CONFIDENTIAL ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): WG-035 DATE RECEIVED BY COURT (Do not file in public court file.) TELEPHONE NO.: E-MAIL ADDRESS: ATTORNEY FOR (Name): FAX NO.: SUPERIOR COURT OF CALIFORNIA, COUNTY OF : STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: PLAINTIFF/PETITIONER: DEFENDANT/RESPONDENT: COURT CASE NUMBER: CONFIDENTIAL STATEMENT OF JUDGMENT DEBTOR'S SOCIAL SECURITY NUMBER (Supplement to Wage Garnishment Forms WG-001, WG-002, WG-004, WG-005, WG-009, WG-012, and WG-030) (Do not attach to forms.) LEVYING OFFICER FILE NUMBER: This separate Confidential Statement of Judgment Debtor's Social Security Number contains the Social Security number of the judgment debtor for whom an earnings withholding order is being sought or has issued in the case referenced above. This supplement must be kept separate from any applications or orders filed in this case, and should not be a public record. INFORMATION ON JUDGMENT DEBTOR: 1. Name: 2. Social Security Number: TO COURT CLERK THIS STATEMENT IS CONFIDENTIAL. DO NOT FILE THIS CONFIDENTIAL STATEMENT IN A PUBLIC COURT FILE. Page 1 of 1 Form Adopted for Mandatory Use Judicial Council of California WG-035 [New January 1, 2012] CONFIDENTIAL STATEMENT OF JUDGMENT DEBTOR'S SOCIAL SECURITY NUMBER Wage Garnishment www.courts.ca.gov American LegalNet, Inc. www.FormsWorkFlow.com