Illinois

Illinois Interrogatory

Firm File Number

Employer/Agent Name(Required)

Email Address(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Fax

Debtor First Name(Required)

Debtor Last Name(Required)

Court Order

County(Required)

Return Date

Case Number(Required)

Do you pay monies to the judgment debtor listed above?

Yes

State whether any funds paid to the debtor are for disability, retirement or are in any other way exempt or subject to other Court Order:

One pay Period Equals

Day(s)

Week(s)

Month(s)

CALCULATION TO DETERMINE AMOUNT OF WITHHOLDING:

(A) Gross Wages minus mandatory contributions to pension or retirement plan:

(B) METHOD I - 15% of Line (A):

(C) METHOD II - the greater of (a) the amount that the weekly disposable earnings exceeds the minimum hourly wage or (b) the minimum hourly wage prescribed by Section 4 of the Minimum Wage Law

(1) Enter Total FICA, State and Federal Tax and Medicare:

(2) Subtract Line (1) from Line (A):

(3) Enter Minimum Wage per pay period:

(4) Subtract Line(3) from Line (2): (enclose negative amount in parenthesis)

(D) Enter the lesser of Line (B) or Line (C):

(E) Enter Child Support or other Court Ordered Deduction:

(F)* Subtract Line (E) from Line (D): (enclose negative amount in parenthesis)

(G) Subtract Employer's Statutory Fee (735 ILCS 5/12-814):

(whichever is greater; $12.00 or 2% of the amount to be deducted)

(H) Amount to be applied to judgment:

Signature of Employer/Agent

INSTRUCTIONS

1. Electronically file a copy of this Answer to the Court and mail to attorney for Plaintiff and give a copy to the Defendant.
2. You will receive a copy of a Court Order by Fax or mail instructing you how to proceed and where to send deducted funds.

Employer/Agent:

Agent Name:(Required)

Employer Name:(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Fax

Phone(Required)

Note: A copy of this Answer should be electronically filed with the Court, Attorney for Plaintiff of judgment creditor and to the Defendant.

CAPTCHA

Blitt and Gaines, P.C. is a debt collector. This is an attempt to collect a debt and any information obtained will be used for that purpose.

Illinois

Illinois Interrogatory

INSTRUCTIONS

Company

Step 1

Step 2

Step 3