Can this form be signed electronically?

Yes. Electronic signatures meeting the ESIGN Act (15 U.S.C. ch. 96) and applicable state UETA rules are generally valid for execution, provided intent, consent, attribution, and retention criteria are met.

What if the employee disputes the calculation?

Document your inputs, attach paystubs and the original order, and follow dispute procedures. Retain the signed Form 27 and audit trail to support your position in administrative or court review.

Do I need notarization or witnesses?

Notarization and witness requirements depend on jurisdiction and document purpose. Check the state-specific rules and applicable court order; some states or orders may require notarized acknowledgements.

Which records must payroll keep?

Maintain the completed form, supporting paystubs, and the audit trail. Follow federal standards (IRC §6501(a)) and any applicable industry rules such as HIPAA (45 CFR §164.530(j)).

How do I correct a calculation error?

Prepare a corrected Form 27, mark it as a revision, notify affected parties, and document the reason. Preserve both versions and the approval chain for audit purposes.

Are there penalties for incorrect withholding?

Yes. Incorrect calculation or improper withholding can lead to statutory penalties, repayment obligations, and potential interest or attorney fee liability depending on the statute and circumstances.

Electronic Signature
Templates
Other
Form 27 Calculation of the Amount of Exempt Earnings

Form 27 Calculation of the Amount of Exempt Earnings

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

Judgment Debtor Interrogatories

______________County, Colorado

County Court

Court Address:

Telephone:

PLAINTIFF(S)/PETITIONER(S):

DEFENDANT(S)/RESPONDENT(S):

COURT USE ONLY

Attorney or Party Without Attorney (Name and Address):

Phone #: E-mail

Atty.Reg.#:

Case Number:

Division Courtroom

DEBTOR INTERROGATORIES

NOTICE TO THE ABOVE NAMED DEFENDANT(S):

1. These interrogatories are served on you as the judgement debtor pursuant to:

C.R.C.P. Rule 69. You must file an answer with the clerk of the above named Court not later than twenty (20) days from the date this document was served.

C.C.R.C.P. Rule 369. You must file an answer with the clerk of the above named Court not later than ten (10) days from the date this document was served.

2. The following Interrogatories must be answered by you in writing and under oath, and filed with the clerk of the above referenced court at the address set forth above, and a copy thereof must be mailed to the Plaintiff’s attorney.

3. If you fail to answer these interrogatories within the time set forth above, the Plaintiff may move for an order to answer these questions or show cause why you should not be held in contempt of this court.

4. You may avoid answering these questions by paying the judgement you owe in full before the date your answers are due by contacting Plaintiff’s attorney.

DATED THIS DAY OF , 200.

INSTRUCTIONS TO PERSON SERVED (CHECK ONE):

You are answering these questions on behalf of your self as an individual judgment-debtor: you are required to answer only questions 1 through 28.

You are answering these questions on behalf of an entity: you are required to answer only questions 29 through 40.

You are answering these questions on behalf of both yourself and an entity: you are required to answer questions 1 through 40.

PART A: QUESTIONS FOR INDIVIDUAL JUDGEMENT-DEBTORS:

1. Please provide the following information about yourself:

a. Your full legal name:

b. List any other names, aliases or nicknames you use:

c. Your current physical address:

d. Your current mailing address:

e. Your social security number:

f. Your date of birth:

g. State your home, cell and other telephone numbers where you may be contacted. Home Cell Other

h. Indicate if you reside in a house, apartment, or mobile home: House; Apartment; Mobile Home; Other (specify):

2. Do you own the home you live in? If Yes please answer the following:

a. The address of that home:

b. The current market value:

c. The balance due on any mortgages: 1st Mortgage: 2nd Mortgage:

d. The name and address of each mortgage holder: 1st Mortgage: 2nd Mortgage:

e. List the name and address of any person or business to whom you lease or rent all or any portion of this property (including oil and gas leases.) Provide amount of rent. Name of tenant Amount of monthly rent Address

f. State the name and address of any person who owns an interest in your home with you. Name of tenant Address

