WAGE EXECUTION Pnoceeomos STATE OF CONNECWUT APPLICATION, ORDER, EXECUTION SUPERIOR COURT Rev. 2.15 jud. ct. gov c.c.s. 31-586). sac/51a. 52cm. I 2 . WAGEEX 29 use. zoeralrr I Instructions mululm? Judgment Creditor or Attorney Clerk Proper om - 1. Unless tiling electronically. prepare original and four copies. 1. Issue execution by signing Originalcopy with employer. 2. Attach form to this form, or Include with execution 2. Enter any court ordered limitation at the bottom of 2. Make return on signed original. as one PDF electronic form. section II on page 2. 3. Leave one copy of Modi?cation and Exemption 3. Present original and 3 copies to clerk of court. 3. Return original and 2 copies It on paper. Claim form with ampioyar and fill in 4. Keep one copy for your tile. It. Retalwscan copy for court ?le. ?Date of Service? on form. Name and mailing address of Judgment creditor or Attorney (To be completedoyduo'gmerri CredrtororAl?iomey) ?1 AD A NOTICE . The Judicial Branch of the State Law tilt-F lures LN: 71043.58 chonnecticutcompiiee with minimalism . .. - . - with Disabilities Act (ADA). "you need a itcrtuar 33"? 1 (IF reasonable accommodation in accordance 3804.40245 contact person listed at . Address of court (Number. street, and town) How? Session Date ot_Iudgmeni Docket numtler W) 70 HUNTIN ?run a Br 9 ?lly/15 our. b?OdoB?ilS Namefs] and addrese(en) of Judgment Creditorts) Nameio) end' addressies) of Judgment Debtoda) Bank of America, N.A. '55 PAPERMILL ROAD 11? RIVER RD NEHARE, DE 19711 PRESTON CT 06365 t: 2 ?53" Name and address ofernpioyer of Judgment Debtor (if known) .. Teiephone number of armloyer Efkncurn) STATE OF CONNECTICUT ., 5:33 ELM STREE i ., ., CT 0610 (860) 71 .zv?tal .39 1 Amount oi Judgment (include where applicable, interest and atlomey?s fees) 2. Amount oi costs and fees 6 $4 .86 3. Total ammntof judgment. coats and fees (Add 1 andZ) 4. Totai amount paid (If any 5. Totat amount 3' (SE two? From 3] $3t3.,514.32 $1 ,220.oo cohorts: 6. Apoiicurion fee for wage execution {if not waived by the court) 7. Application fees paid for prior executions on this judgment $105 .. 00 00 Check if applicable 8. Other Caurt ordered poetjudgment costs and fees 9. Total oiliinea 5. 6. 7 and} Postjudgment interest was - 00 $32 9 399 - 39-5 Eordered by the Court The above-named Judgment Credrtor(s) recovered a judgment agalnst the above-named Judgment Debtor(s) The Judgment Debtorr's) hasfhave failed to pay the total amount due on that judgmen Pursuant to the Connecticut General Statutes, the Court listed above entered an order that the judgment be paid by the above-named Judgment Debtods) in the following installment payments: The amount or $35 . 00 was ordered to be paid in was I . or other) installment payments. ?See Note below (Note; This is not the amount the employer must pay. Employer must pay the amount of execution calculated on page 2 of this icon. The court ordered that installment payments begin on 1 2/28/11 5 (commencement date) The Judgment Debtorts) failed to comply with the Installment Payment Order 5 Therefore, the Judgment Creditoris) appliesiapply for this execution upon the wages of the Judgment Debtor?s) for the remaining amount *5 due on the judgment shown in line 9 above 00 I, Use On {y 3 Signed on 'or y) gmt?lg 9991 File date or - 0 4 To: Any Proper Of?cer By the authority of the State of Connectrcut, you are ordered to cause any wages due to the Judgment Debtor(s). not exceeding the Amount of Execution calculated on page 2. to be paid to the Judgment Creditors) until the judgment to satisfied. including postjudgment Interest as ordered by the court. if applicable, plus the a plicat'on facts) and other Court ordered postjudgment costs and fees. and your own fees or until the execution is modi?ed or set aside. Serve execution within one year at this date, and make return of service to this caurtwitnin thirty days _i'rgrn se?e?ectlon of the execution. ?Wm m. lo Ma . 10/03/16 we?? wees EXECUTION Pnoceeorr?s' Pagetofz . . lmportant Notice To Employer You are being served with a wage execution. a court order requiring you to withhold non-exempt wages from a person erriployed by you. This execution is being served on you because your employee. the Judgment Debtor (on page has had a judgment entered against him/her by the Superior Cour-l requiring to pay judgment. costs and fees to the Judgment creditor (on page 1) and has not made poynnent of the total amount of the iudgmenl plus any costs and fees as shown on page 1. This notice is to inform you of the actions you must take in order to comply with the law regarding wage executions. Hesse read each soulon carefully. I. You must notify the employee Your employee has certain legal rights which executions are to be satis?ed in the order in which you are served with them. (Income may allow him/her to request the court to change or stop this execution upon hicl'hor withholding: and voluntary wage deductions for support ofa family. i! there are any, wages. A notice of hisiher rights and how to get a hearing in court is attached to the