Fill and Sign the Wg 006 Claim of Exemption Wage Garnishment 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: CLAIM OF EXEMPTION (Wage Garnishment) LEVYING OFFICER FILE NO.: COURT CASE NO.: READ THE EMPLOYEE INSTRUCTIONS BEFORE COMPLETING THIS FORM  Copy all the information required above (except the top left space) from the Earnings Withholding Order. The top left space is for your name or your attorney's name and address. The original and one copy of this form with the Financial Statement attached must be filed with the levying officer. DO NOT FILE WITH THE COURT.1.I need the following earnings to support myself or my family (check a or b):a. All earnings. b. $ each pay period. 2. Please send all papers to me.my attorney. at the address shown above following (specify): 3. I am willing for the following amount to be withheld from my earnings each pay period during the withholding period. I understand that the judgment creditor can accept this offer by not opposing the Claim of Exemption, which will result in the following sum being withheld each pay period (check a or b):a. None b. Withhold $ each pay period. 4.I am paid daily every two weeks monthly weekly twice a month other (specify): NOTE: You must attach a properly completed Financial Statement form to this Claim of Exemption.The Financial Statement form is available without charge from the levying officer.I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.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) Form Adopted by the Judicial Council of California WG-006 [Rev. January 1, 2007] CLAIM OF EXEMPTION (Wage Garnishment) CCP 706.124 electronic form 1994-2007 WWW.LawCA.com Law Publishers WG-006