IN THE CIRCUIT COURT OF THE TWENTIETH JUDICIAL CIRCUIT ST. CLAIR COUNTY, ILLINOIS _______________________________ Plaintiff vs. _______________________________ Defendant ) ) ) ) ) ) Case No.:______________________ WAGE DEDUCTION SUMMONS To the employer: __________________________Address: ______________________ YOU ARE SUMMONED and required to file answers to the judgment creditor’s interrogatories, in the Office of the Clerk of the Circuit Court, #10 Public Square, Belleville, IL 62220 on or before _______________________________(21 to 40 days after issuance of summons). However, if this summons is served on you less than 3 days before that date, you must file answers to the interrogatories on or before a new return date, to be set by the court, no less than 21 days after you were served with this summons. This proceeding applies to non-exempt wages due at the time you were served with this summons and to wages which become due thereafter until the balance due on the judgment is paid. IF YOU FAIL TO ANSWER, A CONDITIONAL JUDGMENT BY DEFAULT MAY BE TAKEN AGAINST YOU FOR THE AMOUNT OF THE JUDGMENT UNPAID. FEDERL AGENCY EMPLOYERS: Effective upon service of this summons and pursuant to 5 USC 552(a), you are to commence to pay over deducted wages to the attorney for the judgment creditor in accordance with 735 ILCS 5/12-808. To the Officer: This summons must be returned by the officer or other person to whom it was given for service, with endorsement of service and fees, if any, immediately after service. If service cannot be made, this summons shall be returned so endorsed. This summons may not be served later than the above date. WITNESS______________________________ _______________________________________ Clerk of the Circuit Court (Seal of Court) By: ___________________________________ Deputy Clerk (Plaintiff’s Attorney or Plaintiff if not represented by an Attorney) Name: ________________________________ Attorney for: ___________________________ Address: ______________________________ City: _________________________________ Telephone: ____________________________ E-mail Address: ________________________ American LegalNet, Inc. www.FormsWorkFlow.com INTERROGATORIES/ ANSWER TO WAGE DEDUCTION PROCEEDINGS Employer/Agent: ___________________________________ Return Date: _________________ Defendant’s Name: ____________________ S.S. No. XXX-XX-_____ Case No.: ___________ Defendant’s Address: ____________________________________________________________ Do you pay money to the Defendant listed above? ____ Yes ____ No IF YOUR ANSWER IS “NO,” GO TO “INSTRUCTIONS” BELOW. Are any funds paid to the debtor: ___Subject to prior court ordered deduction ___For Disability ___For Retirement ___Otherwise exempt (Describe ___________). CALCULATION TO DETERMINE AMOUNT OF WITHHOLDING (Note: Withholding must be recalculated for every pay period if income varies.) Do you pay debtor: ___ Every Week ___Every Two Weeks ___Semi-Monthly ___ Monthly ___ Other _______ (A) Gross wages per paycheck minus mandatory contributions to pension or retirement plan. (A) ___________ (B) 15% of (A)= (B) ___________ (C) Enter total FICA, State Tax, Federal Tax and Medicare (C) ___________ (D) Subtract (C) from (A)= (D) ___________ (E) If debtor is paid every week, enter $371.25 If debtor is paid every two weeks, enter $742.50 If debtor is paid semi-monthly, enter $804.37 If debtor is paid monthly, enter $1,608.75 (E) ___________ (F) ___________ If other, multiply 45 times state minimum wage (currently $8.25) times number of weeks in a pay period (F) Subtract (E) from (D) (Enclose a negative number in parentheses, e.g., ($50.00)) IF LINE “F” IS ZERO OR A NEGATIVE NUMBER, WITHHOLD NO WAGES, GO TO “INSTRUCTIONS” BELOW (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) (Enclose a negative number in parentheses, e.g., ($50.00)) (I) ___________ IF LINE “I” IS ZERO OR A NEGATIVE NUMBER, WITHHOLD NO WAGES, GO TO “INSTRUCTIONS” BELOW (J) Subtract Employer’s One-Time (J) ___________ (K) Amount to be applies to Judgment (K) ___________ LINE “I” MUST BE WITHHELD AS OF THE DATE OF SERVICE AND HELD UNTIL FURTHER ORDER OF THE COURT INSTRUCTIONS 1. 2. 