3. How many other tracts of real property do you have an ownership interest in?

a. The address:

b. The current market value:

c. The balance due on any mortgages: 1st Mortgage: 2nd Mortgage:

d. The name and address of each mortgage holder: 1st Mortgage: 2nd Mortgage:

e. List the name and address of any person or business to whom you lease or rent all or any portion of this property. Name of tenant Amount of monthly rent Address

f. State the name and address of any person who also owns an interest in this property. Name of tenant Address

4. If you lease or rent property, provide the following information:

a. The name of your landlord

b. The address of your landlord

c. The amount of your deposit

5. Are you employed? If yes please answer the following:

a. The name of your employer

b. The address of your employer

c. The amount you earn per month

6. Do you have other employment besides that listed above?

a. The name of your employer

b. The address of your employer

c. The amount you earn per month

7. Are you self-employed, own an interest in a closely held corporation, are a member of a limited liability company, are a partner in any kind of a partnership, or a member of a nonprofit corporation?

If yes, how many such entities do you have an ownership interest in?

a. Name of this business or entity:

b. Address of the business or entity:

c. State the average monthly gross income of the business or entity for the past six months.

d. List all personal property and intangible property owned by the business or entity.

e. List all accounts receivable of the business or entity.

f. List all real property in which the business has an ownership interest.

g. State the amount of cash reserves, retained earnings and capital accounts of the business.

h. List the name of the bank, account number and balance of each checking or other bank account held by the business or entity.

i. List the names, addresses and telephone numbers of any person besides yourself who has an ownership interest in this business or entity and describe the percentage of their ownership interest.

j. How much of this business or entity do you own?

k. What type of entity is this business?

l. What does this business do?

8. Are you (or do you expect that you will be in the next 12 months) the beneficiary of any decedent’s estate, trust, annuity, class action lawsuit settlement, or insurance policy proceeds?

a. Describe the nature of each interest in which you are a beneficiary.

b. State the name and address of the personal representative, trustee, insurer, or other administrator involved in each interest.

9. Presently, or in the next twelve months, do you expect to perform services in any of the building trades, work as a consultant in any field, or perform contract labor or services of any kind?

a. Provide the name and address of each and every person or entity with whom you currently have (or expect to have) a bid, contract, or other agreement to perform work for as a builder, tradesman, consultant, or contract laborer in the next twelve months.

b. For each project state the manner of payment, how much, and when you expect to be paid.

c. For each project identify the name and address of the person or entity who will be paying you.

10. Do you have any other sources of income, including gifts, royalties, contest or lottery winnings, yard sales, hobbies, Ebay trades, or government benefits?

a. Description of source of income:

b. Name and address of person or entity paying you this income:

c. Ave. monthly amount paid from this source of income:

11. Does anyone owe you money, or have possession of anything of value that is yours?

a. Description and amount or value:

b. Name and address of person who owes this to you:

12. What is the amount of the income tax refund you expect to receive this year:

13. What were the gross earnings you reported on your last Federal Tax Return:

14. Do you own an interest in any investments?

a. Description of each investment described above, including amount.

b. Name and address of person or entity involved.

15. What is the dollar amount of cash you have on hand:

16. How many bank accounts do you have an interest in or are authorized to sign checks for?

a. Description of your interest in each such account:

b. Name and address of the financial institution holding the account, the balance of each such account and the account number:

17. Do you own or have an interest in any IRA, 401(k), retirement plan, pension, credit union, or profit sharing plans?

a. Name and address of the financial institution or other entity holding or managing these funds, the balance of each such account and the account number:

18. Describe all insurance policies which you own, or have an interest in, and which have a cash surrender value, including the name and address of the insurer and the value.

19. List and describe all copyrights, published or unpublished writings or works, inventions, patents, trade names, trademarks, internet domain names, and other intellectual or intangible property in which you own or have an interest in.

20. How many motor vehicles, boats, aircraft, trailers, or recreational vehicles do you own or have an interest in?

a. Describe each and state the year, make, model, VIN or serial number, value, location, and name and address of any lien holder:

21. Describe and provide the location of all jewelry, precious metals, rare coins, antiques, art, sporting goods, firearms, bicycles, skis, snow boards, rugs, horse tack, electronics, tools, and other collectibles and like property, in which you have an ownership interest:

22. Describe and state the location of all horses, cattle, and other livestock, registered brands, farm and ranch machinery tools and equipment, grazing permits, agricultural leases, and crops in which you have an ownership interest.

