1 [Name; State Bar ID No.] [Address] 2 3 4 [Telephone] Attorney for Debtor/Debtor In Propria Persona 5 UNITED STATES BANKRUPTCY COURT EASTERN DISTRICT OF CALIFORNIA SACRAMENTO AND MODESTO DIVISIONS 6 7 8 In re 9 10 Debtor(s). ) ) ) ) ) ) Case No.: WAGE ORDER 11 12 GOOD CAUSE APPEARING, IT IS HEREBY ORDERED THAT [insert name and address of employer] 13 14 , the employer of the above-named debtor, be and is hereby directed 15 until further court order to deduct from the debtor’s wages, and forward to the Chapter 13 Trustee, 16 [insert Trustee’ name] s , at [insert Trustee’ mailing address] s , the sum of $ 17 each 18 month. Payroll deductions made in accordance with the applicable law for current income tax 19 withholding, federal social security, state disability, insurance premiums, union dues, employee 20 welfare fund agreements, mandatory retirement contributions, and employer sustenance agreements 21 are not affected by this order and may be continued. 22 A copy of this order shall be served by mail on the present and subsequent employers of the 23 debtor. Monies transmitted to the Trustee’s office shall be identified by the debtor’s name and case 24 number as they appear above. 25 DATED: FOR THE COURT Wayne Blackwelder, Clerk 26 27 By: 28 Deputy Clerk EDC 3-083 (Rev. 9/1/10) American LegalNet, Inc. www.FormsWorkFlow.com