3. Fill out and sign the certification below. Mail a copy of this Answer to the Court and Plaintiff’s Attorney and give a copy to the Defendant Mail it to the Clerk of the Court, #10 Public Square, Belleville, IL 62220 DO NOT MAIL CHECK TO THE CLERK’S OFFICE. You will receive a copy of a Court Order instructing you how to proceed and where to send any withheld funds. THIRD PARTY EMPLOYER CERTIFICATION Under the penalties as provided by law pursuant to Section 1-109 of the Code of Civil Procedure (735 ILCS 5/1-109), the under-signed certifies that the statements set forth in this instrument are true and correct and that I have either mailed or hand delivered a copy of this completed Interrogatories/ Answer to the Defendant. Date: _____________________________________ Signature of Employer/ Agent: _______________________________________ Fax: _______________________ Print full name clearly: _____________________________________________ Telephone: __________________ KAHALAH A. DIXON, CLERK OF THE CIRCUIT COURT, ST. CLAIR COUNTY, ILLINOIS American LegalNet, Inc. www.FormsWorkFlow.com IN THE CIRCUIT COURT OF THE TWENTIETH JUDICIAL CIRCUIT ST. CLAIR COUNTY, ILLINOIS ________________________________ Plaintiff- Judgment Creditor Case No.: ________________________ vs. (Summons Return Date)_____________ _________________________________ Defendant- Judgment Debtor Judgment Debtor’s Judgment Creditor/Creditors Atty Name: _____________________________ Name: __________________________ Address: ___________________________ Address: _________________________ City: ______________________________ City: ____________________________ Phone: _____________________________ Phone: __________________________ Attorney No.: ________________________ Attorney No.: _____________________ Judgment in the amount of $_____________ BALANCE DUE: $________________ Employer Name: _____________________________________________________________ NOTICE: The Court has issued a wage deduction summons against the employer names above for wages due or about to become due to the judgment creditor. The wage deduction summons was issued on the basis of a judgment against the judgment debtor in favor of the judgment creditor in the amount stated above. The amount of wage 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 (a) 15% of gross weekly wage or (b) 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 (a) 25% of disposable warnings for a week or (b) 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. The judgment debtor has a right to request and hearing before the Court to dispute the wage deduction because the wages are exempt. To obtain a hearing the judgment debtor must notify the Clerk of the Court in writing at #10 Public Square, Belleville, IL 62220 on or before the return date specified in the Summons. The Clerk of Court will adding a hearing date and provide forms which must be prepared by the debtor or his/her attorney, a copy of which must be sent to the judgment creditor and the employer or their attorney. American LegalNet, Inc. www.FormsWorkFlow.com IN THE CIRCUIT COURT OF THE TWENTIETH JUDICIAL CIRCUIT ST. CLAIR COUNTY, ILLINOIS ________________________________ Plaintiff vs. Case No.: _____________________ ________________________________ Defendant Return Date: ___________________ (21 and 40 days after date of issuance of summons) ________________________________ Employer AFFIDAVIT OF WAGE DEDUCTION ORDER _________________________________________________________on oath states: 1. I believe employer _____________________________________is indebted to the judgment debtor _______________________________________ for wages due or to become due. 2. The last known address of judgment debtor is _____________________________ __________________________________________________________________ ______ I request that a summons issue directed to employer and I certify that a copy of the attached Wage Deduction Notice was mailed to judgment debtor, by first class mail, at his/her last know address prior to filing of this wage deduction proceeding. Name: ___________________________ Affiant: _______________________ Attorney for Judgment Creditor: Under penalty of perjury as provided by law pursuant to 735 ILCS 5/1-109, the affiant certifies that the statements set forth herein are true and correct. Address: _______________________ City: __________ State: ______ Zip: _______ Telephone NO: (_____)_____-_______ Attorney Bar No.: _______________ CERTIFICATE OF ATTORNEY OR JUDGMENT CREDITOR Note: Non-Attorneys must also submit a copy of the underlying judgment or a certification by the clerk of the court that entered judgment. I, the undersigned certify under penalties as provided by law pursuant to 735 ILCS 5/1-109 that the following information is true: 1. 