WPCJ  
           붓-bVp-T6&qJ8 ǋO+TïY$A~yE\/ofڣwizcP6k3pF"A43[LP5#JzBW"usP(YwBos!:ƬG603& s18bӪQ}.4إL)ך_JȦ&ȹn>d"&pɝIyt*a 'p\hq
I&+1LUMiH\2G4HwOxjoG}֌tBe+=uf7WԠg ׋[5	҂dN ͎dwEnQ[]7H{|EbɎu/s/#ƾt81M4|nfrrPia=- f&\8?BR4__e{Ey5CY*dN3n-oL &            U%   >        ~  R  0   h     0   `   8  0   >     0^   t      U   (   J   U   J   r     "                              U   (        "   	   f      (	   a      *	  	B      >	  	B   +   [	  	D   /   	  	D   +   	        	            	        	  0      
  #     
   U   N   i  	%        M           (     N                    ^        w        4                	m                       "   (   \	  	   `  & T i m e s   N e w   R o m a n          '                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
            K J C    0    K J C   
 .      
       
       
           h                    : D e f a u l t   P a r a   D e f a u l t   P a r a g r a p h   F o n t       `                    : F o o t n o t e   R e f   F o o t n o t e   R e f e r e n c e       (                  $           0
   
     \                 : B o d y   T e x t   I n   B o d y   T e x t   I n d e n t      X    X                  $  L Y N N          kI  A   `  2 W P   T y p o g r a p h i c S y m b o l s          
               % 2  A   `    H e l v          
                    T a b l e _ A                      d    '     S i n g l e 1         d    )     1                        d x    d  '                              d x    d 
         9 #| x            (   r               6$          .  .                       X X           S A V I N   4 0 6 0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          0                                                                                                                                                                 ( @  	   Z  6 T i m e s   N e w   R o m a n   R e g u l a r           X                                           @:Z         -|8    :i +00             U   
          9     
   6!    .  .                       X X              _           X         
     
     X         XC  X      Xd X  X XC           %  uA       X Xd (Adopted7/09)#   Xd X  H  #    & % X Xd    & % % &             	 X          ThisAnswerFormandtheattachedinstructionsshallbeusedforallwagesearnedonandafter   	    July24,_        2009._           	 `   Preparedby:   XC  X % &    Xd X  X XC     `	             	 ^      & % X Xd    & % % &          Filer   &- % % & =   & % % &- sname,SC#   	 1   Filer   &- % % & =   & % % &- saddress   	    Filer   &- % % & =   & % % &- sphonenumber   	    {Filer   &- % % & =   & % % &- sfaxphonenumber}   	 	U	   {Filer   &- % % & =   & % % &- semailaddress}   	 
)
   AttorneyforJudgmentCreditor   	 U      InTheDistrictCourtof   & % % & ______   & % % & ԀCounty,Kansas   	 v             JudgmentCreditorname     JudgmentCreditor   	 H   vs.         `	               h               p CaseNo.   & % % & Ԁ______   & % % &    	    JudgmentDebtorname          JudgmentDebtor   	 =   JudgmentDebtoraddress   	 h   Garnisheename    `	      0     Garnishee     (#(#  Garnishee   &- % % & =   & % % &- saddress   	    Garnishee   &- % % & =   & % % &- scounty   	 ]   {Garnishee   &- % % & =   & % % &- sfaxphonenumber(ifknown)}   	 1   {Garnishee   &- % % & =   & % % &- semailaddress(ifknown)}   	 ]   PursuanttoChapter60of   	    KansasStatutesAnnotated   	       ANSWEROFGARNISHEE   	 }%!   (ToAttachEarnings)   	 P"     x
   TotheabovenamedGarnishee:   	 $   1.Ifthejudgmentdebtor(employee)wasneveremployedbyyouorterminatedemploymentbeforethe   	 !D&   firstdayofthepriormonthforwhichthisanswerismade,completethefollowingsectionandsignand   	 o" '   datetheansweratthebottomandsendtothejudgmentcreditor(s)andjudgmentdebtorasinstructed   	 B# (   below.   	 $!)   TheJudgmentdebtor(employee):   	 %c#+      X   ___terminatedemploymenton_________________________   	 &6$,        X Ӏ(date)   	 a'	%-   checkone   	 4(%.      X   ___wasneveremployed.   	 )&/        X 2.IftheaboveparagraphdoesnotapplyyoumustcompletetherestoftheAnswerForm.   	 *U(1   3.ReadcarefullytheattachedInstructionstoGarnishee.   	 S,)3   4.Onlyoneanswerneedstobecompletedeachmonthforeachjudgmentdebtorandyoumayduplicate   	 -+5   thecompletedanswerinanymanneryoudesirefordistributiontothejudgmentcreditor(s)andjudgment   	 .t,6   debtor.   	 /G-7     % uA  
   %        9X    X 
     %  
   
