Fill and Sign the Minnesota Instructions Form

STATE OF MINNESOTA DISTRICT COURT COUNTY OF             JUDICIAL DISTRICT FAMILY COURT DIVISION In Re the Marriage of: Court File No.             , Petitioner, GARNISHMENT EARNINGS AND DISCLOSURE       , Respondent, DEFINITIONS "EARNINGS": For the purpose of garnishment, "earnings" means compensation paid or payable to an employee for personal services or compensation paid or payable to the producer for the sale of agricultural products; milk or milk products; or fruit or other horticultural products produced when the producer is operating a family farm, a family farm corporation, or an authorized farm corporation, as defined in section 500.24, subdivision 2, whether denominated as wages, salary, commission, bonus, or otherwise, and includes periodic payments pursuant to a pension or retirement. "DISPOSABLE EARNINGS": Means that part of the earnings of an individual remaining after the deduction from those earnings of amounts required by law to be withheld. (Amounts required by law to be withheld do not include items such as health insurance, charitable contributions, or other voluntary wage deductions.) "PAYDAY": For the purpose of garnishment "payday(s)" means the date(s) upon which the employer pays earnings to the debtor in the ordinary course of business. If the debtor has no - 1 - regular payday, payday(s) means the fifteenth and the last day of each month. THE GARNISHEE MUST ANSWER THE FOLLOWING QUESTIONS: 1. Do you now owe, or within 70 days from the date the garnishment summons was served on you, will you or do you expect to owe money to the debtor for earnings? YES NO 2. Does the debtor earn more than $       per week? (This amount is the federal minimum wage per week.) YES NO INSTRUCTIONS FOR COMPLETING THE EARNINGS DISCLOSURE A. If your answer to either question 1 or 2 is "No", then you must sign the affirmation on Page 2 and return this disclosure to the creditor's attorney (or the creditor if not represented by an attorney) within 20 days after it was served on you, and you do not need to answer the remaining questions. B. If your answers to both questions 1 and 2 are "Yes", you must complete this form and the Earnings Disclosure Worksheet as follows: For each payday that falls within 70 days from the date the garnishment summons was served on you, YOU MUST calculate the amount of earnings to be retained by completing Steps 3 through 11, and enter the amounts on the Earnings Disclosure Worksheet. UPON REQUEST, THE EMPLOYER MUST PROVIDE THE DEBTOR WITH INFORMATION AS TO HOW THE CALCULATIONS REQUIRED BY THIS DISCLOSURE WERE MADE. Each payday, you must retain the amount of earnings listed in Column I on the Earnings Disclosure Worksheet. You must retain this Earnings Disclosure Form and the Earnings Disclosure Worksheet to the creditor's attorney (or the creditor if not represented by an attorney) and deliver a copy to the debtor within ten days after the last payday that falls within the 70-day period. If the claim is wholly satisfied or if the debtor's employment ends before the expiration of the 70-day period, your disclosure should be made within ten days after the last payday for which earnings were attached. For Steps 3 through 11, "Columns" refers to columns on the Earnings Disclosure Worksheet. 3. COLUMN A. Enter the date of debtor's payday. 4. COLUMN B. Enter debtor's gross earnings for each payday. 5. COLUMN C. Enter debtor's disposable earnings for each payday. 6. COLUMN D. Enter 25 percent of disposable earnings. (Multiply Column C by .25). - 2 - 7. COLUMN E. Enter here 40 times the hourly federal minimum wage ($...) times the number of work weeks included in each payday. (Note: If a period includes days in excess of whole work weeks, the additional days should be counted as a fraction of a work week equal to the number of work days in excess of a whole work week divided by the number of work days in a normal work week.) 8. COLUMN F. Subtract the amount in Column E from the amount in Column C, and enter here. 9. COLUMN G. Enter here the lesser of the amount in Column D and the amount in Column F. 10. COLUMN H. Enter here any amount claimed by you as a setoff, defense, lien, or claim, or any amount claimed by any other person as an exemption or adverse interest which would reduce the amount of earnings owing to the debtor. (Note: Any indebtedness to you incurred by the debtor within the ten days before the receipt of the first garnishment on a debt may not be set off against amounts otherwise subject to the garnishment. Any assignment of earnings made by the debtor to any party within ten days before the receipt of the first garnishment on a debt is void.) You must also describe your claim(s) and the claims of others, if known, in the space provided below the worksheet and state the name(s) and address(es) of these persons. Enter zero in Column H if there are no claims by you or others which would reduce the amount of earnings owing to the debtor. 