(Rev. /1) WORKSHEET FOR COMPUTING AMOUNT OF WAGES EXEMPT FROM ATTACHMENT, EXECUTION AND PAYMENT ORDERS This form is to be completed by a plaintiff or judgment creditor. It should be based on information provided by or obtained from the defendant or judgment debtor (employee) by means of business records, testimony or discovery, including a written financial statement. COMPUTATION DATA Employee222s weekly 223disposable earnings224 1A. Employee222s weekly 223gross wages224 2B. Federal minimum hourly wage 3 C. Massachusetts minimum hourly wage 4D. COMPUTATION 1. multiplied by 25% = 1. $ A 2. minus = 2. $ A( multiplied by 30) C 3. multiplied by 15% = 3. $ B 4. minus = 4. $ B(greater of or multiplied by 50) C D The MAXIMUM amount of weekly wages subject to attachment, execution or a payment order is the LOWEST of the amounts set forth in 1, 2, 3, and 4, above, namely: $ NOTES: 1.This is the amount of wages or salary used for computing the exemption under federal law.223Disposable earnings224 are gross wages or salary minus amounts required by law to bewithheld. See 15 U.S.C.A. 247247 1671 226 1677.2.This is the term used for computing the wage exemption under Massachusetts law.See G.L. c. 246, 247 28.3.See 29 U.S.C. 206. 4. See G.L. c. 151, 247 1. The minimum wage is $11/hr. 1. American LegalNet, Inc. www.FormsWorkFlow.com