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WG-004
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): TELEPHONE NO.: LEVYING OFFICER (Name and Address):

COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. :
ATTORNEY FOR (Name): NAME OF COURT, JUDICIAL DISTRICT, OR BRANCH COURT, IF ANY:

Index No. Calendar No.

: Plaintiff(s) : : :

JUDICIAL SUBPOENA

PLAINTIFF: DEFENDANT:

-against-

: ...................................................... EMPLOYEE: KEEP YOUR COPY OF THIS LEGAL PAPER. THE PEOPLE OF THE STATE OF NEW YORK TO or the date mail receipt was signed):
TO THE EMPLOYER REGARDING YOUR EMPLOYEE:
Name and address of employer

: EARNINGS WITHHOLDING ORDER FOR SUPPORT (Wage Garnishment) Defendant(s)

LEVYING OFFICER FILE NO.:

COURT CASE NO.:

EMPLEADO: GUARDE ESTE PAPEL OFICIAL.

EMPLOYER: Enter the following date to assist your record keeping.
Date this order was received by employer (specify the date of personal delivery by levying officer or registered process server

Name and address of employee

GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court Social Security Number (if known): located at County of 1. A judgment creditor has obtained this order to collect a court judgment against your employee. You any directed to withhold part of in room , on the day of , 20 , at o'clock in the noon, and at are recessed the earnings of the employee (see instructions on reverse this action onPay the withheld sums to the levying officer (name of this form). the part of the or adjourned date, to testify and give evidence as a witness in
and address above). If the employee works for you now, you must give the employee a copy of this order and the Employee Instructions within 10 days after receiving this order.

Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to Complete both copies of the form was issued Return and mail them of $50 and all damages sustained as a the party on whose behalf this subpoena Employer's for a maximum penaltyto the levying officer within 15 days after receiving this resultorder, whether or not the employee works for you. of your failure to comply.
2. The total amount due is $

Court in

Count 10 calendar days from the date when you received this order. If your employee's pay period ends before the tenth day, do County, day of , 20 not withhold earnings payable for that pay period. Do withhold from earnings that are payable for any pay period ending on or after that tenth day. Continue withholding until (Attorney must sign above and type name below) (1) the total amount due has been withheld; or (2) you receive a court order or an order from the levying officer telling you to stop the withholding earlier.

Witness, Honorable

, one of the Justices of the

3. The judgment was entered in the court shown above. The judgment creditor is (name): Attorney(s) for 4. The EMPLOYER'S INSTRUCTIONS on the reverse tell you how much of the employee's earnings to withhold each payday. Follow those instructions unless you receive a court order or order from the levying officer giving you other instructions.
Date:

............................................................................
(TYPE OR PRINT NAME)

Office and P.O. Address
(SIGNATURE) LEVYING OFFICER REGISTERED PROCESS SERVER

Telephone No.: The EMPLOYER'S INSTRUCTIONS on the reverse contain special rules that apply to Earnings Withholding Order For Support. Read Facsimile No.: the instructions carefully. E-Mail Address: (Employer's Instructions on reverse) Page 1 of 2 Code of Civil Procedure, 706 030, Form Adopted by the Mobile Tel. No.: SUPPORT EARNINGS WITHHOLDING ORDER FOR Judicial Council of California 706.108, 706.052 WG-004 [Rev. January 1, 2007] www.courtinfo.ca.gov (Wage Garnishment) American LegalNet, Inc.
www.FormsWorkflow.com

