COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. GARNISHMENT CALCULATION: WORKSHEET Index No. : Calendar No. 2DC27C TWO-SIDED FORM To determine the amount, if any, that can be garnished from a single: paycheck, take the amount of disposable JUDICIAL SUBPOENA Plaintiff(s) earnings on line 4 of this Disposable Earnings Worksheet and perform the calculations according to both the -against: Hawai‘I Law and Federal Law using the Hawai‘I Law Garnishment Worksheet and the Federal Law Garnishment Worksheet. Compare the two amounts, then use the smaller amount. If the smaller amount is zero, then no : garnishment can be made from this particular paycheck. : Disposable Earnings Worksheet Defendant(s) WEEKLY EVERY TWO WEEKS Enter amounts for one pay period only, : . ...... . .. ...... .. .... (26/year) according.to .frequency. of.pay.schedule. . . . . . . . . . . . .(52 ./year) . . . . . . . . . . . . . . 1. Gross pay $ TWICE MONTHLY (24/year) $ $ $ $ $ $ $ State tax $ $ $ Federal Tax $ $ $ GREETINGS: Medicare $ $ MONTHLY (12/yr) $ 2. Mandatory Deductions OF THE STATE OF NEW YORK THE PEOPLE FICA $ TO Union dues, only if required by law YOU, that all business and excuses being laid aside, you and each of you attend before $ $ $ WE COMMAND , at the $ Court $ $ $ located at County of $ $ 4. Disposable Earnings in room , on the day of , 20 $ , at o'clock in the noon, and at any $ recessed Subtract line adjourned date, to this amount give evidence as a witness in this action on the part of the 3 from line 1. Take testify and or the Honorable 3. Subtotal, Mandatory Deductions. and enter on lines 1 of Hawai‘I Law and Federal Law Garnishment Worksheets Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to See Reverse Side for Hawai‘i Law maximum penalty of $50 and all damages the party on whose behalf this subpoena was issued for a and Federal Law Worksheets sustained as a result of your failure to comply. Witness, Honorable Court in County, , one of the Justices of the day of , 20 (Attorney must sign above and type name below) Attorney(s) for In accordance with the Americans With Disabilities Act, if you require an accommodation or assistance with your court hearing, please contact the District Court Administration Office PHONE NO.244-2852, FAX 244-2849, or TTY 244-2865 at least ten (10) working days in advance of your hearing or appointment date. For Civil related matters, please call 244-2838. Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index Hawai‘i Law Garnishment Worksheet No. : Weekly (52/yr) Enter amounts for one pay period only, according to frequency of pay schedule. $ -against- Monthly (12/yr) JUDICIAL SUBPOENA $ : 2. Multiply by this amount; place answer on line 3 Twice Monthly (24/yr) Weeks (26/yr) : Plaintiff(s) 1. Enter amount from line 4, Disposable Earnings Worksheet Every No. CalendarTwo $ $ x52 x26 x24 $ $ $ : ÷12 ÷12 ÷12 $ $ $ Amt. on line 1 -$200.00 -$200.00 -$200.00 -$200.00 $ $ $ $ x 0.20 x 0.20 x0.20 x 0.20 9. Garnishment on disposable earnings in excess of $200 per month $ $ $ $ 10. Garnishment on first $200 disposable earnings per month. Add this amount to amount on line 9. Enter answer on line 11. +$15.00 +$15.00 +$15.00 +$15.00 : 3. Annual equivalent Disposable Earnings 4. Divide amount on line 3 by 12 months; enter answer on line 5 Defendant(s) : ...................................................... 5. Monthly Equivalent Disposable Earnings 6. Subtract 1st $200 of Monthly Equivalent Disposable Earnings from amount on line 5; enter answer on line 7 7. Disposable earnings in excess of $200 per monthNEW YORK THE PEOPLE OF THE STATE OF 8. Multiply amount on line 7 by 20%; enter answer on line 9 TO GREETINGS: $ 11. Total monthly garnishment $ $ $ WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before To determine the amount, if any, to garnish from one paycheck,at the perform the calculations below for the correct pay perio . d , the Honorable Court located at County of on line 11 by 12 months; enter answer on 12. Multiply the amount x 12 x 12 x 12 in , on the day of , 20 , at o'clock in the noon, and at any recessed line 13 room or adjourned date, to testify and give evidence as a witness in this action on the part of the 13. Annual equivalent amount of garnishment $ $ $ 14. Divide the amount on line 13 by the number of pay periods per ÷52 ÷26 ÷24 year; enter answer on line 15 to comply with this subpoena is punishable as a contempt of court and will make you liable to Your failure the party on whose behalf period Amt. on line a 15. Garnishment amount for this pay this subpoena was issued for a maximum penalty of $50 and all damages sustained as11 result of your failure to comply. 16. Compare amount on line 15 with amount on line 2 of Federal Law Garnishment Worksheet and use th smaller amount. If e smaller amount is zero or less, do not garnish any amount from this pay period. Witness, Honorable Court in County, , one of the Justices of the day of , 20 Federal Law Garnishment Worksheet 1. Enter amount from line 4 of Disposable Earnings Worksheet . $ 2. Choose the column below that applies to the pay period to find the amount(Attorney mustgarnished.and$type name below) that can be sign above Weekly (52/yr) Every Two Weeks (26/yr) Twice Monthly (24/yr) Monthly (12/yr) $154.50 or less: None $309.00 or less: None $334.75 or less: Attorney(s) for $669.49 or less: None More than $154.50 but less than $206.00: Amount above $154.50 More than $309.00 but less than $412.00: Amount above $309.00 $206.00 or more: Maximum 25% $412.00 or more: Maximum 25% None More than $334.75 but less than More than $669.49 but less than $446.33: $892.65: Amount above $334.75 Amount above $669.49 Office and P.O. Address $446.33 or more: Maximum 25% $892.65 or more: Maximum 25% Telephone No.: 3. Compare the amount from step 2 with the amount on line 15 of Hawai‘I Law Garnishment Worksheet and use th smaller amount. e Facsimile If the smaller amount is zero or less, do not garnish any amount from this pay period. No.: GARNCALCU.27C (6/15/98) E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com