Revised effective 9/1/2018 by 9/14/2018 Notice to the Bar, CN 11236 (Appendix XI-I) NOTICE: This is a public document, which means the document as submitted will be available to the public upon request. Therefore, do not enter personal identifiers on it, such as Social Security number, driver222s license number, vehicle plate number, insurance policy number, active financial account number, or active credit card number. Plaintiff or Filing Attorney Information: Check if new address/phone number Name NJ Attorney ID Number Address Telephone Number Superior Court of New Jersey Law Division, Special Civil Part County , Docket No: Plaintiff, Civil Action Notice of Application for Wage Execution v. , Defendant(s). To : Name of Judgment - Debtor Address TAKE NOTICE that an application is being made by the judgment-creditor to the above-named court, located at , New Jersey for a Wage Execution Order to issue against your salary, to be served on your employer, , (name and address of employer), for: (a) 10% of your gross salary when the same shall equal or exceed the amount of $217.50 per week; or (b) 25% of your disposable earnings for that week; or (c) the amount, if any, by which your disposable weekly earning s exceed $217.50, whichever shall be the least. Disposable earnings are defined as that portion of the earnings remaining after the deduction from the gross earnings of any amounts required by law to be withheld. In the event the disposable earnings so d efined are $217.50 or less, if paid weekly, or $435.00 or less, if paid every two weeks, or $471.25 or less, if paid twice per month, or $942.50, or less, if paid monthly then no amount shall be withheld under this execution. In no event shall more than 1 0% of gross salary be withheld and only one execution against your wages shall be satisfied at a time. Your employer may not discharge, discipline or discrim inate against you because your earnings have been subjected to garnishment. You may notify the Cle rk of the Court and the attorneys for the judgment- creditor, whose address appears above, in writing, within ten days after service of this notice upon you, why such an Order should not be issued, and thereafter the application for the Order will be set d own for a hearing of which you will receive notice of the date, time and place. If you do not notify the Clerk of the Court and the judgment -creditor222s attorney, or the judgment-creditor if there is no attorney, in writing of your objection, you will receive no further notice and the Order will be signed by the Judge as a matter of course. You also have a continuing right to object to the wage execution or apply for a reduction in the amount withheld even after it has been issued by the Court. To object or apply for a reduction, file a written statement of your objection or reasons for a reduction with the Clerk of the Court and send a copy to the creditor222s attorney or directly to the creditor if there is no attorney. You will be entitled to a hearin g within 7 days after you file your objection or application for a reduction. Certification of Service I served the within Notice upon the judgment -debtor, , on this date by sending it simultaneously by regular and certified mail, return receipt requested, to the judgment -debtor's last known address, set forth above. I certify that the foregoing statements made by me ar e true. I am aware that if any of the foregoing statements made by me are willfully false, I am subject to the punishmen t . Date Attorney for Judgment - Creditor or Judgment - Creditor Pro Se American LegalNet, Inc. www.FormsWorkFlow.com