 _        	      5.Thisanswercoversallpayperiodswhichendduringthepriormonthwhichisasfollows:month:   	     ___________,year:__________.   	    6.Thenormalpayperiodforemployeeis(designateone):   	 L   weekly_____everytwoweeks_____semi-monthly_____monthly_____.   	 X   '    0  x  (#   X' 7.Totalgrossearningsdueforthepayperiodorperiodscoveredbythisanswerare:   	    Ѐ            .    $_____________.   	 	   8.Amountsrequiredbylawtobewithheldforthepayperiodorperiodscoveredare:   	 w>
      X   (1)Federalsocialsecuritytax       .  /  $_____________.   	 	   (2)Federalincometax       .  &  $_____________.   	 
   (3)Stateincometax       .  $  $_____________.   	    (4)RailroadRetirementTax       .  WW+  $_____________.   	 ]        X TOTALDEDUCTIONS       .    $_____________.   	 <      X   Ӏ(Deductonlythoseitemslistedabove)   	         X 9.Disposableearningsforthepayperiodorperiodscoveredare:       .  M  $_____________.   	 |   Ѐ(7minus8)   	 O   SeetheattachedInstructionstoGarnisheetodetermineamountofdisposableearningstobewithheld.   	 .   10.Iamsubtractingfromthedisposableearningsin9pursuanttoanincomewithholdingorderfor   	    supporttheamountof       .  ..   $_____________.   	 n   11.Iamsubtractingfromthedisposableearningsin9pursuanttoalienwhichhaspriorityover   	 M   garnishmentsunderthelawthefollowingamount:typeoflien______________       .  W     	                 .    $_____________.   	    12.Inaccordancewiththeinstructionsaccompanyingthisanswerform,Ihavedeterminedthatthe   	 `    amountwhichmaybepaidtoemployeeis       .  2  $_____________.   	 l3!   13.Iamholdingfromtheamountin12anadministrativefeeintheamountof       .  uuY  $_____________.   	  #   SeeattachedInstructionstoGarnisheeforamountoftheadministrativefeethatcanberetained.   	 !%   14.Afterpayingtotheemployeetheamountstatedin12lesstheadministrativefeein13,anddeducting   	 ^#% '   anyamountshownin10and11,Iamholdingtheremainderoftheemployee'sdisposableearningsinthe   	 1$ (   amountof       .    $_____________.   	 %!)   15.IfIdonotreceiveanobjectiontothisAnswerwithin10daysafterIdeliverittoallpartiesentitledto   	 &q#+   acopy,Iwillpaytheamountheldin14tothefollowingjudgmentcreditors:   	 }'D$,   *     X 0  x  (#*      CaseNo.    `	      Name     0    h 0    h(#h(# Address0    p(#(# 0    p(#p(# 0     (#(# Amount    #)%.  (# (#  A.___________     _______________     _____________________0      $____________    *'0  (# (#       0     0    `	(#(# 0    `	(#`	(# 0    (#(# 0    h(#(# 0    h(#h(# _____________________    +c(1 (#(#       0     0    `	(#(# 0    `	(#`	(# 0    (#(# 0    h(#(# 0    h(#h(# _____________________    o,6)2 (#(#  B.___________     _______________     _____________________0      $____________    .*4  (# (#       0     0    `	(#(# 0    `	(#`	(# 0    (#(# 0    h(#(# 0    h(#h(# _____________________    .+5 (#(#       0     0    `	(#(# 0    `	(#`	(# 0    (#(# 0    h(#(# 0    h(#h(# _____________________    /,6 (#(#     	 0U-7     	     
   	        9     
     	  
