IN THE CIRCUIT COURT OF THE SIXTEENTH JUDICIAL CIRCUIT KENDALL COUNTY, ILLINOIS GEN. NO. RETURN DATE AND VS. PLAINTIFF(S) DEFENDANT EMPLOYER INTERROGATORIES/ANSWER TO WAGE DEDUCTION PROCEEDINGS Employer/Agent , certifies under penalty of perjury that the following Answer is true and correct to the best of his/her knowledge and belief concerning the property or the judgment debtor: Debtor Name: Soc. Sec. No. Yes Do you pay monies to the judgment debtor listed above? No State whether any funds paid to the debtor are for disability, retirement or are in any other way exempt or subject to other Court Order: One Pay Period equals: day(s) week(s) month(s) CALCULATION TO DETERMINE AMOUNT OF WITHHOLDING: (A) Gross Wages minus mandatory contributions to pension or retirement plans is (A) (B) METHOD I (B) - 15% or (A) = METHOD II (C) Enter Total FICA, State and Federal Tax and Medicare (C) (D) Subtract (C) from (A) = (D) (E) Enter Minimum Wage Per Pay Period (45 x $8.00 per week) (E) (F) Subtract (E) from (D) = (F) (G) Enter the lesser of line (B) or (F) (G) (H) Enter Child Support or other Court Ordered Deduction (H) (I) Subtract (H) from (G) = (I) (J) Subtract Employer's Statutory Fee (§5/12 - 814) (J) (K) Amount to be applied to judgment (K) Line I is the amount to be withheld from employee's paycheck as of the date of service of Summons and not disbursed until further order of the Court. Signature of Employer INSTRUCTIONS 1. Mail a copy of this Answer to the Court and mail to attorney for Plaintiff and give a copy to the Defendant. 2. You will receive a copy of a Court Order by fax or mail instructing you how to proceed and where to send deducted funds. Employer/Agent: Agent Name Becky Morganegg Employer Name Clerk of the Circuit Court Address Kendall County Courthouse 807 W. John St., Box M Phone Yorkville, IL 60560 Fax NOTE: A copy of the Answer should be mailed to the Court, Attorney for Plaintiff or Judgment Creditor and to the Defendant 35A American LegalNet, Inc. www.USCourtForms.com