must be paid before this execution. Family support kmne Wholdings and voluntary second cepy of the wage execution given to you by the officer. You must complete wage deductions are issued on Form your portion of the wage execution and your portion of the exemption and modification V. Maximum amount deducted The maximum amount which can be legalty claim lonn and deliver marl, ?5:899 prepaid. a copy Of these papers to your withheld from your employee?s wages is 25% of Mother disposable earnings for each employee immediately so that your employee can make any claims allowed bylaw. week. The amount to be withheld to my this exemtion may be then 25%. but it can never be more. The com utations you complete below will slow to calculate it. Execution not eltoctive for 20 days This execution is not effective until after the exact Emu,? which shout: be withheld item employee?s wage? 20 days from the day the of?cer served the? papers on you. No money should be . dwudad "am your m10ye8'3 wages un?t ?rst wages you pay to your emphyao Un?e? the court orders that this 0mm" ?3 '0 b5 (or a amailar amount, you "lust after the 20-day period ends. ir your employee elects within the 20-day period to withhold .and Pay over the maximum amigimt when you ?euw out uane the make a claim to the court that hislhor wages are partially or totally exempt from computations below. mime ?53 3 '0 request '0 MUN 3?00 execution to pay this judgment or helshe seeks to have the amount of this execution withheld. until "3?95? the court has 39'9? 1? allow the changed. wages are not to be withheld train the employee until the court decides the ?0 be Wmd- maximum am- claims or determines the rights or youremployee in this case. if you are not notltlod VI- you, dug, 1? comply with up. execution You have a legal duty to make that your employee has ?led papers the court. the execution rs to be enforced deductions from your employee?s wages and pay any amounts deducted as required a?erZO days from the date ofsewica on you. by this execution. it you do not, legal action may be taken against you. if you are lit. Stay of execution No earnings claimed to be exempt or subiect to a claim for Creditor for the amounts of wages which you did not withhold from your employee. modification may be withheld from any employee until determination of the claim by the court. IV. Only one execution issued under section 52-36? of the Generalsottutes to - - I laymen bench - . to be satisfied at I time You must matte deductions from your employee's wages 1 ts mm the time 0? your action to the um. and pay over the withheld money against only one execiilicn issued under General . . smite: section 52-ssia at a time. 1r you are served with more than one exectrtion The law allows you to take dimmer! measures the BMW if you are issued under General Statutes section 52-3613 against this employee's wages. the served with more than 7 wage executions against hislher wages ?t any calendar year. Section I. Calculation Of Employee's Disposable Earnings "Disposable Earnings" means that part of the earnings of an individual remaining after the deduction from those earnings of amounts to be withheld for payment of federal income and employment taxes. nonnai retirement contributions. union dues and initiation fees. group life insurance premiums. health insurance premiums. and federal tax levies. t. Employee's gross compensation per week .. . . 2. Federal income tax withheld 3. Federal employment tax . . 4. Normal retirement contribution . . . 5. Union dues and initiation fees . . . 6. Group life insurance premium . . . 7. Health insurance premium . . 8. Other federal tax levies 9. Total allowable deductions (Add lines 2-8) . 10. Weekly Disposable Earnings (Subtract line 9 from line 1) Section ll. Calculation Of Employee's Disposable Earnings To be calculated by employer Column 1 I Column 2 Weekly disposable earnings (from line 10 above) 25% of disposable earnings for week 5 B-1. Weekly disposable earnings (from line 10 above) 3-2 Forty times the higher of the current federal minimum 3 hourly wage orstate full minimum fair wage. Amount by which line 8-1 exceeds 3 Amount Of Execution (Employer must pay the lesser ofthe two amounts in column 2 unless the court ordered limitation set forth below is a lesser amount, in which case the employer muatpey that lesser amount) ?9 Court ordered limitation (If any. to be entered by clerk} JD-CV-3 Rev. 2-15 Page 2 of 2 EXEMPTION AND MODIFICATION . . CLAIM FORM. WAGE EXECUTION STATE OF CONNECTICUT f??igi?, 212-32. 52-3503. 