Form 28 - Objection To Calculation Of The Amount Of Exempt Earnings
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1
2County Court
District Court
______________________County, Colorado
Court address:
Plaintiff(s):__________________________________
v.
Defendant(s):__________________________________
COURT USE ONLY
Judgment Debtor’s Attorney or Judgment Debtor
Case Number:
(Name and Address):
Phone Number:
E-mail:
FAX Number:
Atty.Reg. #:
Division
Courtroom
OBJECTION TO CALCULATION OF THE AMOUNT OF EXEMPT EARNINGS
Instructions to Judgment Debtor: Use this form to object to the calculations of your exempt earnings.
Name: ______________________________________________________Phone Number: _________________________
Street Address: _________________________________________________________________________________
Mailing Address, if different: _____________________________________________________________________________
City: ____________________________ State: _______________________________ Zip Code: ______________________
1.
I object to the Garnishee’s Calculation of the Amount of Exempt Earnings because I believe that the correct
calculation is:
Gross Earnings for My Pay Period from ___________________thru _________________
$ ____________
Less Deductions Required by Law (For Example, Withholding Taxes, FICA)
- $ ____________
Disposable Earnings (Gross Earnings Less Deductions)
= $ ____________
Less Statutory Exemption (Use Exemption Chart on Writ)
- $ ____________
Net Amount Subject to Garnishment
= $ ____________
Less Wage/Income Assignment(s) During Pay Period (If Any)
- $ ____________
Amount which should be withheld
= $ ____________
OR
2.
The earnings garnished are pension or retirement benefits/deferred compensation/health, accident or disability insurance
and they are totally exempt because:
_________________________________________________________________________________________________
I understand that I must make a good faith effort to resolve my dispute with the Garnishee.
I
have
have not attempted to resolve this dispute with the Garnishee.
Name of Person I Talked to: _________________________________________________
Position: _________________________________________ Phone Number: __________________________________
FORM 28
R11/10
OBJECTION TO CALCULATION OF THE AMOUNT OF EXEMPT EARNINGS
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