SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

PEOPLE OF THE STATE OF CALIFORNIA 

DEFENDANT:

v.

ORDER FOR INCOME DEDUCTION 
(Pen. Code, § 1202.42)

CASE NUMBER:

FOR COURT USE ONLY

CR-119

To: Employer:

Address:

Phone:

Date:

SEAL

1.  The court has found that the defendant has the ability to pay restitution under Penal Code section 1202.42 and has ordered that

he or she pay restitution of  $

plus 10% interest.

2.  You are ordered to withhold a portion of the earnings of the defendant in this action (name):

(last 4 digits of social security number (specify):

), each pay period.

,

3.  You are ordered to deduct:  $

from the above named employee's pay each period and forward

funds to the

Clerk of the above entitled court

Other
          (specify):

4. This order will terminate upon payment in full or further order of this court.

CLERK'S CERTIFICATE

The foregoing is a full, true, and correct 
copy of the original on file in this office.

CLERK OF THE SUPERIOR COURT

Date:

By

, Deputy

Form Approved for Optional Use 
Judicial Council of California 
CR-119 [New January 1, 2005]

ORDER FOR INCOME DEDUCTION 
(Pen. Code, § 1202.42)

Page 1 of 2

Penal Code, § 1202.42
www.courts.ca.gov

PEOPLE OF THE STATE OF CALIFORNIA v.
DEFENDANT:

CASE NUMBER:

Notice to Employer re: Order for Income Deduction (Pen. Code, § 1202.42)

1. You are required to deduct the amount specified in the Order for Income Deduction from the employee's income and to pay 

that amount to the clerk of the above entitled court or its agent.

2. The order is to be implemented no later than the first payment date that occurs more than 14 days after the date of service of 

the order.

3. Within two days after each payment date, forward the amount deducted and a statement about whether the amount totally 

or partially satisfies the periodic amount specified in the income deduction order.

4.

If you fail to deduct the proper amount from the employee's income, you are liable for the amount you should have deducted, 
plus costs, interest, and reasonable attorney fees.

5. You may collect up to five dollars ($5) against the employee's income to reimburse you for administrative costs for the first 

deduction and up to one dollar ($1) for each deduction thereafter.

6. This order and notice are binding until further notice by the court or until you no longer provide income to the employee.

7. When you no longer provide income to the employee, you must notify the clerk of the above entitled court and provide the 
employee's last known address and the name and address of the employee's new employer, if known. If you violate this 
provision, you are subject to a civil penalty not to exceed two hundred fifty dollars ($250) for the first violation or five hundred 
dollars ($500) for any subsequent violation.

8. You must not discharge, refuse to employ, or take disciplinary action against the employee because of an income 

deduction order. If you violate this provision, you are subject to a civil penalty not to exceed two hundred fifty dollars ($250) for 
the first violation or five hundred dollars ($500) for any subsequent violation.

9.

If you receive income deduction orders for two or more employees sent by the same court, you may combine the amounts 
that are to be paid in a single payment, but you must identify the portion of the payment that is attributable to each employee.

10. If you receive two or more income deduction orders against the same employee, you must contact the above entitled court for 

further instructions.

CR-119 [New January 1, 2005]

Page 2 of 2

ORDER FOR INCOME DEDUCTION 
(Pen. Code, § 1202.42)