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

DATE RECEIVED BY COURT (Do not file in public court file.)

CONFIDENTIAL

WG-035

FAX NO.:

SUPERIOR COURT OF CALIFORNIA, COUNTY OF
:

TELEPHONE NO.:

E-MAIL ADDRESS:

ATTORNEY FOR (Name):

   STREET ADDRESS:

  MAILING ADDRESS:

CITY AND ZIP CODE:

        BRANCH NAME:

       PLAINTIFF/PETITIONER:

DEFENDANT/RESPONDENT:

CONFIDENTIAL STATEMENT OF JUDGMENT DEBTOR'S
 SOCIAL SECURITY NUMBER
(Supplement to Wage Garnishment Forms
 WG-001, WG-002, WG-004, WG-005, WG-009, WG-012, and WG-030)

(Do not attach to forms.)

COURT CASE NUMBER:

LEVYING OFFICER FILE NUMBER:

This separate Confidential Statement of Judgment Debtor’s Social Security Number contains the Social Security number of the 
judgment debtor for whom an earnings withholding order is being sought or has issued in the case referenced above.  This 
supplement must be kept separate from any applications or orders filed in this case, and should not be a public record.

INFORMATION ON JUDGMENT DEBTOR:

1.  Name:

2.  Social Security Number:

TO COURT CLERK 
THIS STATEMENT IS CONFIDENTIAL. 
 DO NOT FILE THIS CONFIDENTIAL STATEMENT IN A PUBLIC COURT FILE.

Form Adopted for Mandatory Use 
Judicial Council of California 
WG-035 [New January 1, 2012]

CONFIDENTIAL STATEMENT OF JUDGMENT DEBTOR'S
 SOCIAL SECURITY NUMBER
Wage Garnishment

Page 1 of 1

www.courts.ca.gov



Confidential Statement of Judgment Debtor's Social Security Number

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.

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• Sourced from selfhelp.courts.ca.gov (2023-03)
• Page(s): 1
• Fields(s): 20
• Average fields per page: 20
• Reading Level: Grade 9
• LIST Grouping(s): CO-07-00-00-00, CO-00-00-00-00.

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