Received by clerk on: My Name Address Phone Fax E-mail In the District Justice Court of the State of Utah Judicial District County Address: Plaintiff/Petitioner Garnishee’s answers to interrogatories. Earnings. Subsequent pay period. v. Case Number Judge Commissioner Defendant/Respondent (1) Write your answers in the spaces provided. Attach additional sheets if necessary. (2) What is the pay period to which these answers relate? ANSWER: Start Date: End Date: (3) Is the Writ of Continuing Garnishment in effect on the last day of this period? (The Writ is in effect for 120 days after the date of service on you or for 120 days after the date the previous writ expired, whichever is later. A Writ of Continuing Garnishment in favor of the Office of Recovery Services or the Department of Workforce Services is effective when served on you and continues indefinitely until fully satisfied.) ANSWER: Yes No (4) Calculate, in the table, the amount to be withheld from the defendant. Assume you are calculating this on the last day of the pay period for which these answers apply. Garnishee’s answers to interrogatories. Earnings. Subsequent pay period. Revised August 1, 2007 Page 1 American LegalNet, Inc. www.FormsWorkflow.com (4)(a) Gross earnings from all sources payable to the defendant for personal services, including salary, wages, tips, commissions, bonuses, per diem, etc. (4)(b) Deductions required by law. (4)(b)(i) Federal income tax (4)(b)(ii) State income tax (4)(b)(iii) Social security tax (FICA) (4)(b)(iv) Medicare tax (FICA) (4)(b)(v) Other amounts required by law to be deducted. (Please describe reason for deduction.) $ $ $ $ $ $ (4)(c) Total deductions. Calculate and record the sum of Lines (4)(b)(i) through (4)(b)(v). (4)(d) Disposable earnings. Calculate and record Line (4)(a) minus Line (4)(c). (4)(e) Calculate: (4)(e)(i) 25% of the amount in Line (4)(d); or, if this is a judgment for child support, 50% of the amount in Line (4)(d). (4)(e)(ii) The difference between Line (4)(d) and the federal minimum hourly wage ($5.85) times 30 times the number of weeks in this pay period. For example: Line (4)(d) minus ($5.85 X 30 X 2 weeks) OR Line (4)(d) minus ($5.85 X 30 X 4.28 weeks) (4)(f) Of Line (4)(e)(i) and Line (4)(e)(ii), record the lesser amount. (4)(g) Amount of any income withholding order. (4)(h) Calculate and record Line (4)(f) minus Line (4)(g) (4)(i) Amount deducted for an undisputed debt owed to you by the (check one or both): plaintiff defendant. (4)(j) Total amount to be withheld. (Calculate and record Line (4)(h) minus Line (4)(i).) $ $ $ $ $ $ $ $ $ Note: Do not withhold more than the balance the defendant owes on the judgment. You may contact the plaintiff or plaintiff’s attorney to obtain the outstanding balance. (5) I served a copy of these Answers to Interrogatories on the plaintiff (or plaintiff’s attorney) by: first class mail by hand delivery Garnishee’s answers to interrogatories. Earnings. Subsequent pay period. Revised August 1, 2007 Page 2 American LegalNet, Inc. www.FormsWorkflow.com to (address) on (date) (6) I served a copy of the Writ of Garnishment, these Answers to Interrogatories, Notice of Garnishment and Exemptions form, and two copies of the Reply and Request for Hearing form on the defendant by: first class mail by hand delivery to (address) on (date) (7) I served a copy of the Writ of Garnishment, these Answers to Interrogatories, Notice of Garnishment and Exemptions form, and two copies of the Reply and Request for Hearing form upon the following persons other than the defendant shown by my records to have an interest in the property by: first class mail by hand delivery to (name) to (address) on (date) I declare under penalty of Section 46-5-101 that this document is true and correct. Date: Sign here Ź Typed or printed name Garnishee’s answers to interrogatories. Earnings. Subsequent pay period. Revised August 1, 2007 Page 3 American LegalNet, Inc. www.FormsWorkflow.com NOTICE OF GARNISHMENT AND EXEMPTIONS NOTICE: YOUR PROPERTY MAY BE TAKEN TO PAY A CREDITOR. PLEASE READ THIS CAREFULLY. 1. If you are the defendant in this action, your rights may be affected. You should read this notice and take steps to protect your rights. 2. If you are not the defendant in this action, papers filed with the court indicate that you may have an interest in the defendant’s property. Your rights may be affected, and you should read this notice and take steps to protect your rights. 3. The garnishee (someone who possesses your property) has been ordered to hold your property. This means that you cannot obtain the property and it may be used to pay a judgment creditor. 4. Certain property and money are exempt from execution (cannot be seized). The following is a partial list of exempt property and money, but some of these exemptions might not apply to judgments for alimony or child support. (A) A burial plot for you and your family. (B) Health aids. (C) Benefits because of disability, illness or unemployment. (D) Medical care benefits. (E) Veteran’s benefits. (F) Social security benefits. (G) Supplemental security income benefits (SSI). (H) Workers’ compensation benefits. (I) Certain retirement benefits. (J) Public assistance. (K) Money or property for child support, alimony or separate maintenance. (L) Certain furnishings, appliances, carpets, animals, books, musical instruments, and heirlooms. (M) Provisions for 12 months. (N) Wearing apparel, not including jewelry or furs. (O) Beds and bedding. (P) Certain works of art. (Q) Compensatory damages from bodily injury or wrongful death. (R) The proceeds of certain life insurance contracts and trusts. (S) Books, implements and tools of a trade. (T) A personal motor vehicle. (U) A motor vehicle used in trade or business. Notice of Garnishment and Exemptions Revised August 1, 2007 Page 1 American LegalNet, Inc. www.FormsWorkflow.com (V) Part of your wages. (W) Property of a person who did not have a judgment entered against him or her, such as the co-owner of the property being held. 5. You should consult the Utah Exemption Act, Utah Code Title 78, Chapter 23. (Available at: (http://www.le.state.ut.us/~code/TITLE78/78_1E.htm). There is no exemption solely because you are having difficulty paying your debts. 6. If you believe that the Writ of Garnishment was issued improperly, that the Answers to Interrogatories are inaccurate, that the judgment creditor owes you money, or that you are entitled to an exemption, DO THE FOLLOWING IMMEDIATELY. You have a deadline of 10 business days from the date the garnishee mailed or delivered this notice to you. (A) Complete the attached “Reply and Request for Hearing” form. (B) Sign your name in the space provided and write the address at which the court clerk should notify you of the hearing. (C) Mail or deliver the form to: the court clerk, the plaintiff, (or plaintiff’s attorney) and the garnishee. Keep a copy for your records. The name and address of the clerk of the court, the plaintiff, (or plaintiff’s attorney) and the garnishee are on the Writ of Garnishment. 7. The court clerk will schedule the matter for hearing and notify you. You should file with the Reply and Request for Hearing form or bring to the hearing any documents that help you prove your property is exempt. 8. If you fail to take these steps, the property being held may be used to pay a judgment creditor. 9. You may consult an attorney and have the attorney represent you at the hearing. Notice of Garnishment and Exemptions Revised August 1, 2007 Page 2 American LegalNet, Inc. www.FormsWorkflow.com