Judgment Data Form (Wage Garnishment For Child Support And Or Spousal Maintenance)

Case Number__________________ JUDGMENT DATA FORM (WAGE GARNISHMENT FOR CHILD SUPPORT AND/OR SPOUSAL MAINTENANCE) Custodial Parent or Obligee Information Name:* Non Custodial Parent of Obligor Information Name:* Date of Birth Date of Birth* Name and Address of Employer Name and Address of Employer* Social Security Number Social Security Number* Obligee's Mailing Address Obligor's Mailing Address Name of Children* Child's Date of Birth* · (*)Denotes required fields for an Income Withholding Statement to issue to an employer American LegalNet, Inc. www.FormsWorkFlow.com