23. Describe and list the location of all of your furnishings and appliances.

24. Describe and provide the location of any bank safe deposit box or storage units which you own or lease and describe the contents of each.

25. Describe all other real, personal, or intangible assets which you have not listed elsewhere.

26. Have you given, sold, transferred, or assigned to any person or entity any money, real property, personal property, intangible property, or anything else of value during the past 36 months?

a. Describe separately all property and things of value that you have given, sold, transferred or assigned.

b. Provide the name and address of the person or entity to whom it was transferred.

c. The date transferred.

d. The value of the property transferred.

e. The amount you were paid for the property.

f. Describe how the person or entity who received the property is related to you.

27. State the name and current address of your spouse and/or former spouse:

28. How many pages have you attached to these interrogatories?

PART B: SMALL BUSINESS DEBTOR INTERROGATORIES:

29. Please state the following information about the person answering these interrogatories on behalf of a corporate debtor:

a. Your name:

b. Your address:

c. Your telephone number:

d. Your title and relationship to the debtor company

30. If corporate debtor leases real property, provide the following information:

a. The name of landlord

b. The address of landlord

c. The amount of security deposit

31. Answer all of the following questions about the corporate debtor:

a. All names and trade names used by this business:

b. Addresses of all business locations:

c. State the average monthly gross income of the business for the past twelve months.

d. List all personal property and intangible property owned by the corporate debtor.

e. List all accounts receivable of the debtor.

f. List all real property in which the debtor has an ownership interest.

g. State the amount of cash reserves, capital accounts and retained earnings of the debtor.

h. List the bank, account number and balance of each checking or other bank account held by the debtor.

i. List the names, addresses and telephone numbers of every person who has an ownership interest in the debtor entity.

j. What type of entity is this business?

k. What is the EIN or tax ID number for this business?

l. List the names and addresses of the managers, directors, or partners of the debtor.

m. List the names and addresses of the president, secretary, treasurer, CEO, CFO and other officers of the debtor.

n. State the dates the members or shareholders of the debtor have met during the past 36 months.

o. State the dates the managers or directors of the debtor have met during the past 36 months.

p. Provide the name and address of the person who has possession of the minutes other corporate records of the debtor.

q. Provide the name and address of the person who has possession of the books and financial records of this business.

32. What type of entity is corporate debtor taxed as for Federal Tax purposes?:

33. State the amount of gross income reported for corporate debtor on its last Federal Tax return:

34. List all other assets for the corporate debtor which have not already listed.

35. How many employees does this debtor have?

36. What kind of business is this debtor engaged in?

37. If any single contract, customer or client of the debtor company is expected to be the source of more than 10% of its total gross income over the next twelve months, please describe nature of the products to be sold or services to be performed and state the name and address of each such customer or client.

38. Except in the usual course of its business, has the debtor sold, given, transferred, or assigned to any person or entity any of its assets, capital, or other property during the past 36 months?

a. Describe separately all property and things of value that debtor has given, sold, transferred or assigned.

b. Provide the name and address of the person or entity to whom it was transferred.

c. The date transferred.

d. The value of the property transferred.

e. The amount debtor was paid for the property.

f. Describe how the person or entity who received the property is related to the debtor.

39. List and describe debtor’s other debts and liabilities:

40. How many pages have you attached to these interrogatories on behalf of corporate debtor?

Signature

STATE OF COLORADO )

)ss.

COUNTY OF )

I swear under penalty of perjury that the foregoing answers to these interrogatories when are true and complete, to the best of my knowledge, information and belief as of this date.

_____________________________________

Signature of Defendant/Judgement Debtor

Subscribed and sworn to before me this day of , 200, by .

Witness my hand and official seal. My commission expires: .

____________________________________

Notary Public

Address:

AFFIDAVIT OF SERVICE

STATE OF COLORADO )

)ss.

COUNTY OF )

I , being first duly sworn do hereby declare to the undersigned authority that I personally served a true and correct copy of the foregoing RULE 69/369 DEBTOR INTERROGATORIES on , by on the day of , 200.

I state that I am over the age of 18 years and that I am not a party to this case.

I have charged the Plaintiff the sum of $ for service and $ for millage for a total of $.

_____________________________________

Signature of Process Server

Subscribed and sworn to before me this day of , 200, by .

