Establishing secure connection…Loading editor…Preparing document…

Affidavit for Order of Wage Garnishment

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

DECLARATION OF JUDGMENT CREDITOR FOR GARNISHMENT OF WAGES; EXHIBIT(S); NOTICE TO EMPLOYER OF JUDGMENT DEBTOR; GARNISHEE INFORMATION

IN THE DISTRICT COURT OF THE FIFTH CIRCUIT

STATE OF HAWAII

Plaintiff(s)

Reserved for Court use

Civil No.:

Defendant(s)

Filing Party/Attorney Name, Attorney number, Address, Telephone, and Fax numbers

Garnishee (Name and Address)

Certified copy of the Judgment attached as Exhibit

Current Amount Due: $

(If this amount is different from the Judgment Amount, please attach separate sheet showing calculations as Exhibit B

Judgment Debtor(s):

Current Place of Employment:

DECLARATION

1. I am the Judgment Creditor of Judgment Creditor's Attorney;

2. Judgment(a copy of which is attached as Exhibit A) was entered on the date shown on the Judgment for Judgment Creditor and against Judgment Debtor(s);

3. There is still due and owing the Judgment amount shown in Exhibit A or the Current Amount Due as evidenced by Exhibit B;

4. The Judgment has not been appealed (or if appealed, no bond has been filed), reversed, modified, set aside or satisfied except as stated above, and otherwise remains in full force and effect;

5. The Judgment Creditor is still the owner and holder of the Judgment;

6. Judgment Debtor is presently believed to be employed at the Current Place of Employment listed above; and

7. The Judgment has been in effect for at least 10 days.

I DECLARE UNDER PENALTY OF LAW THAT EVERYTHING IN THIS DECLARATION IS TRUE AND CORRECT.

Date:

Signature of Declarant:

Print/Type Name:

RG-AC-508 (1/18)

5D-P-187

Declaration of Judgment Creditors - Garnishment of Wages

Form #DC25

NOTICE TO EMPLOYER OF JUDGMENT DEBTOR

The applicable law found in Hawaiʻi Revised Statutes 652-1(b) provides as follows:

"...the employer shall thereupon either file a disclosure within one week or shall withhold from the wages of the judgment debtor the amounts as [provided by this law] and pay the same to the judgment creditor."

Prior to making the final payment, you should contact the Judgment Creditor or the Judgment Creditor's attorney to obtain the final payoff amount, that may include additional interest as allowed by law.

If you file a disclosure, send it to:

District Court of the Fifth Circuit

Small Claims Division

3970 Kaʻana Street, Suite 207

Lihu'e, Hawaiʻi 96766

For additional information, please refer to Garnishee Information (Form #DC27)

In accordance with state and federal disability laws, if you require an accommodation for a disability when working with a court program, service, or activity, please contact the Administration office at PHONE NO. 482-2347, FAX 482-2309, OR TTY 482-2533 at least ten(10) working days before your proceeding, hearing, or appointment date.

FOR ALL CIVIL RELATED MATTERS, PLEASE CALL 482-2303 OR VISIT DISTRICT COURT, SMALL CLAIMS DIVISION AT 3970 KAʻANA STREET, LIHU'E, HAWAI'I.

Enter text✕
Prepare your document for signing right on this page
  • 01 Edit the text and complete the fields
  • 02 Click Sign Now and on the next screen add recipients and signature fields in SignNow
  • 03 Start your free trial to sign and send your doc
Sign Now

What the Affidavit for Order of Wage Garnishment Is

An Affidavit for Order of Wage Garnishment is a sworn statement filed by a judgment creditor or its attorney to obtain a court order directing an employer to withhold a portion of a debtor's wages to satisfy a money judgment. The affidavit documents the judgment balance, identifies the debtor and employer, and sets out the calculation and statutory basis for withholding. It is typically supported by the certified judgment, proof of service, and a notarized signature or compliant remote notarization record where permitted by state law.

Why a Complete Affidavit Matters

A properly completed affidavit provides the court and employer with the factual and legal information needed to implement garnishment, reduces procedural challenges, and increases the likelihood of timely collection while protecting debtor rights under applicable statutes and exemptions.

