Fill and Sign the Wg 005 Employers Return Form

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and Address) : TELEPHONE NO.: ATTORNEY FOR (Name): LEVYING OFFICER (Name and Address): NAME OF COURT, JUDICIAL DISTRICT, OR BRANCH COURT, IF ANY PLAINTIFF: DEFENDANT: EMPLOYER'S RETURN (Wage Garnishment) LEVYING OFFICER FILE NO.: COURT CASE NO.: EM PLO YER : You m ust c o m ple te b oth c o pie s o f th is fo rm a nd m ail th em to th e le vyin g o ffic e r w it h in 1 5 d ays. P le a se co rre ct a ny e rro rs in th e m ailin g in fo rm atio n a bove a nd p ro vid e a ny m is sin g in fo rm atio n, in clu din g th e na m e o f t h e p ers o n t o w hom n otic e s s h ould b e d ir e cte d.F A IL U R E T O C O M PLE TE A N D R ETU RN T H ESE F O RM S M AY S U BJE C T Y O U T O P AYM EN T O F ATT O RNEY F E E S A N D O TH ER C IV IL P EN ALT IE S.Name and address of employerName and address of employee Attn: Social Security Number (if known): (Insert name above) 1.I received the Earnings Withholding Order on (date): 2. The employee isa. not employed by this employer (if not employed, omit items 2b through 6 and proceed to item 7 on reverse). b. now employed by this employer and in the last pay period had gross earnings of $ 3. The employee's pay period isa. daily b. weekly c. every two weeks d. twice a month e. monthly f. other (specify): 1(IF YOU HAVE RECEIVED NO OTHER ORDERS THAT PRESENTLY AFFECT THIS EMPLOYEE'S EARNINGS, OMIT ITEMS 4, 5, AND 6, AND PROCEED TO ITEM 7 ON REVERSE.) (Continued on reverse) Form Adopted by the Judicial Council of CaliforniaWG-005 [Rev. January 1, 2007] EMPLOYER'S RETURN (Wage Garnishment) Code Civ. Proc., § 706.126 electronic form 2001-2007 WWW.LawCA.com Law Publishers WG-005 SHORT TITLE: LEVYING OFFICER FILE NO.: COURT CASE NO.: If you have received other orders that presently affect this employee's earnings, another order may have priority over this one.The following list indicates the priority of orders:Wage and Earnings Assignment Order (For support). . . . . .Earnings Withholding Order for Support. . . . . . . . . . . . . . . . .Earnings Withholding Order for Taxes . . . . . . . . . . . . . . . . . .Earnings Withholding Order . . . . . . . . . . . . . . . . . . . . . . . . . .First prioritySecond priorityThird priorityFourth priorityIf t w o o r m ore o rd ers h ave t h e s am e p rio rit y , c o m ply w it h t h e o ne r e ceiv ed f ir s t. If b oth w ere r e ceiv ed o n t h e s am e d ate , c o m ply wit h t h e o ne w it h t h e e arlie r d ate o f j u dgm en t. If t h e d ate s o f j u dgm en t a re t h e s am e, y o u m ay s ele ct w hic h o rd er y o u c h oo se t o com ply w it h .4. T his o rd er a ppears t o h ave h ig her p rio rit y t h an a ny o th er o rd er. E arn in gs w ill b e w it h held f o r t h is o rd er in a cco rd w it h t h e E M PLO YER 'S I N STR UCTIO NS ( o n r e ve rs e o f E arn in gs W it h hold in g O rd er).5 . T he e m plo ye r h as r e ce iv e d a noth er o rd er a ffe ctin g t h e e m plo ye e's e arn in gs a nd e arn in gs a re b ein g w it h held f o r t h e o th e r o rd e r b eca u se :a. h e o th er o rd er w as r e ce iv e d f ir s t. T he o th er o rd er w as r e ce iv e d o n ( d ate ): b. T his o rd er d oes n ot h ave h ig her p rio rit y . c . A c o py o f t h e o th er o rd er is a tta ch ed ( R eta in o rig in al f o r y o ur r e co rd s. If a c o py is n ot a tta ch ed, c o m ple te it e m d .) d . A c o py o f t h e o th er o rd er is N O T a tta ch ed. D escrib e t h e o th er o rd er b y p ro vid in g t h e f o llo w in g in fo rm atio n: (1 ) Cou rt n am e, a ddre ss, a nd c a se n um ber: (2 ) Levyin g o ffic e r, n am e, a ddre ss a nd f ile n um ber: (3 ) Tota l a m oun t t o b e w it h held : $ 6. T his o rd er is n ot e ffe ctiv e f o r t h e r e aso n s h ow n in it e m 5 . It is r e tu rn ed t o t h e le vyin g o ffic e r w it h t h is r e tu rn . 7 . I d ecla re u nder p enalt y o f p erju ry u nder t h e la w s o f t h e S ta te o f C alif o rn ia t h at t h e f o re goin g is t r u e a nd c o rre ct.D ate :
( T Y PE O R P R IN T N AM E)(S IG NATU RE O F D EC LA R AN T) If a n E arn in gs W it h hold in g O rd er is n ot e ffe ctiv e w hen s erv ed , fo r a n y re aso n, d o n ot h old it . R etu rn it to th e le v yin g o ffic er w it h t h is r e tu rn .F A IL U RE T O C O M PLE TE A ND R ETU RN T H IS F O RM M AY S U BJE C T A N E M PLO YER T O C IV ILL IA BIL IT Y A ND A TTO RNEY F E ES. WG-005 WG-005 [Rev. January 1, 2007] EM PLO YER 'S R ETU RN (W ag e G arn is h m en t) P ag e t w o Electronic Form Copyright © 1997 Fresno LaserGraphics Inc