CIRCUIT COURT OF ILLINOIS Sixth Judicial Circuit Champaign County Case No: Petitioner vs. Respondent Name and Address of Petitioner's Attorney or Petitioner if not represented by an attorney: Respondent's last known address: NAME: ADDRESS: CITY: PHONE: Amount of Judgment: $ Balance Due: Name of Employer: Return Date: WAGE DEDUCTION NOTICE NOTICE: The Court has issued a Wage Deduction Summons against the Employer named above for wages due or about to become due to you. The Wage Deduction Summons was issued on the basis of a Judgment against you in favor of the Petitioner in the amount stated above. This Judgment is a lien on the Respondent's wages until the total amount due is paid. The amount of wages that may be deducted is limited by Federal and Illinois law. (1) Under Illinois law, the amount of wages that may be deducted is limited to the lessor of (i) 15% of gross weekly wages or (ii) the amount which disposable earnings for a week exceed the total of 45 times the Federal minimum wage or, under a wage deduction summons served on or after January 1, 2006, the Illinois minimum hourly wage, whichever is greater. (2) Under Federal law, the amount of wages that may be deducted is limited to the lesser of (i) 25% of disposable earnings for a week or (ii) the amount by which disposable earnings for a week exceed 30 times the federal mini-mum hourly wage. (3) Pension and retirement benefits and refunds may be claimed as exempt from wage deduction under Illinois law. You have the right to request a hearing before the Court in Champaign County to dispute the wage deduction because the wages are exempt. To obtain a hearing you must notify the Clerk of the Court, in writing, at Circuit Clerk, 101 East Main, Urbana, Illinois 61801 on or before the return date specified above. The Clerk of the Court will provide a hearing date and the necessary forms that must be prepared by you or your attorney and sent to the Petitioner and the Employer, or their attorney, regarding the time and location of the hearing. This Notice may be sent by regular first class mail. Revised: 01/09 Linda S. Frank Clerk of the Sixth Judicial Circuit Court 101 E. Main Street Urbana, Illinois 61801 White-Circuit Clerk Canary-Employer Pink-Petitioner Goldenrod-Respondent American LegalNet, Inc. www.FormsWorkflow.com