11. COLUMN I. Subtract the amount in Column H from the amount in Column G and enter here. This is the amount of earnings that you must retain for the payday for which the calculations were made. AFFIRMATION I, ____________________ (person signing Affirmation), am the garnishee or I am authorized by the garnishee to complete this earnings disclosure, and have done so truthfully and to the best of my knowledge. Dated: ____________ _______________________________ Signature _______________________________ Title _______________________________ Telephone Number - 3 - EARNINGS DISCLOSURE WORKSHEET Debtor's Name A B C Payday Gross Disposable Date Earnings Earnings 1. ________________ ________________ 2. 3. 4. ________________ ________________ 5. 6. 7. ________________ ________________ 8. 9. 10. D E F 25% of 40 X Min. Column C Column C Wage Minus Column E 1. ________________ ________________ 2. 3. 4. ________________ ________________ 5. 6. 7. ________________ ________________ 8. 9. 10. G H I Lesser of Setoff, Lien, Column G Column D and Adverse Interest, Minus Column F or Other CLaims Column H 1. ________________ ________________ 2. 3. - 4 - 4. ________________ ________________ 5. 6. 7. ________________ ________________ 8. 9. 10. TOTAL OF COLUMN I $ *If you entered any amount in Column H for any payday(s), you must describe below either your claims, or the claims of others. For amounts claimed by others, you must both state the names and addresses of these persons, and the nature of their claim, if known.       AFFIRMATION I, ____________________ (person signing Affirmation), am the third party or I am authorized by the third party to complete this earnings disclosure worksheet, and have done so truthfully and to the best of my knowledge. Dated: ____________________ Signature: ____________________ Title: ____________________ Telephone Number ( ) ____________ - 5 - (EARNINGS DISCLOSURE FORM AND WORKSHEET FOR CHILD SUPPORT DEBTOR) STATE OF MINNESOTA DISTRICT COURT COUNTY OF             JUDICIAL DISTRICT FAMILY COURT DIVISION In Re the Marriage of: Court File No.             , Creditor, GARNISHMENT EARNINGS AND DISCLOSURE       , Debtor, Garnishee. DEFINITIONS "EARNINGS": For the purpose of execution, "earnings" means compensation paid or payable to an employee for personal services or compensation paid or payable to the producer for the sale of agricultural products; milk or milk products; or fruit or other horticultural products produced when the producer is operating a family farm, a family farm corporation, or an authorized farm corporation, as defined in section 500.24, subdivision 2, whether denominated as wages, salary, commission, bonus, or otherwise and includes periodic payments pursuant to a pension or retirement, workers' compensation, or unemployment compensation. "DISPOSABLE EARNINGS": Means that part of the earnings of an individual remaining after the deduction from those earnings of amounts required by law to be withheld. (Amounts required by law to be withheld do not include items such as health insurance, charitable contributions, or other voluntary wage deductions.) "PAYDAY": For the purpose of execution, "payday(s)" means the date(s) upon which the - 6 - employer pays earnings to the debtor in the ordinary course of business. If the judgment debtor has no regular payday, payday(s) means the fifteenth and the last day of the each month. THE GARNISHEE MUST ANSWER THE FOLLOWING QUESTIONS: 1. Do you now owe, or within 70 days from the date the execution levy was served on you, will you or may you owe money to the debtor for earnings? YES NO INSTRUCTIONS FOR COMPLETING THE EARNINGS DISCLOSURE A. If your answer to question 1 is "No", then you must sign the affirmation below and return this disclosure to the creditor's attorney (or the creditor if not represented by an attorney) within 20 days after it was served on you, and you do not need to answer the remaining questions. B. If your answer to questions 1 is "Yes", you must complete this form and the Earnings Disclosure Worksheet as follows: For each payday that falls within 70 days from the date the garnishment summons was served on you, YOU MUST calculate the amount of earnings to be retained by completing Steps 2 through 8 on page 2, and enter the amounts on the Earnings Disclosure Worksheet. UPON REQUEST, THE EMPLOYER MUST PROVIDE THE DEBTOR WITH INFORMATION AS TO HOW THE CALCULATIONS REQUIRED BY THIS DISCLOSURE WERE MADE. Each