Fill and Sign the Judgment Debtor Financial Disclosure Minnesota Judicial Form

FORM 28SC R3/18 OBJECTION TO CALCULATION OF THE AMOUNT OF EXEMPT EARNINGS County Court  District Court ______________________County, ColoradoCourt address:Plaintiff(s):v.Defendant(s): COURT USE ONLY Judgment Debtor’s Attorney or Judgment Debtor (Name and Address): Phone Number: E-mail:FAX Number: Atty.Reg. #:Case Number:Division Courtroom OBJECTION TO CALCULATION OF THE AMOUNT OF EXEMPT EARNINGS Instructions to Judgment Debtor: Use this form to object to the calculations of your exempt earnings.Name: ______________________________________________________Phone Number: _________________________Street Address: _________________________________________________________________________________Mailing Address, if different: _____________________________________________________________________________City: ____________________________ State: _______________________________ Zip Code: ______________________EXEMPTION CHART (“Minimum Hourly Wage” means state or federal minimum wage, whichever is greater.)PAY PERIODWeeklyBi-WeeklySemi-monthlyMonthly AMOUNT EXEMPT IS THE GREATER OF:30 x Minimum Hourly Wage or 75% of Disposable Earnings 60 x Minimum Hourly Wage or 75% of Disposable Earnings65 x Minimum Hourly Wage or 75% of Disposable Earnings130 x Minimum Hourly Wage or 75% of Disposable Earnings1.Judgment Debtor’s objection to the Garnishee’s Calculation of the Amount of Exempt Earnings because I believe that the correct calculation is:Gross Earnings for My Pay Period from ___________________thru _________________ $ ____________Less Deductions Required by Law (For Example, Withholding Taxes, FICA) - $ ____________Disposable Earnings (Gross Earnings Less Deductions) = $ ____________Less Statutory Exemption (Use Exemption Chart on Writ) - $ ____________Net Amount Subject to Garnishment = $ ____________Less Wage/Income Assignment(s) During Pay Period (If Any) - $ ____________Amount which should be withheld = $ ____________ OR 2. The earnings garnished are pension or retirement benefits/deferred compensation/health, accident or disability insuranceand they are totally exempt because: I understand that I must make a good faith effort to resolve my dispute with the Garnishee.I  have  have not attempted to resolve this dispute with the Garnishee.Name of Person I Talked to: _________________________________________________Position: _________________________________________ Phone Number: __________________________________ FORM 28SC R3/18 OBJECTION TO CALCULATION OF THE AMOUNT OF EXEMPT EARNINGSDebtor’s Notice to Garnishee: Even though I am filing this Objection, you are directed to send my nonexempt earnings to the Court at the address noted instead of to the party designated in paragraph “e” on the front of the Writ of Continuing Garnishment. The Court will hold my nonexempt earnings in its registry until my Objection is resolved. I certify that the above is correct to the best of my knowledge and belief and that I sent a copy of this document by certified mail (return receipt requested) to both the Garnishee and to the Judgment Creditor, or if the Judgment Creditor is represented by Counsel, certified mail (return receipt requested) to the Judgment Creditor’s Attorney or E-Service to the Judgment Creditor’s Attorney. By checking this box, I am acknowledging I am filling in the blanks and not changing anything else on the form. By checking this box, I am acknowledging that I have made a change to the original content of this form.Garnishee Judgment Creditor or AttorneyAddress: ________________________________________ Address: ___________________________________________________________________________________ ___________________________________________ ___________________________________________Signature of Judgment Debtor orJudgment Debtor’s Counsel and Reg. Number