STATE OF ILLINOIS IN THE CIRCUIT COURT OF THE FOURTH JUDICIAL CIRCUIT CLINTON COUNTY, CARLYLE, ILLINOIS ) ) Case No. Judgment Creditor Plaintiff ) vs. ) ) ) Name and address of attorney for Judgment Debtor Defendant ) Judgment Creditor or of Judgment Creditor if not represented by an Address of Judgment Debtor: Attorney: Amount of Judgment: $ Return Date: Name of Employer: Wage Deduction Notice NOTICE: The court shall be asked to issue a wage deduction summons against the employer named above for wages due or about to become due to you. The wage deduction summons may be issued on the basis of a judgment against you in favor of the judgment creditor in the amount stated above. 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 lesser of (i) 15% of gross weekly wages, or (ii) the amount by which disposable earnings for a week exceed the total of 45 times the federal minimum hourly wage. (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 minimum 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 to dispute the wage deduction because the wages are exempt. To obtain a hearing in counties with a population of less than 1,000,000, you must notify the clerk of the court in writing at 850 Fairfax St, Carlyle, IL 62231 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 judgment creditor and the employer, or their attorney, regarding the time and locations of the hearing. This notice may be sent by regular first class mail. (Source P.A. 86-1268.) American LegalNet, Inc. www.FormsWorkFlow.com