Voluntary Wage Assignment

VOLUNTARY WAGE ASSIGNMENT. This form is used in the Allen Superior Court Small Claims Division in Indiana when a judgment debtor agrees to have a portion of their wages withheld by their employer to repay a court-ordered judgment. Unlike a court-ordered garnishment, this is a voluntary agreement made between the debtor (employee) and the creditor (plaintiff), as permitted under Indiana Code 22-2-6-2. By signing the form, the debtor consents to having a specified amount deducted from their wages—on a weekly, biweekly, or monthly basis—until the full judgment, including costs and interest, is paid. The employer is instructed to withhold these payments and remit them to the Clerk of the Allen Circuit and Superior Courts. Importantly, the debtor retains the right to revoke the wage assignment at any time by providing written notice to their employer. The form also includes guidelines for employers to ensure that payments are properly processed, requiring identifying information such as the debtor’s full name and the court case number with each payment. www.FormsWorkflow.com