   
 C.___________     _______________     _____________________0      $____________         (# (#       0     0    `	(#(# 0    `	(#`	(# 0    (#(# 0    h(#(# 0    h(#h(# _____________________      (#(#       0     0    `	(#(# 0    `	(#`	(# 0    (#(# 0    h(#(# 0    h(#h(# _____________________    u (#(#  JudgmentDebtorName&Address:    h ___________________   	 L        0     0    `	(#(# 0    `	(#`	(# 0    (#(# 0    h(#(# ___________________     h(#h(#       0     0    `	(#(# 0    `	(#`	(# 0    (#(# 0    h(#(# ___________________     h(#h(#       0     0    `	(#(# 0    `	(#`	(# 0    (#(# 0    h(#(# ___________________    	 h(#h(#  Ifmorespaceisneeded,attachseparatesheet.   	 :k	   PursuanttoK.S.A.53-601,asamended,Ideclareunderthepenaltyofperjurythattheforegoingistrue   	 	   andcorrect.   	 
   EXECUTEDon___________________,_________.   	 ,]         _______________________________   	    Garnishee   	 x              THISCOMPLETEDANSWEROFGARNISHEEMUSTBESENTTOALLOFTHE   	 "   JUDGMENTCREDITORSLISTEDABOVEANDTOTHEJUDGMENTDEBTOR.DONOT   	    SENDTOCLERKOFTHEDISTRICTCOURT.	   	          _R  INSTRUCTIONSTOGARNISHEE   	       (ToAttachEarnings)   	       )      ,   YoumustcompletetheAnswerformwhichaccompaniestheseinstructionsonorbeforethe15thday   	 Hy   ofeachmonth.YoumustcompletetheAnswerformforallpayperiodswhichendduringthepriormonth   	 L   forthatportionoftheemployee'searningswhichisnotexemptfromwagegarnishment.Earningsare   	    definedascompensationforpersonalservices,whethercalledwages,salary,commission,bonusor   	    otherwise.   	 	        ,    ,   Thegarnishmentordertakeseffectonthedayitisservedonyou.Ifthereisonlyonegarnishmentin   	 :k	   effectagainstthejudgmentdebtor,forthefirstmonthitisineffect,theordercoversallpayperiodswhich   	 >
   endonorafterthedaytheordertakeseffect.Foreachsubsequentmonth,theordercoversallpayperiods   	 	   whichendduringeachmonth.   	 	        ,    ,   Thegarnishmentorderserveduponyouisacontinuingorderandshallremainineffectuntilthe   	 Y   judgmentagainstthejudgmentdebtorhasbeenpaidorthegarnishmentisreleased,whicheveroccurs   	 ,]   sooner.Aslongasthegarnishmentorderisineffect,youmustcompleteanAnswerformforeachmonth.   	 0        ,    ,   Morethanoneorderofgarnishmentmaybeservedonyouagainstthesamejudgmentdebtor.If   	    morethanoneorderisineffectattheendofthemonth,youneedonlycompleteoneAnswerforthat   	 x   month,butyoumustsendacopyofittoalljudgmentcreditorswhohavegarnishmentordersineffectat   	 K|   theendofthemonth,andacopytothejudgmentdebtor(youremployee).YoumayduplicatetheAnswer   	 O   forminanymanneryoudesire.Youmaysendacopytoeachjudgmentcreditorandthejudgmentdebtor   	 "   byregularmail,faxtransmission,electronicmail,personaldelivery,oranyotherreliabledelivery   	    method.   	         ,    ,   TheAnswerformisprovidedforyourconvenienceinfurnishingtherequiredinformation.Itis   	 =n   designedsothatyoumayprepareyouranswerinconjunctionwiththepreparationofyourpayroll.Wait   	 A   untiltheendofthepriormonthandapplythetestssetforthintheseinstructionstotheentireearningsof   	    theemployeeduringthemonth,completingyouranswerinaccordancewiththeseinstructions.Ifyoudo   	    notchoosetousetheAnswerformprovided,youranswer,underpenaltyofperjuryshallcontainatleast   	    thesameinformationcontainedontheAnswerformprovided.   	 \        ,    ,   HerearetheinstructionstocompletetheAnswerform:   	 3!        , 1.     Forallpayperiodsforthejudgmentdebtor(youremployee)whichendduringthepriormonth,   	  #   completeparagraphs5through9oftheform.Forthefirstmonththefirstgarnishmentisineffect,make   	 {!$   yourcomputationsforallpayperiodswhichendonandafterthedaythisordertakeseffect.Afterthat,   	 N"%   makeyourcomputationsforallpayperiodswhichendduringthepriormonth.   	 !#R&   2.Iftheorderofgarnishmentstatesatthetopoftheorderthatitisissuedforthepurposeofenforcingan   	 $ (   orderofanycourtforchildsupportorspousalsupport,youmustretaininyourpossessionuntilfurther   	 %!)   orderofthecourt50%ofthedisposableearningsforallpayperiodsendingduringthemonth,orsuch   	 m&"*   greaterpercentageasmaybeindicatedinparagraphDinthetablebelowinparagraph6.Ifthisparagraph   	 @'q#+   applies,signanddatetheformatthebottomandsendacopytoalljudgmentcreditorswhohavea   	 (D$,   garnishmentineffectattheendofthemonthandtothejudgmentdebtor.   & % % &    	 (%-      & % % & 3.Ifparagraph2doesnotapply,continuetoparagraph4.   	 *&/          4.Ifyouarewithholdingmoneyfromthejudgmentdebtor   &- % % & =   & % % &- searningsunderanincomewithholding   	 2,c(1   order,completeparagraph10oftheform.   	 -7)2   5.     Ifyouarewithholdingmoneyfromthejudgmentdebtor   &- % % & =   & % % &- searningsunderanyotherlienwhichhas   	 .*4   priorityovergarnishmentsunderthelaw,completeparagraph11ofthe_      form.   	 /+5      _R      
          9 
              9 
       