52-352b. 52-3613. SUPERIOR COURT 52-361b. 29 u.s.c.2oe(ay1ldebto who i a ma ng a mus pay many) or Ilj?ull' (To be completed by judgment creditor (person who money is paid 10)) 1' M0 TH BOWL ES To proper of?cer: Complete Section ll below and 1 1 1? RIVER I) make service on employerin accordance wine the or 06365 To employer: Complete Section ill below and TH 1' ES COMMUN Section i Juggmenpt (?oater ipCeLrsLokr?thhokmoney is paid to) must fill out this section and attach to one copy of the wage execution application . . Geographical Nam. ofcourf .. .. . MIC i H0 I may T70 HUN till: 1 UN oi LUNDLIN LT Nameofcaae Docket number ice-mic: of emerica N. ?t .. vs; BONLES fiUltii?OE?Ei?PIS Name of judgment debtor (person who must pay money) TI MC) THY HOMES Section ll - Pro Home of proper of?cer Date of service of wage exeolnbn on employer Section Empio yer must ?ll out this section and TEL send one copy of this form and the Wage Execution form (JD-CV-S) to the 'udment dethr General Statutes section 52-3618 - . Nam and address ofempioyer Telephone number of payroll department Dale of dellvety or mating to judgment debtor Total amount of wage execution Amount to be taken out from weekly earnings named above. Beginning twenty (20) days from the Date of Service of Wage Execution on Employer indicated above. the employer will remove from your weekly earnings an amount of money which leaves you with seventy-?ve percent of your disposable earnings 0R forty (40) times the higher of the minimum houny wage set by federal law or state law; whichever is the larger amount. On page 2 of this form are the sections of the Connecticut General Statutes which your employer must follow to figure out (calculate) the weekly amount that may be taken out of your wages to agree with the wage execution. if you think that your employer has not calculated the weekly amount correctly, you should tell your employer. Your earnings may be exempt from execution (do not have to be taken) Any wage earned by a person who gets public assistance under an incentive earnings or similar program are exempt from (may not be taken from you) execution. (Section 524352b(d) of the Connecticut General Statutes). Modi?cation of execution if you have reasonable cause to believe that you have a right to a modi?cation (change) of the wage execution and you want to ask for a modi?cation (to have less money taken from your wages), you must fill out the Claim for Modification on come to court. you may, within four (4) months of the date the court made its judgment and upon belief that you have reasonable cause. ask the court to set aside the judgment entered against you and the case will begin again. A fee will be charged to you for a motion to set aside judgment. Page 1 of2 Exemption and modi?cation claim Section - Claim of exemption established by law l, the Judgment Debtor (person who must pay money), claim and certify under the penalty of false statement that my earnings are exempt from execution (do not have to be taken) because: I get public assistance and earn wages under an incentive earnings or similar program and my earnings are exempt from execution, or Other statutory exemption (state exemption and statutory citation) Signed (Judgment Debtor) Date signed Name and address ctjudgnent debtor Telephone number Section Vi - Claim for modi?cation l. the Judgment Debtor (person who must pay money). ask for a modi?cation of the wage execution against me because: New amount requested Desatbe why you think you should get a mdi?mtien (have less mney taken from your wages) I For week Signed (Judgment Debtor) Date signed Name and complete mailing address of judgment debtor Telephone number Section VII - Agreement to a modification The Judgment Creditor(s) (person who money is paid to) agrees to the modi?cation of the Wage Execution claimed Signed (Judgment orAttomeyj) Name of Judgment Creritode) or Attomey Date Section - Notice of hearing on exemption I modi?cation claim Date of hearing Time of heart Courtroom "9 By the Assistant Clerk Section ix - Order of court it is ordered that: Signed (Judge. Magistrate, Assistant Clem rd rt Date Signed 0 er 0 cou General Statutes 1. The following is the part of section 52-361a(l) of me Connecticut General Statutes which says what part of yourwagee can be removed by the employer and given to the judgment creditor. "The maximum part of the aggregate weekly comings of an individual which may be subject under this section to levy or other withholding for payment of a judgment is the lesser of (1) Monty-live (25) percent of his disposable earnings for that week, or the amount by which his disposable earnings for that week exceed forty (40) times the higher of (A) the minimum hourly wage prescribed by section 6(a)(1 of the Fair Labor Standards Act of 1938. 29 U.S.C. Section 206(c)(1). or (B) the full minimum fair wage established by subsection of section 31-58. in effect at the time the earnings are payable.? 2. The following is the part of section of the Connecticut General Statutes which de?nes disposable and which de?nes inlet ports of your wages which can not be included in your total when ?guring out (caiwlating) the Weekly amount which is subject to execution. "Disposable earnings' means that part of the earnings of an individual remaining alter the deduction from those earnings of amounts required to be withheld for payment of federal income and employment taxes, normal retirement contributions. union dues and initiation fees. group life insurance premiums. health insurance premiums and federal tax levies.? (ham 2) Rev. 11-15 . Page 2 of 2 .