Clerk / Deputy Clerk - Circuit Cour t Served on employer by mailing Notice and Order for Income Assignment by certified mail return receipt requested on this date _____________________.
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