Here is the text we could read:
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
LEVYING OFFICER (Name and Address):
WG-004
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:
EARNINGS WITHHOLDING ORDER FOR SUPPORT
LEVYING OFFICER FILE NUMBER:
(Wage Garnishment)
COURT CASE NUMBER:
EMPLOYEE: KEEP YOUR COPY OF THIS LEGAL PAPER.
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 or the
date mail receipt was signed):
TO THE EMPLOYER REGARDING YOUR EMPLOYEE:
Name and address of employee
Name and address of employee
Social Security No.
on form WG-035
unknown
1.
A judgment creditor has obtained this order to collect a court judgment against your employee. You are directed to withhold part
of the earnings of the employee (see instructions on reverse of this form). Pay the withheld sums to the levying officer (name
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.
Complete both copies of the form Employer's Return and mail them to the levying officer within 15 days after receiving this
order, whether or not the employee works for you.
2.
The total amount due is: $
Count 10 calendar days from the date when you received this order. If your employee's pay period ends before the tenth day, do
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
(1)
(2)
the total amount due has been withheld; or
you receive a court order or an order from the levying officer telling you to stop the withholding earlier.
The judgment was entered in the court shown above. The judgment creditor is (name):
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.
3.
4.
Date:
(TYPE OR PRINT NAME)
(SIGNATURE)
LEVYING OFFICER
REGISTERED PROCESS SERVER
The EMPLOYER'S INSTRUCTIONS on the reverse contain special rules that apply to Earnings Withholding Order for Support. Read
the instructions carefully.
(Employer's Instructions on reverse)
Form Adopted for Mandatory Use
Judicial Council of California
WG-004 [Rev. January 1, 2012]
EARNINGS WITHHOLDING ORDER FOR SUPPORT
(Wage Garnishment)
Page 1 of 2
Code of Civil Procedure, ยงยง 706 030,
706.108, 706.052
www.courts.ca.gov
EMPLOYER'S INSTRUCTIONS
(EARNINGS WITHHOLDING ORDERS FOR SUPPORT)
WG-004
The 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 em-
ployee and the levying officer.
Your other duties are TO WITHHOLD THE CORRECT
AMOUNT OF EARNINGS (if any) and PAY IT TO THE LEVY-
ING 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 Earn-
ings 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.
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
the employee's
limitations are based on
withheld. The
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, WITH-
HOLD 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, 2012]
Page 2 of 2
EARNINGS WITHHOLDING ORDER FOR SUPPORT
(Wage Garnishment)
