Form Edc-111 - Response To Levy - Employer Page 2
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1
2Instructions for Form EDC-111, Levy Response
General Information
Line 10 - Payment
Total Column H and write the amount. This is the amount due.
Who must complete Form EDC-111?
You must complete this form because you received a levy
Write the Debtor’s name and Taxpayer ID on your
notice. Figure the amount of the levy payment due by
payment. Mail payment and a copy of Form EDC-111 at least
completing this form.
once every two months until the balance of the levy is fully
When is Form EDC-111 and the payment due?
paid.
Send a copy of the completed form with the fi rst payment at the
close of your current payroll period.
Step 3: Sign below
You must sign that your answers are true and complete.
If the amount you send us does not fully pay this levy, you must
Remember to mail or hand-deliver a copy of Form EDC-111 to
send additional payments at least once every two months.
the debtor.
These additional payments must be sent with a completed
Form EDC-111.
Write your name and mailing address.
Each time you send a payment to us, you must also mail or
hand deliver one copy of Form EDC-111 to the debtor. You may
Note: Keep a copy of a blank Form EDC-111 for future
photocopy this form, but it must have an original signature.
payments.
Instructions
Step 1: Provide the following debtor information
Please provide the requested information. If you do not know
the answer to one of the questions, write “not known” on the
line provided. If this is your last payment, be sure to check
the box that best describes why this is your last payment. If
you no longer employ the debtor, write the date the debtor left
your service. Before you calculate the amount to withhold, you
must determine if the debtor is entitled to any exemptions by
completing Lines 6 and 7.
Step 2: Complete if you pay funds to the debtor
You must compute the amount to withhold on a weekly basis
(even if your payroll is not weekly).
If you are required to withhold payments for child support, write
the weekly amount of child support on Line 8. You will need this
for the calculation of Column H.
Column A - Write the debtor’s gross weekly wages.
Column B - Multiply Column A by 15 percent (0.15) and write
the result.
Column C - Write the total amount of Social Security, federal
tax, and state tax required to be withheld.
Column D - Subtract Column C from Column A. The result is
the debtor’s disposable earnings.
Column E - Multiply the Illinois minimum hourly wage by
45 and write the result. (For current rates, see
or call the Illinois Department of Labor at
312-793-2800.)
Column F - Subtract Column E from Column D and write the
result.
Column G - Compare the amount you wrote in Column B
to the amount you wrote in Column F. Write the
smaller amount.
Column H - Subtract the amount of child support payments on
Line 8 from the fi gure in Column G.
EDC-111 Instructions (R-3/12)
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Parent category: Financial