Witness my hand and official seal. My commission expires: .

____________________________________

Notary Public

Address:

What the Form 27 Calculation of the Amount of Exempt Earnings Is

The Form 27 Calculation of the Amount of Exempt Earnings is a structured worksheet used to determine the portion of an individual’s pay that is exempt from withholding, garnishment, or levy under applicable federal and state rules. The form gathers payroll details, statutory exemption amounts, and calculation steps to produce a clear exempt-earnings figure for payroll, collections, or court reporting purposes. It standardizes inputs such as pay period, gross wages, pre-tax deductions, and legally protected amounts so employers and payors can apply consistent, auditable calculations.

Why a Clear Form 27 Calculation Matters

A professional Form 27 calculation reduces legal risk, improves payroll accuracy, and provides an auditable record for disputes. Accurate calculations protect employee rights, limit employer liability, and support compliance with federal and state withholding rules.

Who Typically Prepares and Uses This Calculation

The form is used by a range of payroll and compliance professionals when determining exempt earnings.

Payroll administrators and payroll service providers responsible for processing wage attachments and exemptions.
Employers and HR staff who must apply garnishment orders or levy instructions to employee pay.
Collections, courts, and legal counsel needing an auditable calculation for disputes or filings.

Use by these roles ensures consistent calculations, appropriate withholding, and defensible recordkeeping when wage protections are contested.

Step-by-Step: Completing the Form 27 Calculation

Follow these sequential actions to produce an auditable exempt earnings amount.

01

Gather Documents: Collect the latest paystub, order or notice, and benefit deduction detail.
02

Compute Gross Pay: Enter total gross wages for the applicable pay period.
03

Apply Deductions: Subtract pre-tax deductions and allowable exemptions per statute.
04

Sign and File: Sign, date, and route the completed form to payroll and the ordering authority.

How the Form 27 Calculation Flows Through Your Organization

The calculation follows a simple operational path from intake to payroll posting and record retention.

Intake: Receive garnishment order or employee claim and supporting paystubs.
Calculation: Prepare Form 27 and compute exempt amounts using documented steps.
Verification: Have payroll or legal review for statutory compliance and accuracy.
Distribution: Apply payroll changes and store the executed form in the employee record.

Configuring a Digital Workflow for Form 27

Set consistent fields and routing rules to reduce errors when processing multiple cases.

Field \| Configuration	Name \| Required; Date \| MM/DD/YYYY; Gross \| Numeric
Routing	Payroll Approval \| One-step approval
Retention	Records Folder \| Employee payroll archive
Authentication	Signer Verification \| Email + SMS OTP
Notifications	Alerts \| Payroll and legal on completion

Platform and File Requirements for eSubmission

Choose a platform that supports PDF and DOCX ingestion, robust audit trails, and common integrations.

File Formats: PDF, DOCX, XLSX supported
Integrations: Payroll systems, HRIS, cloud storage
Security: TLS in transit; AES-256 at rest

Ensure the chosen platform supports access controls, preserves audit logs, and produces a timestamped certificate of completion for records.

Consequences of Incorrect or Late Calculations

IRS Information Return Penalty: IRC §6721: $60–$330 per form

Intentional Disregard: IRC §6721: $660+ per form, no cap

I-9 Paperwork Violations: 8 CFR §274a.2: $281–$2,789 per violation

Wrongful Garnishment Liability: Potential civil damages and attorney fees

State Fines: Varies by state and statute

Interest and Wage Restitution: May require repayment plus interest

Common Errors to Avoid When Preparing the Calculation

Using the wrong pay period or stale paystub leads to incorrect exempt amounts and downstream payroll reversals.
Omitting pre-tax deductions such as retirement or health premiums inflates disposable earnings erroneously.
Failing to apply jurisdiction-specific exemption rules can create liability for unlawful withholding.
Not obtaining a signed preparer verification or missing a signature causes payroll teams to reject the calculation.

Practical Tips for Accurate and Efficient Completion

Adopt standard controls and verification steps to reduce rework and legal exposure.

Reconcile Source Documents

Match the calculation to the employee’s most recent paystub and the original order. Reconciliation prevents overstating exempt earnings and reduces payroll corrections.

