STATE OF ILLINOIS IN THE CIRCUIT COURT OF THE 17th JUDICIAL CIRCUIT WINNEBAGO COUNTY Plaintiff- CC-81 No. Judgment Creditor Return Date: vs. DefendantJudgment Debtor Address of Judgment Debtor: (insert last known address) Amount of Judgment:$ Name and Address of Attorney for Judgment Creditor or of Judgment Creditor if not represented by an attorney: Balance Due: 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 the judgment debtor. The wage deduction summons may be 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 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 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 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, the judgment debtor must notify the clerk of the court in writing at (Address) on or before the return date specified in the summons. The Clerk of Court will provide a hearing date and the necessary forms that must be prepared by the judgment debtor or the attorney for the judgment debtor and sent to the judgment creditor and the employer, or their attorney, regarding the time and location of the hearing. This notice may be sent by regular first class mail. American LegalNet, Inc. www.FormsWorkflow.com