HB 2428
| Plaintiff, |
| No. ________ |
| Defendant, |
| Garnishee. |
HB 2428
| 3 | Defendant ___________________ | Plaintiff's attorney _________________________ | |
| 4 | Address __________________________________ | Address ________________________________________ | |
| 5 | __________________________________________ | _______________________________________________ |
| ____________________ |
| (Signature), Clerk |
| 30 | Service, First Person | $__________ |
| 31 | ___________________________ Additional Persons | $__________ |
| 32 | ___________________________ Persons Not Found | $__________ |
| 33 | Mileage: _________________ miles | $__________ |
| 34 | Total | $__________ |
| Plaintiff, |
HB 2428
| No. ________ |
| Defendant, |
| Garnishee. |
| 24 | Defendant _______________________ | Plaintiff's attorney _________________________ | |
| 25 | Address ____________________________ | Address ______________________________________ | |
| 26 | ____________________________________ | ______________________________________________ |
| ________________ |
| (Signature), Clerk |
HB 2428
| 7 | Service, First Person | $__________ |
| 8 | ____________________ Additional Persons | $__________ |
| 9 | ____________________ Persons Not Found | $__________ |
| 10 | Mileage: _________ miles | $__________ |
| 11 | Total | $__________ |
HB 2428
| ____________________ |
| ____________________ |
| (Signature) Garnishee |
HB 2428
| pay the defendant-employee $127.50 |
| pay the defendant-employee $255.00 |
| period pay the defendant-employee $276.25 |
| pay the defendant-employee $552.50 |
| pay the defendant-employee 75% of |
HB 2428
| the defendant-employee's disposable earnings |
| pay the defendant-employee 75% of |
| the defendant-employee's disposable earnings |
| pay the defendant-employee 75% of |
| the defendant-employee's disposable earnings |
| pay the defendant-employee 75% of |
| the defendant-employee's disposable earnings |
| 28 | (c)Total gross earnings due for the period or periods covered by (b)are | $__________ | |
| 29 | (d)Average gross earnings for normal pay period as designated in (b)are | $__________ |
| 32 | (1)Federal social security tax | $__________ |
| 33 | (2)Federal income tax | $__________ |
| 34 | (3)State income tax | $__________ |
| 35 | (4)Railroad retirement tax | $__________ |
| 36 | Total | $__________ |
| 38 | (f)Disposable earnings for the period or periods covered by (b) are(c minus e) | $___________ |
HB 2428
| 12 | (g)I am subtracting from the disposable earnings in (f) an amountsubject to an income withholding order for support | $___________ | |
| 13 | (h)In accordance with the instructions accompanying this answerform, I have determined that the amount which may be paid to defendantis | $___________ | |
| 14 | (i)I am withholding from the amount in (h) an administrative fee inthe amount of | $__________ | |
| 15 | (j)After paying to defendant the amount stated in (h) less the ad-ministrative fee in (i), I am holding the remainder of defendant's dispos-able earnings in the amount of | $__________ |
| 19 | Available disposable earnings from (j) | $__________ | |
| 20 | Amount of claim | $__________ | |
| 21 | Difference paid to the defendant in addition to amount shown in (g) | $__________ |
| ____________________ |
HB 2428
HB 2428
| 31 | __________________________________ | ____________________________________________ | |
| 32 | Name of Defendant | ||
| 33 | __________________________________ | ____________________________________________ | |
| 34 | Address |
HB 2428
| ____________________ |
HB 2428
HB 2428
| 1 | ___________________________________ | ____________________________________________ | |
| 2 | Name of Defendant | ||
| 3 | ___________________________________ | ____________________________________________ | |
| 4 | Address |
| ____________________ |