Use Standard Field Formats

Require MM/DD/YYYY for all dates, numeric formats for wages, and full legal names. Standardization reduces parsing errors in automated workflows and avoids mismatches.

Document Reviewer Signoff

Have payroll or legal review and sign the completed Form 27. A formal reviewer reduces the chance of statutory misapplication or missed exemptions.

Preserve an Audit Trail

Retain the completed form, attachments, and a timestamped audit log showing who prepared and approved the calculation for future disputes.

Key Components of a Professional Form 27 Calculation

A complete Form 27 includes identifiable sections, calculation logic, and verification zones to support payroll action and legal defense.

Header

Identifies the payor, employee, case number, and jurisdiction so the calculation is clearly attributable in records and correspondence.

Pay Period Data

Captures pay period start/end, pay date, gross wages, and hours to establish the wage base for exemptions.

Deductions

Lists pre-tax and statutory deductions such as retirement, health insurance, and other withholdings that reduce disposable earnings.

Exemption Table

Applies statutory exemption amounts or formulas specific to the ordering jurisdiction and documents the legal basis for each exemption.

Verification Block

Provides space for preparer name, title, signature, date, and reviewer signoff to create an auditable approval chain.

Notes and Attachments

Includes references to the original garnishment order, paystubs, and any correspondence supporting the applied calculations.

Practical Use Cases for the Form 27 Calculation

These short examples show how the form supports common operational scenarios.

Payroll Compliance Case

A payroll clerk receives a wage garnishment order and gathers two months of paystubs to compute exempt earnings.

The clerk applies pre-tax deductions and statutory exemptions for the jurisdiction.
The completed Form 27, signed by payroll and retained in the employee file, prevented wrongful over-withholding and provided clear documentation for a later audit.

Collections Verification

A collections unit requests Form 27 to validate an alleged unpaid judgment before initiating withholding.

The document shows exact disposable earnings after deductions.
Using a standardized calculation reduced processing time and clarified the amount legally available for collection while protecting exempt income.

eSignature Platform Pricing and Compliance Comparison

Compare typical starting prices and key capabilities relevant when completing and executing Form 27 electronically. Vendor features and plan details vary by contract.

	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 free trial, no credit card required	Varies by vendor	Varies by vendor	Varies by vendor	Varies by vendor
Bulk Send	Yes (Business Premium)	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes (BAA available)	Yes	Yes	No	No

Frequently Asked Questions about Form 27 Calculations

Answers to common operational and legal questions encountered when preparing this calculation.

Need help? Contact support

Can this form be signed electronically?
Yes. Electronic signatures meeting the ESIGN Act (15 U.S.C. ch. 96) and applicable state UETA rules are generally valid for execution, provided intent, consent, attribution, and retention criteria are met.
What if the employee disputes the calculation?
Document your inputs, attach paystubs and the original order, and follow dispute procedures. Retain the signed Form 27 and audit trail to support your position in administrative or court review.
Do I need notarization or witnesses?
Notarization and witness requirements depend on jurisdiction and document purpose. Check the state-specific rules and applicable court order; some states or orders may require notarized acknowledgements.
Which records must payroll keep?
Maintain the completed form, supporting paystubs, and the audit trail. Follow federal standards (IRC §6501(a)) and any applicable industry rules such as HIPAA (45 CFR §164.530(j)).
How do I correct a calculation error?
Prepare a corrected Form 27, mark it as a revision, notify affected parties, and document the reason. Preserve both versions and the approval chain for audit purposes.
Are there penalties for incorrect withholding?
Yes. Incorrect calculation or improper withholding can lead to statutory penalties, repayment obligations, and potential interest or attorney fee liability depending on the statute and circumstances.

Explore Templates

Independence Timesheet Form Biweekly Timesheet for Personal Care Homemaker Telesearch Timesheet Form Sweet Home Healthcare Timesheets Form Timesheet Template Timesheet

be ready to get more

Join over 28 million airSlate SignNow users

Sign Now

Field \| Configuration	Name \| Required; Date \| MM/DD/YYYY; Gross \| Numeric
Routing	Payroll Approval \| One-step approval
Retention	Records Folder \| Employee payroll archive
Authentication	Signer Verification \| Email + SMS OTP
Notifications	Alerts \| Payroll and legal on completion