Arizona Supreme Court Page 1 of 3 AOC CVGE12F-100518 (1) [ ] JUSTICE COURT , COUNTY OF (2) [ ] MUNICIPAL COURT , COUNTY OF (3) [ ] ARIZONA SUPERIOR COURT, COUNTY OF (4) Petitioner/Plaintiff [ ] Judgment Creditor [ ] Judgment Debtor Name: Address: City, State, Zip Code: Email Address: Phone(s): (5) Respondent/Defendant [ ] Judgment Debtor [ ] Judgment Creditor Name: Address: City, State, Zip Code: Email Address: Phone(s): (6) Garnishee: Name: Address: City, State, Zip Code: Email Address: Phone(s): Attorney: (7) Case Number: GARNISHEE222S NONEXEMPT EARNINGS STATEMENT (NOT FOR SUPPORT OF A PERSON) (A.R.S. 247247 12-1598.11 & 12-1598.16(J)) 1. This Nonexempt Earnings Statement covers the following pay period: (8) to . American LegalNet, Inc. www.FormsWorkFlow.com Case Number: (7) Arizona Supreme Court Page 2 of 3 AOC CVGE12F-100518 2. Do you currently employ the judgment debtor? (9) [ ] Yes [ ] No 3. If no, what was the last date on which the judgment debtor worked for you? (10) . 4. Is the judgment debtor owed any earnings for this pay period? (11) [ ] Yes [ ] No WITHHOLDING WORKSHEET Judgment debtor222s gross earnings (pre - tax) for this pay period (12) $ Judgment debtor222s disposable earnings (gross minus deductions required by law) (13) $ 25% of line (13) (or other percentage ordered by the Court) (14) $ Judgment debtor222s pay period: (15) (C heck one . ) [ ] Weekly (factor = 30) [ ] Biweekly (factor = 60) [ ] Semimonthly (factor = 65) [ ] Monthly (factor = 130) Current federal minimum wage: (16) $ /hr. Line (16) multiplie d by factor selected in (15) (17) $ Line (13) minus line (17) (18) $ Amount from line (14) or line (18), whichever is smaller (19) $ Amount withheld for other court - ordered assignment for support of a person or other garnishment or levy for collection of taxes (20) $ Line (19) minus line (20), this is the amount withheld (21) $ Line (21) minus employer222s $5.00 processing fee (22) $ The amount shown on line (21) is the amount you should withhold for this pay period. The amount shown on line (22) is the amount you deliver to the judgment creditor. American LegalNet, Inc. www.FormsWorkFlow.com Case Number: (7) Arizona Supreme Court Page 3 of 3 AOC CVGE12F-100518 (23) (24) Copy provided to judgment debtor on: Date: By: [ ] Mail [ ] Hand delivery Copy provided to judgment creditor on: Date: By: [ ] Mail [ ] Hand delivery (25) Date Garnishee or Authorized Agent American LegalNet, Inc. www.FormsWorkFlow.com