Why a Complete Affidavit Matters

Who Prepares and Responds to This Affidavit

Typical users who prepare or respond to this affidavit include judgment creditors, their counsel, and employers directed to withhold wages.

  • Judgment creditors and collection attorneys who seek enforcement of money judgments through wage garnishment.
  • Employers, payroll and HR staff required to implement withholding orders and remit funds to the court.
  • Debtors who are subject to garnishment and may need to file exemptions or contest the order.

Step-by-Step: Preparing and Filing the Affidavit

Follow this sequence to gather information, complete the affidavit, notarize if required, file with court, and serve the employer according to state rules.

  • 01
    Gather documents: Collect the judgment, itemized balance, and proof of service to support the affidavit.
  • 02
    Identify parties: Enter full legal names, current addresses, and employer contact details exactly as verified.
  • 03
    Calculate amount: Show principal, interest, costs, and per-paycheck deduction with the calculation date documented.
  • 04
    File and serve: File with the clerk, obtain the signed order, and serve the employer per jurisdictional requirements.

Key Sections to Include in a Professional Affidavit

A complete affidavit follows a standard structure that lets courts and employers verify authority, identity, and calculation; include the elements below in clear, labeled sections.

Caption

Court caption with case name and docket number so the clerk and employer can identify the underlying case and link the garnishment request to the judgment.

Judgment summary

Statement of the original judgment, judgment creditor, debtor, judgment date, original amount, and outstanding balance to establish the basis for garnishment.

Debtor identity

Full legal name, aliases, current mailing address, and identifying numbers as permitted to prevent misdirected garnishment and ensure proper service.

Employer details

Employer legal name, payroll address, payroll contact, and EIN if available; these details ensure correct routing of withholding instructions and payments.

Garnishment calculation

Line-by-line computation showing wages subject to withholding, exempt amounts, per-paycheck deduction, and statutory references used for the calculation.

Verification & signature

Notary jurat or equivalent, declarant signature, printed name, title, date, and certificate of service with references to attached exhibits.

Essential Data Elements at a Glance

Creditor Name: Full legal name as on the judgment
Debtor Name: Full legal name and known aliases
Case Number: Court docket or case number
Judgment Amount: Original amount and outstanding balance
Employer Info: Payroll address and contact person
Signature & Notary: Signed, dated, and notarized where required

Penalties and Risks of an Incorrect Affidavit

Rejected Filing: Procedural defects cause rejection
Delay in Enforcement: Incomplete data delays garnishment
Employer Liability: Improper withholding may invite suit
Tax Withholding Errors: Incorrect amounts trigger penalties
Perjury Risk: False statements may be criminal
Financial Impact: Uncollected judgment increases costs

Common Preparation Mistakes to Avoid

  • Using incomplete employer information that prevents service or causes payroll to misapply the garnishment calculation leading to delays and possible court rework.
  • Failing to include a precise calculation showing exempt amounts and per-paycheck deduction, which causes the employer or court to return the affidavit for clarification.
  • Submitting unsigned or improperly notarized affidavits, including missing jurat language or incorrect RON procedures, resulting in rejection by the clerk.
  • Neglecting to serve required parties or to attach the judgment and proof of service, creating grounds for debtor to contest on procedural grounds.

Where to File, Obtain the Order, and Serve the Employer

This section explains where to file the affidavit, how the court issues a garnishment order, and the typical employer notification steps required for withholding.

  • File with court: Submit the affidavit to the county clerk where the judgment was entered.
  • Obtain order: Judge or clerk reviews and signs the garnishment order if the affidavit meets requirements.
  • Serve employer: Serve the employer per state rules, commonly by certified mail or personal service.
  • Employer action: Payroll computes withholding and remits funds to the court or registry.

Digital Signing, Notarization, and Delivery Considerations

Use eSignature and RON options to sign, notarize, and route the affidavit electronically where state law permits and courts accept digital filings.

  • Document formats: PDF or Word DOCX accepted
  • Authentication: Email link or SMS code
  • Integrations: Payroll and court e-filing integrations

How to Configure an Online Affidavit Workflow

Set up a digital workflow to pre-fill fields, require signatures and notarization, capture audit trails, and route copies to court and employer.