EMPLOYER'S INSTRUCTIONS (EARNINGS WITHHOLDING ORDERS FOR SUPPORT)
These instructions apply only to Earnings Withholding Orders for Support. Applicable instructions appear on the reverse of the other types of Earnings Withholding Orders. The instructions in paragraph 1 on the reverse of this form describe your early duties to provide information to your employee and the levying officer. Your other duties are TO WITHHOLD THE CORRECT AMOUNT OF EARNINGS (if any) and PAY IT TO THE LEVYING OFFICER during the withholding period. The usual withholding period begins ten (10) calendar days after you receive the Earnings Withholding Order. In the case of an Earnings Withholding Order for Support (this Order) the withholding period continues until one of two things happens: (1) the total amount specified in the Order, plus any amounts listed in a notice from the levying officer, has been withheld,or (2) you receive a court order or notice signed by the levying officer specifying a termination date. You are entitled to rely on and should obey all written notices signed by the levying officer. The form Employer's Return describes several situations that could affect the withholding period for this order. If you receive more than one Earnings Withholding Order during a withholding period, review that form (Employer's Return) for instructions. Your duty to withhold does not end merely because the employee no longer works for you. Withholding for an Earnings Withholding Order for Support does not automatically terminate until one year after the employment of the employee by the employer ends. WHAT TO DO WITH THE MONEY The amounts withheld during the withholding period must be paid to the levying officer by the 15th of the next month after each payday. If you wish to pay more frequently than monthly, each payment must be made within ten (10) days after the close of the pay period. Be sure to mark each check with the case number, the levying officer's file number, if different, and the employee's name so the money will be applied to the correct account WHAT IF YOU STILL HAVE QUESTIONS? The garnishment law is contained in the Code of Civil Procedure beginning with section 706.010. Sections 706.022, 706.025, and 706.104 explain the employer's duties. The Federal Wage Garnishment Law and federal rules provide the basic protections on which the California law is based.

WG-004

Inquiries about the federal law will be answered by mail, telephone or personal interview at any office of the Wage and Hour Division of the U.S. Department of Labor. Offices are listed in the telephone directory under the U.S. Department of Labor in the U.S. Government listing. COMPUTATION INSTRUCTIONS State and federal law limits the amount of earnings that can be withheld. The limitations are based on the employee's disposable earnings, which are different from gross pay or take-home pay. To determine the CORRECT AMOUNT OF EARNINGS TO BE WITHHELD (if any), compute the employee's disposable earnings. (A) Earnings include any money, (whether called wages, salary, commissions, bonuses or anything else) that is paid by an employer to an employee for personal services. Vacation or sick pay is subject to withholding as it is received by the employee. Tips are generally not included as earning since they are not paid by the employer. (B) Disposable earnings are the earnings left after subtracting the part of the earnings a state or federal law requires an employer to withhold. Generally these required deductions are (1) federal income tax, (2) federal social security, (3) state income tax, (4) state disability insurance, and (5) payments to public employees' retirement systems. Disposable earnings will change when the required deductions change. After the employee's disposable earnings are known, WITHHOLD FIFTY (50) PERCENT of the disposable earnings for the Withholding Order for Support. For example, if the employee has monthly disposable earnings of $1,432, the sum of $716 would be withheld to pay to the levying officer on account of this order. Occasionally, the employee's earnings will also be subject to a Wage and Earnings Assignment Order, an order available for child support or spousal support. The amount required to be withheld for that order should be deducted from the amount to be withheld for this order. For example, if the employee is subject to a Wage and Earnings Assignment Order and the employer is required to withhold $300 per month to pay on that order, when the employer receives this Earnings Withholding Order for Support, the employer should deduct the $300 for the Wage and Earnings Assignment Order from the $716 and pay the balance to the levying officer each month for this order.

IMPORTANT WARNINGS 1. IT IS AGAINST THE LAW TO FIRE THE EMPLOYEE BECAUSE OF EARNINGS WITHHOLDING ORDERS FOR THE PAYMENT OF ONLY ONE INDEBTEDNESS. No matter how many orders you receive, so long as they all relate to judgment (no matter how many debts are represented in that judgment) the employee may not be fired. 2. IT IS ILLEGAL TO AVOID AN EARNINGS WITHHOLDING ORDER BY POSTPONING OR ADVANCING THE PAYMENT OF EARNINGS. The employee's pay period must not be changed to prevent the order from taking effect.
3. IT IS ILLEGAL NOT TO PAY AMOUNTS WITHHELD FOR THE EARNINGS WITHHOLDING ORDER TO THE LEVYING

OFFICER. Your duty is to pay the money to the levying officer who will pay the money in accordance with the laws that apply to this case. IF YOU VIOLATE ANY OF THESE LAWS, YOU MAY BE HELD LIABLE TO PAY CIVIL DAMAGES AND YOU MAY BE SUBJECT TO CRIMINAL PROSECUTION!
WG-004 [Rev. January 1, 2007]

EARNINGS WITHHOLDING ORDER FOR SUPPORT (Wage Garnishment)

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