Kansas

Firm File Number(Required)

Email(Required)

County(Required)

Case No.(Required)

Judgment Creditor(Required)

Judgment Debtor(Required)

Employer Phone

To the above-named Garnishee:

Termination Date

2. If the above paragraph does not apply you must complete the rest of the Answer Form.
3. Read carefully the attached Instructions to Garnishee.
4. You must complete this answer within 14 days following the date the initial garnishment order is served on you. Only one answer needs to be completed under this garnishment for each judgment debtor and you may duplicate the completed answer in any manner you desire for distribution to the judgment creditor(s) and judgment debtor.
5. This answer covers all pay periods which end within 14 days following the date the garnishment order is served on you. Indicate the pay periods covered under this answer:

Start Date

End Date

6. The normal pay period for employee is (designate one):

Weekly

Every two weeks

Semi-monthly

Monthly

7. Total gross earnings due for the pay period or periods covered by this answer are:

8. Amounts required by law to be withheld for the pay period or periods covered are:

(1) Federal FICA (includes social security tax and medicare tax) $_____________.

(2) Federal income tax

(3) State income tax

(4) Railroad Retirement Tax

TOTAL DEDUCTIONS

9. Disposable earnings for the pay period or periods covered are: $_____________. (7 minus 8) See the attached Instructions to Garnishee to determine amount of disposable earnings to be withheld.

10. I am subtracting from the disposable earnings in 9 pursuant to an income withholding order for support the amount of $_____________.

11. I am subtracting from the disposable earnings in 9 pursuant to a lien which has priority over garnishments under the law the following amount: type of lien ______________ $______________

A

B

12. In accordance with the instructions accompanying this answer form, I have determined that the amount which may be paid to employee is $_____________.

13. I am holding from the amount in 12 an administrative fee in the amount of $_____________. See attached Instructions to Garnishee for amount of the administrative fee that can be retained.

14. After paying to the employee the amount stated in 12 less the administrative fee in 13, and deducting any amount shown in 10 and 11, I am holding the remainder of the employee's disposable earnings in the amount of $_____________.

15. If I do not receive an objection to this Answer within 14 days after I deliver it to all parties entitled to a copy, I will promptly pay the amount held in 14 to the following judgment creditors, unless I receive prior to such payment an order of the court to the contrary:

Judgment Debtor Name & Address:

EXECUTED on

I hereby certify that a copy of the completed interrogatories has been mailed and or hand-delivered to the judgment debtor.

I (WE) AFFIRM UNDER PENALTIES FOR PERJURY THAT THE FOREGOING REPRESENTATIONS ARE TRUE

Garnishee

To be used on and after July 1, 2010.

1. If the judgment debtor (employee) terminated employment before the first day of the payroll period for which this form is made, complete the following section and sign and date the form at the bottom. The Judgment debtor (employee) terminated employment on

2. If the above paragraph does not apply you must complete the rest of this form.
3. Read carefully the attached Instructions to Garnishee.
4. You must complete this form for each payroll period for the judgment debtor, that ends while the garnishment order remains in effect. Only one form needs to be completed for each payroll period for the judgment debtor.
5. This Written Explanation form covers the following pay period:

Start Date

End Date

6. The normal pay period for employee is (designate one):

weekly

every two weeks

semi-monthly

monthly

7. Total gross earnings due for the pay period covered by this form are: $_____________.

Amounts required by law to be withheld for the pay period or periods covered are:

(1) Federal FICA (includes social security tax and medicare tax) $_____________.

(2) Federal income tax $_____________.

(3) State income tax $_____________.

(4) Railroad Retirement Tax $_____________.

TOTAL DEDUCTIONS

9. Disposable earnings for the pay period covered are: $_____________. (7 minus 8) See the attached Instructions to Garnishee to determine amount of disposable earnings to be withheld

10. I am subtracting from the disposable earnings in 9 pursuant to an income withholding order for support the amount of $_____________.

11. I am subtracting from the disposable earnings in 9 pursuant to a lien which has priority over garnishments under the law the following amount: type of lien ______________ $ _____________.

A

B

12. In accordance with the instructions accompanying this form, I have determined that the amount which may be paid to employee is $_____________.

13. I am holding from the amount in 12 an administrative fee in the amount of $_______________ . See attached Instructions to Garnishee for amount of the administrative fee that can be retained

14. After paying to the employee the amount stated in 12 less the administrative fee in 13, and deducting any amount shown in 10 and 11, I am holding the remainder of the employee's disposable earnings in the amount of $_____________.

15. If I do not receive an objection to this Answer within 14 days after I deliver it to all parties entitled to a copy, I will promptly pay the amount held in 14 to the following judgment creditors, unless I receive prior to such payment an order of the court to the contrary:

Judgment Debtor Name & Address:

EXECUTED on

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Kansas Interrogatory

To the above-named Garnishee:

To be used on and after July 1, 2010.

Company

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