Field Configuration
Form Template Use pre-filled fields and conditional visibility rules
Signer Order Specify declarant, notary, employer recipients and routing
Authentication Enable email or SMS verification and optional KBA
Audit Trail Capture timestamps, IP, and certificate of completion

How This Affidavit Differs From a Writ of Garnishment

Compare the Affidavit for Order of Wage Garnishment with alternative enforcement documents to determine the appropriate procedural vehicle for collection.

Criteria Affidavit Writ
Initiation post-judgment filing court-issued
Purpose obtain withholding broader asset levy
Typical signer creditor/declarant court clerk or judge
Local variation

eSignature Vendor Comparison for Filing and Signing Affidavits

Basic vendor pricing and feature indicators relevant to affidavit creation, signature capture, bulk send, audit trails, and HIPAA compliance are shown below for quick reference.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day trial Varies Varies Varies Varies
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No
Envelope Cap No envelope cap 100 envelopes/user/year Varies Varies Varies

Timelines and Expected Processing Steps

Key timing considerations from filing to the first withholding help set expectations for courts, creditors, and employers.

File after judgment:

File the affidavit only after entry of final money judgment.

Clerk review period:

Court review and signing can take days to weeks depending on local docket.

Service on employer:

Serve employer promptly; some states require certified mail or personal service.

Employer response window:

Employers often have a statutory period, commonly 7 to 14 days, to verify and act.

First withholding pay date:

Withholding usually begins with the next payroll after the employer receives and processes the order.

Best Practices to Reduce Rejection and Employer Liability

Adopt consistent preparation and attachment standards to help clerks and payroll departments process garnishments without delay or dispute.

Verify full legal names and identifiers
Confirm names, aliases, and last four SSN digits match the judgment and service documents. Cross-check employer legal name and payroll address against state registries to avoid misdirected service and postponements.
Attach judgment and proof of service
Include a certified copy of the judgment, itemized ledger showing interest and costs, and proof of service to the debtor. Clearly label exhibits and reference them in the affidavit for quick court verification.
Follow notarization and local form rules
Use the court's local affidavit form when required, and follow notarization or RON procedures precisely. If RON is used, confirm the court accepts remote notarizations for garnishment filings.
Provide payroll calculation examples
Show a sample paycheck calculation with gross wages, exempt amounts, and exact deduction amount. This helps payroll implement withholding correctly and reduces employer liability concerns.

Real-World Examples of Digital Affidavit Workflows

These examples show how organizations use digital workflows and eSignature providers to standardize affidavit preparation and speed enforcement.

Optica Ventures LLC

Optica Ventures streamlined enforcement workflows by moving affidavit preparation and signature capture online to reduce turnaround and manual filing steps.

  • signNow simplified signature capture and secure sharing.
  • As a result, operations reported faster processing and fewer clerical errors when preparing garnishment affidavits; digital retention and audit trails also reduced follow-up from payroll departments.

Fertility Centers of Illinois

Fertility Centers of Illinois adopted digital affidavit workflows to ensure compliant signatures and consistent storage of court-filed garnishment documents.

  • Compliance and API integration supported their processes.
  • They cited improved document control and responsive support for clerk requests; centralized signed records reduced time spent locating supporting exhibits and simplified future enforcement.

Who Signs and Certifies the Affidavit

Brian Fitzgibbons, COO

As COO of Optica Ventures LLC, he emphasizes that a user-friendly signature workflow reduced turnaround on enforcement documents and made it easier for clients to complete affidavits while staff tracked returned forms and evidence.

John Butler, Founder

As founder of Fertility Centers of Illinois, he underscores the importance of secure, compliant e-signature and centralized document storage to preserve audit trails and reduce administrative time when preparing court filings.

Frequently Asked Questions and Troubleshooting

Common questions about completing, notarizing, filing, serving, and contesting an Affidavit for Order of Wage Garnishment are answered below with practical guidance.


Need help? Contact support

Explore Templates

CHAMPVA Insurance Forms Texas Department of Insurance Form DWC-82 Florida Department of Insurance Form OIR A3 467 LR Volunteer Driver's Insurance Form Application for National Insurance Credits Application for Crop Insurance
be ready to get more
Join over 28 million airSlate SignNow users
Sign Now
Company
Forms
Pricing
Resources
Knowledge base
Other Products
© 2026 airSlate Inc. All rights reserved.