Affidavit For Order Of Wage Garnishment Form Page 3
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4WDKy424 (Rev. 10/14) Instruction to Garnishee (Employer) for Completing Affidavit & Answer to Order of Wage Garnishment (Continuous or as Designated)
INSTRUCTIONS TO GARNISHEE (EMPLOYER) FOR COMPLETING AFFIDAVIT AND
ANSWER TO ORDER OF WAGE GARNISHMENT (CONTINUOUS OR AS DESIGNATED)
Note: You should make copies of the Order of Wage Garnishment (Continuous or as Designated) and keep
them for future use.
You Are Summoned and Ordered to Do the Following:
1. Complete the Affidavit and Answer on the bottom of Order under oath and send copies as directed in
paragraph 2 below:
(a) within 20 days from your receipt of this Order; AND
(b) when you first withhold as required by this Order; AND
(c) whenever the amount withheld from any later paycheck differs from the amount withheld from the last
paycheck.
2. Send copies of each completed Affidavit and Answer to:
(a) the Judgment Debtor-Employee; AND
(b) the Judgment-Creditor's Attorney or to the Creditor (if no attorney is named); AND
(c) the Clerk, U.S. District Court; AND
(d) retain a copy for your records.
3. The following provisions apply to money or property of the Judgment Debtor consisting of earnings
(compensation for personal services):
(a) This Order creates a lien on all non-exempt earnings of the Judgment Debtor earned during the pay
period in which this Order is served and during all succeeding pay periods until the entire judgment
balance is paid in full or for the pay periods designated on the front of this Order. At a later date, the
Creditor or Creditor's Attorney may provide you with notice of any remaining unpaid principal, interest
and court costs due.
(b) Orders of Wage Garnishment shall have priority according to the date of service on you. If you
receive more than one Order of Wage Garnishment against a Judgment Debtor, honor the first Order you
receive until the amount due, plus interest and costs, is paid in full (or for the pay periods designated on
the front of that Order). The second Order received then automatically takes effect.
(c) You may be notified by the Creditor's Attorney, the Judgment Creditor, or the Court to discontinue
withholding pursuant to this Order The second Order received then automatically takes effect.
(d) Calculate the amount of non-exempt earnings on the Order or on a copy of it. It is based on a certain
portion of disposable earnings, determined as follows:
i. "Disposable Earnings" means that part of the earnings of any individual remaining after the
deduction from those earnings of any amounts required by law to be withheld. Amounts required by
law to be withheld include income taxes, occupational license taxes, social security, ordered child
support, railroad retirement and retirement for teachers and state and county employees.
ii. The percentage of disposable earnings exempted from this Order is the greater of
(a) 75% of disposable earnings, or
(b) the other amount set forth in subparagraph iii. below.
iii. The other amount referred to in subparagraph ii.(b) above is:
(a) for weekly pay periods, 30 times the federal minimum hourly wage; or
(b) for all other pay periods, the multiple of the federal minimum hourly wage as prescribed by
the U.S. Department of Labor.
4. Include a copy of the Notice to Judgment Debtor (Employee) of Right To Assert Exemption to Wage
Garnishment with each completed Affidavit and Answer sent to the Judgment Debtor (Employee).
Note: Contact your attorney, the creditor's attorney or the creditor if you need assistance to determine the amount to
withhold. Do not contact the Clerk’s Office. It cannot give you advice on completing the Affidavit and Answer of
the Garnishee. It cannot give you legal advice.
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