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Here is the text we could read:

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):

RETURN TO LEVYING OFFICER. DO NOT FILE WITH COURT

WG-006

FOR LEVYING OFFICER USE ONLY

(Levying Officer Name and Address)

FAX NO. (Optional):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:

TELEPHONE NO.:

E-MAIL ADDRESS (Optional):

ATTORNEY FOR (Name):

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

PLAINTIFF/PETITIONER:

DEFENDANT/RESPONDENT:

CLAIM OF EXEMPTION
(Wage Garnishment)

LEVYING OFFICER FILE NUMBER:

FOR COURT USE ONLY

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.

1. My name is:

I need the following earnings to support myself or my family (check a or b):
a.

All earnings.

CASE NUMBER:

each pay period.

3. Please send all papers to

me
my attorney

at the address
shown above
(specify):

following

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):

None

Withhold $

I am paid

each pay period.

daily

weekly

every two weeks

twice a month

monthly

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 for Optional Use
Judicial Council of California
WG-006 [Rev. January 1, 2009]

CLAIM OF EXEMPTION
(Wage Garnishment)

(SIGNATURE OF DECLARANT)

Page 1 of 1

Code of Civil Procedure, § 706.124

Claim of Exemption

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the California state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from selfhelp.courts.ca.gov (2023-03)
Page(s): 1
Fields(s): 36
Average fields per page: 36
Reading Level: Grade 7
LIST Grouping(s): Unknown

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

g_page_p_info_number_name was WG-006[0].Page1[0].p1Caption_sf[0].LevOfcrInfo_sf[0].LevNumber_name[0] (0.60 conf)
w_g_page_p_sf_lev_number was WG-006[0].Page1[0].p1Caption_sf[0].LevNumber_sf[0].LevNumber_ft[0] (0.41 conf)
w_g_page_p_case_number was WG-006[0].Page1[0].p1Caption_sf[0].CaseNumber[0].CaseNumber[0] (0.35 conf)
page_p_party_info_text_field was WG-006[0].Page1[0].p1Caption_sf[0].AttyPartyInfo[0].TextField1[0] (0.44 conf)
w_page_p_party_info_phone was WG-006[0].Page1[0].p1Caption_sf[0].AttyPartyInfo[0].Phone[0] (0.35 conf)
w_page_p_caption_party_info was WG-006[0].Page1[0].p1Caption_sf[0].AttyPartyInfo[0].Fax[0] (0.35 conf)
w_page_p_party_info_email was WG-006[0].Page1[0].p1Caption_sf[0].AttyPartyInfo[0].Email[0] (0.35 conf)
w_g_page_p_party_info was WG-006[0].Page1[0].p1Caption_sf[0].AttyPartyInfo[0].Attorneyname[0] (0.35 conf)
w_page_p_sf_info_county was WG-006[0].Page1[0].p1Caption_sf[0].CourtInfo[0].CrtCounty[0] (0.33 conf)
w_page_p_caption_info_street was WG-006[0].Page1[0].p1Caption_sf[0].CourtInfo[0].Street[0] (0.31 conf)
w_page_p_caption_info_add was WG-006[0].Page1[0].p1Caption_sf[0].CourtInfo[0].MailingAdd[0] (0.35 conf)
w_g_page_p_caption_sf_court_info_city_zip was WG-006[0].Page1[0].p1Caption_sf[0].CourtInfo[0].CityZip[0] (0.33 conf)
w_page_p_court_info_branch was WG-006[0].Page1[0].p1Caption_sf[0].CourtInfo[0].Branch[0] (0.31 conf)
w_page_p_title_party_name__1 was WG-006[0].Page1[0].p1Caption_sf[0].TitlePartyName[0].Party1[0] (0.32 conf)
w_page_p_title_party_name__2 was WG-006[0].Page1[0].p1Caption_sf[0].TitlePartyName[0].Party2[0] (0.32 conf)
w_g_page_list_item_fill_text was WG-006[0].Page1[0].List1[0].item1[0].FillText1[0] (0.37 conf)
w_g_page_list_lia_cb_choice__1 was WG-006[0].Page1[0].List2[0].Lia[0].CBChoice1_cb[0] (0.34 conf)
w_g_page_list_lib_cb_choice__1 was WG-006[0].Page1[0].List2[0].Lib[0].CBChoice1_cb[0] (0.34 conf)
w_page_list_lib_decimal_field was WG-006[0].Page1[0].List2[0].Lib[0].DecimalField1[0] (0.34 conf)
w_g_page_list_lia_cb_choice__2 was WG-006[0].Page1[0].List3[0].Lia[0].CBChoice3_cb[0] (0.34 conf)
w_g_page_list_lib_cb_choice__2 was WG-006[0].Page1[0].List3[0].Lib[0].CBChoice3_cb[0] (0.34 conf)
w_g_page_list_lic_ch__1 was WG-006[0].Page1[0].List3[0].Lic[0].Ch1[0] (0.33 conf)
w_g_page_list_lic_ch__2 was WG-006[0].Page1[0].List3[0].Lic[0].Ch2[0] (0.33 conf)
w_g_page_list_lic_fill_text was WG-006[0].Page1[0].List3[0].Lic[0].FillText91[0] (0.39 conf)
w_g_page_list_lia_cb_choice__3 was WG-006[0].Page1[0].List4[0].Lia[0].CBChoice2_cb[0] (0.34 conf)
w_g_page_list_lib_cb_choice__3 was WG-006[0].Page1[0].List4[0].Lib[0].CBChoice2_cb[0] (0.34 conf)
w_g_page_list_lib_fill_text was WG-006[0].Page1[0].List4[0].Lib[0].FillText95[0] (0.39 conf)
w_g_page_list_item_cb_choice__1 was WG-006[0].Page1[0].List5[0].item5[0].CBChoice5_cb[0] (0.39 conf)
w_g_page_list_item_cb_choice__2 was WG-006[0].Page1[0].List5[0].item5[0].CBChoice5_cb[1] (0.39 conf)
w_g_page_list_item_cb_choice__3 was WG-006[0].Page1[0].List5[0].item5[0].CBChoice5_cb[2] (0.39 conf)
w_g_page_list_item_cb_choice__4 was WG-006[0].Page1[0].List5[0].item5[0].CBChoice5_cb[3] (0.39 conf)
w_g_page_list_item_cb_choice__5 was WG-006[0].Page1[0].List5[0].item5[0].CBChoice5_cb[4] (0.39 conf)
w_g_page_list_item_cb_choice__6 was WG-006[0].Page1[0].List5[0].item5[0].CBChoice5_cb[5] (0.39 conf)
w_g_page_list_item_specify was WG-006[0].Page1[0].List5[0].item5[0].specify[0] (0.32 conf)
w_g_page_sign_date was WG-006[0].Page1[0].Sign[0].Date1[0] (0.34 conf)
w_g_page_sign_print was WG-006[0].Page1[0].Sign[0].Print1[0] (0.34 conf)

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

Claim of Exemption

About This Form:

Identified Data Fields:

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The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02