2. 3. Judgment in the above captioned case was entered on the _____day of ___________, 20____. The amount of the judgment was ………………………………………………… $______________ Allowable costs previously expended: a. Initial filing fee…………………………………………………………………. $______________ b. Original and alias summons …………………………………………………… $______________ c. Filing and Summons cost of prior supplementary proceeding…………………. $______________ 4. Filing and summons cost for this proceeding…………………………………….. $______________ 5. Statutory interest due on Judgment from date above……………………………... $______________ Total $______________ DEDUCT: Total amount paid by or on behalf of the judgment debtor prior to this proceeding $______________ BALANCE DUE JUDGMENT CREDITOR……………………………………….. $______________ ______________________________ Attorney for Judgment Creditor American LegalNet, Inc. www.FormsWorkFlow.com IN THE CIRCUIT COURT OF THE TWENETHIETH JUDICIAL CIRCUIT ST. CLAIR COUNTY, ILLINOIS ______________________________ Plaintiff Vs. ______________________________ Defendant ) ) ) ) ) ) Case No.___________________ ___________________________ Employer WAGE DEDUCTION ORDER THIS CAUSE coming on to be heard upon the return of a Wage Deduction Summons served upon the employer and the answer filed by the employer, a Wage Deduction Notice having been served upon the employer and the Court fully advised; IT IS HEREBY ORDERED: 1. That a lien is hereby imposed upon the non-exempt of ____________________as of the date of service of the Wage Deduction Summons in the amount of $____________________ which includes court costs and interest to date and credit for payment to date. 2. That ________________________is ordered to deduct 15% of the defendant’s non – exempt gross wages after deduction for mandatory pension or retirement plans or where the spouse/child support deduction order, if any, leaves funds up to 15% of the non-exempt gross wages, each pay period, to be remitted to Plaintiffs attorney (or Pro Se creditor) at least monthly. No deductions may occur if Defendant’s net check is less than 45 times the state minimum wage of $8.00. 3. That a Wage Deduction judgment is hereby entered against Employer, _____________________ in the periodic sum ordered above each pay period if in favor of defendant ______________________, for the use of the Plaintiff, _______________________. 4. That employer turn over to Plaintiff the withheld wages from the date of service of the wage deduction proceedings to the date of this order, pursuant to calculation set forth herein. 5. A lien obtained hereunder shall have priority over any subsequent lien obtained hereunder, except that liens for the support of a spouse or dependent children shall have priority over all other liens obtained hereunder. Employer is further directed to file an amended Answer with this Court and send a copy to the attorney for Plaintiff or the Plaintiff, informing the Court as to spouse/child support deductions received after the entry of this order. 6. That this continuing Wage Deduction Order shall remain in effect until the judgment of $__________________ plus 9% simple interest and costs of $_________________ are paid in full, the defendant ceases to be employed by the employer, the employee files a bankruptcy, or this Court enters an order modifying this order. 7. That any other liens or wage deduction proceedings (other than spouse/child support) shall be held and stacked in the order received by the employer and take effect only upon the conclusion of this Order. 8. That this Court Retains jurisdiction of the parties hereto and subject matter hereof to amend this order upon any change in circumstances. Name: ____________________________ Attorney for: _______________________ Address: __________________________ City: _____________________________ Phone: ___________________________ E-mail Address: ____________________ DATE: __________________________ ________________________________ JUDGE American LegalNet, Inc. www.FormsWorkFlow.com