Claim of Exemption (Wage Garnishment) ~ WG-006

Claim of Exemption (Wage Garnishment) ~ WG-006
RETURN TO LEVYING OFFICER. DO NOT FILE WITH COURT
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
WG-006
FOR LEVYING OFFICER USE ONLY
(Levying Officer Name and Address)
TELEPHONE NO.:
FAX NO. (Optional):
E-MAIL ADDRESS (Optional):
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
LEVYING OFFICER FILE NUMBER:
PLAINTIFF/PETITIONER:
DEFENDANT/RESPONDENT:
CLAIM OF EXEMPTION
FOR COURT USE ONLY
(Wage Garnishment)
READ EMPLOYEE INSTRUCTIONS (FORM WG-003)
BEFORE COMPLETING THIS FORM
Copy all the information required above (except the top left space) from the
Earnings Withholding Order. The top left space is for your name or your attorney's
name and address. The original and one copy of this form with the Financial
Statement attached must be filed with the levying officer.
DO NOT FILE WITH THE COURT.
CASE NUMBER:
1. My name is :
2. I need the following earnings to support myself or my family (check a or b):
a.
All earnings.
b.
$
each pay period.
3. Please send all papers to
me.
my attorney
at the address
shown above
following (specify):
4. I am willing for the following amount to be withheld from my earnings each pay period during the withholding period. I understand
that the judgment creditor can accept this offer by not opposing the Claim of Exemption, which will result in the following
sum being withheld each pay period (check a or b):
a.
None
b.
Withhold $
5. I am paid
daily
weekly
each pay period.
every two weeks
monthly
twice a month
other (specify):
NOTE: You must attach a properly completed Financial Statement form to this Claim of Exemption.
The Financial Statement form is available without charge from the levying officer.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date:
(TYPE OR PRINT NAME)
Form Approved by the
Judicial Council of California
WG-006 [Rev. January 1, 2009]
(SIGNATURE OF DECLARANT)
For your protection and privacy, please press the Clear This Form
button after you have printed the form.
Save This Form
Page 1 of 1
Code of Civil Procedure, § 706.124
www.courtinfo.ca.gov
CLAIM OF EXEMPTION
(Wage Garnishment)
Print This Form
Clear This Form
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