gArnishmEnt cAlculAtion WorkshEEt Form #5DC27C To determine the amount, if any, that can be garnished from a single paycheck, take the amount of disposable earnings on line 4 of this Disposable Earnings Worksheet and perform the calculations according to both 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 Enter amounts for one pay period only, according to frequency of pay schedule. 1. 2. Gross pay Mandatory Deductions FICA State tax Federal Tax Medicare Union dues, only if required by law 3. 4. Subtotal Mandatory Deductions Disposable Earnings Subtract line 3 from line 1. Take this amount and enter on lines 1 of Hawai`i Law and Federal Law Garnishment Worksheets $ $ $ $ $ $ $ $ WEEKLY (52/year) EVERY TWO WEEKS (26/year) $ $ $ $ $ $ $ $ $ TWICE MONTHLY (24/year) $ $ $ $ $ $ $ $ $ $ $ MONTHLY (12/year) $ see reverse side for hawai`i law and Federal law Worksheets In accordance with the Americans with Disabilities Act, and other applicable state and federal laws, if you require an accommodation for a disability when working with a court program, service, or activity please contact the District Court Administration Office at PHONE NO. 482-2347, FAX 482-2509, or TTY 482-2533 at least (10) working days before your proceeding, hearing, or appointment date. RepRogRaphics (08/09) page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com gaRncalcu 5D-p-254 hawai`i law garnishment Worksheet Enter amounts for one pay period only, according to frequency of pay schedule. 1. Enter amount from line 4, Disposable Earnings Worksheet 2. Multiply by this amount; place answer on line 3 3. Amount equivalent Disposable Earnings 4. Divide amount on line 3 by 12 months; enter answer on line 5 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 $200.00 per month 8. Multiply amount on line 7 by 20%; enter answer on line 9 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. 11. Total monthly garnishment $ $ +$15.00 $ $ x 0.20 $ +$15.00 $ WEEKLY (52/year) $ x52 $ ÷12 $ -$200.00 EVERY Two Weeks (26/year) $ x26 $ ÷12 $ -$200.00 TWICE Monthly (24/year) $ x24 $ ÷12 $ -$200.00 MONTHLY (12/year) $ Amt on line 1 -$200.00 $ x 0.20 $ x 0.20 $ +$15.00 $ x 0.20 $ +$15.00 $ to determine the amount, if any, to garnish from one paycheck, perform the calculations below for the correct pay period. 12. Multiply the amount on line 11 by 12 months; enter answer on line 13 13. Annual equivalent amount of garnishment 14. Divide the amount on line 13 by the number of pay periods per year; enter answer on line 15 15. garnishment amount for this pay period. $ $ ÷52 x12 x12 x12 $ ÷26 $ ÷24 $ $ Amt on line 11 16. compare amount on line 15 with amount on line 2 of Federal law garnishment Worksheet and use the smaller amount. if smaller amount is zero or less, do not garnish any amount from this pay period. 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 that can be garnished. $ Weekly (52/yr) $217.50 or less; None More than $217.50 but less than $290.00 Amount above $217.50 $290.00 or more; Maximum 25% Every Two Weeks (26/yr) $435.00 or less; None More than $435.00 but less than $580.00 Amount above $435.00 $580.00 or more; Maximum 25% Twice Monthly (24/yr) $471.25 or less; None More than $471.25 but less than $628.33 Amount above $471.25 $628.33 or more; Maximum 25% Monthly (12/yr) $942.50 or less; None More than $942.50 but less than $1,256.67 Amount above $942.50 $1,256.67 or more; Maximum 25% 3. compare the amount from step 2 with the amount on line 15 of hawai`i law garnishment Worksheet and use the smaller amount. if the smaller amount is zero or less, do not garnish any amount from this pay period. RepRogRaphics (08/09) page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com gaRncalcu 5D-p-254