Affidavit For Order Of Wage Garnishment Form Page 4
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4KWDKy424 (Rev. 10/14) Notice to Judgement Debtor (Employee) of Right to Assert Exemption to Wage Garnishment)
U
S
D
C
NITED
TATES
ISTRICT
OURT
WESTERN DISTRICT OF
K
ENTUCKY
at
Case No.
NOTICE TO JUDGMENT DEBTOR (EMPLOYEE) OF RIGHT
TO ASSERT EXEMPTION TO WAGE GARNISHMENT
Judgment Debtor:
Date of Judgment:
Post Judgment Int Rate:
%
Judgment Creditor:
Amount of Judgment:
$
Pre-judgment Interest:
$
Garnishee (Employer):
Allowed Court Costs:
$
Amount Due:
$
Creditor’s Attorney
To Judgment Debtor:
The Judgment Creditor is garnishing a portion of your wages to satisfy a judgment entered against you, which
includes the Amount Due shown above, plus interest and costs. You may have a right to recover all or part of the money
your employer will withhold, but you must follow the instructions given below.
IMPORTANT LEGAL NOTICE OF RIGHTS TO ASSERT EXEMPTION
If you are not the actual Judgment Debtor named above, or if the judgment has been paid, immediately notify the
Creditor's Attorney (or the Creditor if no attorney is named above) to avoid garnishment, or request a hearing from the
Court (see below).
You are entitled to receive a copy of the first Affidavit and Answer of Garnishee (Employer) to be prepared by your
employer in response to the garnishment of your wages. Read it carefully. Your employer is required to send you a copy
of the Affidavit and Answer of Garnishee each time garnished funds have been withheld from your paycheck if the
amount withheld is different from the amount previously withheld from your last paycheck. If you do not receive a copy,
request one from your employer. If refused, request a hearing from the Court (see below). The percentage of disposable
earnings exempted from each garnishment, where the pay period Is weekly, is the greater of (A) 75% of disposable
earnings or (B) 30 times the federal minimum hourly wage.
If you believe that your employer has completed the form incorrectly and withheld wages which are properly exempt,
you must take the following step: Within thirteen (13) days of the date on the payroll check from which funds have been
withheld as a result of this garnishment, you must file an objection to the garnishment in the U.S. District Court Clerk's
office which issued this garnishment.
You may request a hearing. If a hearing is granted, you will be notified of the date. The judge will check the
withholding made by your employer to determine if a mistake has been made. If a portion of your wages was improperly
seized, the judge will order that it be returned to you. Otherwise, the judge will order that the garnishment proceed as
planned. If you do not request a hearing within thirteen (13) days of the date on the payroll check, the wages withheld
will be later sent to the Judgment Creditor's Attorney or the Judgment Creditor(if there is no Creditor's Attorney) who
will hold the garnished money received from your employer for 30 days from the issuance date on the employer's
garnishment check. This is to allow you to assert any exemption you may have.
Note: The Clerk does not have legal forms for your use. The Clerk cannot give you legal advice.
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