payday, you must retain the amount of earnings listed in Column G on the Earnings Disclosure Worksheet. You must pay the attached earnings and return this Earnings Disclosure Form and the Earnings Disclosure Worksheet to the creditor's attorney (or the creditor if not represented by an attorney) and deliver a copy to the debtor within ten days after the last payday that falls within the 70-day period. If the claim is wholly satisfied or if the debtor's employment ends before the expiration of the 70-day period, your disclosure should be made within ten days after the last payday for which earnings were attached. For Steps 2 through 8, "Columns" refers to columns on the Earnings Disclosure Worksheet. 2. COLUMN A. Enter the date of debtor's payday. 3. COLUMN B. Enter debtor's gross earnings for each payday. 4. COLUMN C. Enter debtor's disposable earnings for each payday. 5. COLUMN D. Enter either 50, 55, 60 or 65 percent of disposable earnings, based on which of the following descriptions fits the child support judgment debtor: A) 50 percent of the judgment debtor's disposable income, if - 7 - the judgment debtor is supporting a spouse or dependent child and the judgment is 12 weeks old or less (12 weeks to be calculated to the beginning of the work week in which the execution levy is received); B) 55 percent of the judgment debtor's disposable income, if the judgment debtor is supporting a spouse or dependent child, and the judgment is over 12 weeks old (12 weeks to be calculated to the beginning of the work week in which the execution levy is received); C) 60 percent of the judgment debtor's disposable income, if the judgment debtor is not supporting a spouse or dependent child and the judgment is 12 weeks old or less (12 weeks to be calculated to the beginning of the work week in which the execution levy is received); or D) 65 percent of the judgment debtor's disposable income, if the judgment is not supporting a spouse or dependent child, and the judgment is over 12 weeks old (12 weeks to be calculated to the beginning of the work week in which the execution levy is received). (Multiply Column C by .50, .55, .60, or .65, as appropriate.) 6. COLUMN E. Enter here any amount claimed by you as a setoff, defense, lien, or claim, or any amount claimed by any other person as an exemption or adverse interest that would reduce the amount of earnings owing to the debtor. (NOTE: Any assignment of earnings made by the debtor to any party within ten days before the receipt of the first garnishment on a debt is void. Any indebtedness to you incurred by the debtor within the ten days before the receipt of the first garnishment on a debt may not be set off against amount otherwise subject to the garnishment.) You must also describe your claim(s) and the claims of others, if known, in the space provided below the worksheet and state the name(s) and address(es) of these persons. Enter zero in Column E if there are no claims by you or others that would reduce the amount of earnings owing to the judgment debtor. 7. COLUMN F. Subtract the amount in Column E from the amount in Column D and enter here. This is the amount of earnings that you must remit for the payday for which the calculations were made. AFFIRMATION I, ____________________ (person signing Affirmation), am the garnishee or I am authorized by the garnishee to complete this earnings disclosure, and have done so truthfully and to - 8 - the best of my knowledge. Dated: ____________ _______________________________ Signature _______________________________ Title _______________________________ Telephone Number - 9 - EARNINGS DISCLOSURE WORKSHEET Debtor's Name A B C Payday Gross Disposable Date Earnings Earnings 1. ________________ ________________ 2. 3. 4. ________________ ________________ 5. 6. 7. ________________ ________________ 8. 9. 10. D E F Either 50, 55 Setoff, Lien Column D 60, or 65% of Adverse Interest, Minus Column C or Other Claims Column E 1. ________________ ________________ 2. 3. 4. ________________ ________________ 5. 6. 7. ________________ ________________ 8. 9. 10. TOTAL OF COLUMN F $ *If you entered any amount in Column E for any payday(s), you must describe below either your claims, or the claims of others. For amounts claimed by others, you must both state the names and addresses of such persons, and the nature of their claim, if known.       - 10 - AFFIRMATION I, ________________ (person signing Affirmation), am the third party or I am authorized by the third party to complete this earnings disclosure worksheet, and have done so truthfully and to the best of my knowledge. Dated: ________________ Signature: ________________ Title: ________________ Telephone Number ( ) ___________ - 11 -