Fill and Sign the Ca Withholding Form

ATTORNEY (NAME AND ADDRESS): TELEPHONE NO.: ––––– ––––– ––––– ––––– Attorney for State Tax Agency: ––––– FOR COURT USE ONLY Name of court, judicial district or branch court, if any and post office street address: ––––– ––––– ––––– ––––– Application of: ––––– ––––– ––––– Taxpayer — Respondent : ––––– EARNINGS WITHOUT ORDER FOR TAXES Court Case Number: ––––– Name of State Tax Agency: ––––– Tax Agency Number: ––––– 1. The State’s application for an Earnings Withholding Order for Taxes came on for hearing on (date): ––––– in Dept.: ––––– Div.: ––––– Room: ––––– before Judge (name): ––––– 2. a. Attorney for state tax agency present in court (name): ––––– b. Taxpayer present in court c. Attorney present in court (name): ––––– 3. The court has considered the tax payer’s Claim of Exemption and Financial Declaration the evidence presented the parties’ stipulation. 4. THE COURT FINDS a. The taxpayer (employee) is entitled to a monthly exemption of $ ––––– b. The taxpayer is employed by (name and address of employer): ––––– ––––– ––––– ––––– c. $ ––––– has been withheld from the employee's earnings under a Temporary Earnings Withholding Order for Taxes. from the employee’s earnings. 5. THE COURT ORDERS the employer to a. withhold and pay to the state tax agency $ ––––– from the employee's disposable earnings each month. b. pay to the employee any disposable earnings above that amount, not to exceed: $ ––––– per month. c. WITHHOLD AND PAY TO THE STATE TAX AGENCY ANY DISPOSABLE EARNINGS ABOVE THOSE SET FORTH IN ITEMS 4a AND 4b. d. begin withholding with the first pay period that ends on or after the 10th day after this order is served.. e. continue withholding until the tax liability has been satisfied unless an order with higher priority is received. f. All sums withheld shall be sent to the state tax agency within 10 days after the last pay check for each month g. Other (specify): ––––– ––––– ––––– (continued on reverse) Form Adopted for Mandatory Use Judicial Council of California WG-022 [Rev. January 1, 2007] EARNINGS WITHHOLDING ORDER FOR TAXES (Wage Garnishment—State Tax Liability) CCP 723.076 723.080 WG-022 electronic form ã 1994- 2007 WWW.LawCA.com Law Publishers APPLICATION OF (Name): ––––– CASE NUMBER: ––––– TAXPAYERRESPONDENT INSTRUCTIONS TO EMPLOYER A. When remitting withheld sums to the state tax agency, include the employee’s name and social security number, and the tax agency number B. PRIORITY OF EARNINGS WITHHOLDING ORDERS First: Order Assigning Salary or Wages Second: Earnings Withholding Order for Support Third: Earnings Withholding Order for Taxes Fourth: Earnings Withholding Order WG-022 [Rev January 1, 2007] EARNINGS WITHHOLDING ORDER FOR TAXES (Wage Garnishment—State Tax Liability) Page 2 of 2 WG-022