CIRCUIT COURT OF ILLINOIS
Sixth Judicial Circuit
Champaign County
___________________________________
Petitioner
vs.
Case No:_________________
___________________________________
Respondent
MOTION TO CLAIM EXEMPTION UNDER
MOTION TO CLAIM EXEMPTION
WAGE DEDUCTION OR CITATION PROCEEDINGS
WAGE DEDUCTION
PROCEEDINGS
__________________________________, Respondent, requests the Court to find him/her to be exempt
for the following reasons(s):
1. The amount of wages that are being deducted:
is greater than (A) 15% of his/her gross weekly wages or (B) the amount by which disposable
earnings for a week exceed the total of 45 times Illinois minimum hourly wages.
is greater than (A) 25% of disposable earnings for a week or (B) the amount by which
disposable earnings for a week exceed 30 times the Federal minimum hourly wage.
includes pension and retirement benefits and funds.
2. This claim is made based on the following facts:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
WHEREFORE, Respondent requests that his/her wages be declared to be exempt.
Respondent’s Name: ___________________________
_______________________________
Address: _____________________________________
Respondent’s Signature
City/State/Zip Code:_____________________________
Telephone: ____________________________________
Date: __________________________
Name: __________________________________
Address: ________________________________
City/State/ZIP: ___________________________
Phone: _________________________________
Revised: 12/12
Clerk of the Sixth Judicial Circuit Court
101 E. Main Street
Urbana, Illinois 61801