Free Wage Execution Application - Connecticut

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UNITED STATES BANKRUPTCY COURT DISTRICT OF CONNECTICUT AT : : : Docket No. : : APPLICATION FOR WAGE EXECUTION Pursuant to Rule 69 of the Federal Rules of Civil Procedure ans section 52-361a of the Connecticut General Statutes, ____________________________________________________, here by applies for the issuance of a wage execution and in support thereof makes the following representations: 1. On __________________________________________judgement entered in this action against _______________________________________________________________________ for $ _____________________________plus cost of $______________________________and interest at the rate of _____________________________pursuant to 28 U.S.C. Section 1961. 2. (Name of Judgement Debtor) ______________________________________________ has made __________________________________payments and (insert name of party making application) ___________________________________________________ has received(enter amount) __________________________________________ pursuant to the Courts judgement. 3. As of ________________________________________________ , the total amount of the unpaid judgement, including interest and costs, is $ ________________________________. Interest continues to accrue on the principle amount of the judgement at the rate of ___________ per annum. 4. The last known employer of the Judgement Debtor, (insert name)___________________ is: (indicate name and address of employer) Dated this ______________________ day of _________________________ , 19 .

Respectfully submitted,

__________________________

UNITED STATES BANKRUPTCY COURT DISTRICT OF CONNECTICUT AT : : : Docket No. : : WAGE EXECUTION To the marshal of the District of Connecticut or to any person authorized to serve process under the Federal rules of Civil Procedure - Greetings: WHEREAS the (insert the name and address of party making application)_______________ ______________________________________________________________________________ ______________________________________________________________________________ On the _____________________ day of __________________________ 19_______, recovered judgment against the Judgment Debtor (insert name) _________________________________ Whose last known address is __________________________________________________ before the United States Bankruptcy Court of the District of Connecticut for the sum of $ ______________ plus cost of $__________________ An interest as appears of record; AND WHEREAS, the said Judgment debtor ( insert name)__________________________ failed to comply with said judgment, as appears of record by the application of (insert name) _________________________________________ moving that this execution issue; AND WHEREAS, execution remains to be done on the total unpaid judgment, including cost and interests, in the amount of $______________________. These are, therefore, by the authority of the United States of America, to command you, that of any amount of debt accruing by reason of personal services due said (insert name of party making application)__________________________ as may not exceed the amount of execution as calculated in the attached "Wage Execution Notice to Employer", within your precinct or jurisdiction, you cause to be levied, paid, and satisfied unto the said (insert name of party making application) _______________________________, with interest from the said date of judgment on the total unpaid judgment to the date when this execution is satisfied and your own fees . You are further commanded to serve with this execution two copies of the "Wage Execution Notice to Employer" and Wage Execution Exemption and Modification Claim form", that are accompanied herewith. (Insert name of Judgment Debtor)______________________________ last known employer is (insert name and address) _________________________________________________ Make service hereof within one year of this date, and due return hereof with your doings thereon, within thirty days from satisfaction hereof. Dated at___________________________, Connecticut, this ____________________ day of _______________________, 2002. By _______________________
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