   
 6.Computetheamountofearningswhichmaybewithheldfromtheearningsofthejudgmentdebtor   	     (youremployee)andcompleteparagraphs12,13and14oftheAnswerforminaccordancewiththe   	 u   followingtable:   	 Hy         XC  X % & DISPOSABLEEARNINGSTABLE   	      X>          X           >           >  >   ݌   	 	   Ќ     X 	        & %  X XC *       
     d                d d      X        d d      X        d d      X                             (#(# ,    [             ,    [             +
   
 :     '  
 
 
           :        X             X    r@           XC  X % &    r@  @   ݌̌        	            X             X    A           ȇ
   X XC Employeepaidweekly   A  TA   ݌   	 s
   Ќ        	     E  .    `	   h   p    x  (#  XE        X             X    6B        DisposableEarnings:Withhold:   6B  mB   ݌   	    Ќ        	            X             X    C           C  ;C   ݌̌        	     Lessthan217.51$0.00   	 #T
          X             X    C        $217.51to290.00allover$217.50   C  D   ݌   	     Ќ        	            X             X    D        $290.01andover25%oftotal   D  D   ݌   	 {   Ќ        	            X             X    E        󀀀disposableearnings_              E  E   ݍ   	 'X   Ќ   	 'X           	     ̎   XC  X
  ȇ _      
   
 _      
7     $                    7        X             X    HG           HG  G   ݌̌        	            X             X    G           ȇ
   X XC Employeepaideverytwoweeks   G  H   ݌   	 s   Ќ        	            X             X    H        DisposableEarnings:Withhold:   H  H   ݌   	    Ќ        	            X             X    vI           vI  I   ݌̌        	     Lessthan435.01$0.00   	 #T
          X             X    JJ        $435.01to580.00allover$435.00   JJ  J   ݌   	     Ќ        	            X             X    'K        _      $580.01_      Ԁandover25%oftotal   'K  ^K   ݌   	 {   Ќ        	            X             X     L        󀀀disposableearnings_               L  WL   ݍ   	 'X   Ќ   	 'X           	         
  ȇ _      _      _      _      _      _      _      _      _      _      _      
   
 O     < $  
    

          
           O        X             X K    (                   X                   M~              K    mN           ȇ
       mN  N   ݌̌        	            X             X K    (                   X                  *              K    fO        Employeepaidsemimonthly(twicepermonth)   fO  O   ݌   	 *   Ќ        	            X             X K    (                   X                               K    yP           yP  P   ݌̌        	            X             X K    (                   X                  Q             K    PQ        Disposableearnings:Withhold:   PQ  Q   ݌   	 Q    Ќ        	            X             X K    (                   X                  .             K    dR           dR  R   ݌̌        	     K    (                   X                               K Lessthan471.26$0.00   	 "          X             X K    (                   X                  U             K    S        $471.26to628.33allover$471.25   S  JT   ݌   	 U#   Ќ        	            X             X K    (                   X                  2             K    T        $628.34andover25%oftotal   T  iU   ݌   	 2$   Ќ        	            X             X K    (                   X                               K    V        ݀disposableearnings   V  V   ݌   	 %   Ќ        	     K    (                   X                  Y             K E  .    `	   h   p    x  (# X(#E 
6     #  Y&                  6        X             X    W           XC  X
  ȇ    W  -X   ݌̌        	        ȇ
   X XC        X             X    X        Employeepaidmonthly   X  X   ݌   	 3d(   Ќ        	            X             X    uY           uY  Y   ݌̌        	            X             X    Z        Disposableearnings:Withhold:   Z  8Z   ݌   	 *   Ќ        	            X             X    Z           Z  Z   ݌̌        	         
  ȇ    ȇ
    Lessthan942.51$0.00   	 ,          X             X    [        $942.51to1256.67allover$942.50   [  \   ݌   	 -   Ќ        	            X             X    \        $1256.68andover25%oftotal   \  \   ݌   	 ;l.   Ќ        	            X             X    s]        ݀disposableearnings#    
  ȇy[  # _              s]  ]   ݍ   	 /   Ќ   	 /           	     _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      _      
   
 4  * ( 0 
    

           4 K    (                   X                 >          	   K    XC  X   0     NOTE:Thenumbersusedinthisparagraphareillustrativeonlyandmustbe   	 $1   adjustedtocomplywithK.S.A.60725.    
2 (#(#     & %  X XC      A.    `	 SUPPORTORDERS.Ifthepersonseekingthegarnishmentforcourtorderedsupport   	 x5   desirestogarnishmorethan50%ofdisposableearnings,thatpersonmayrequestinwritingtotheclerk   	 K|6   ofthecourttocheckoneofthebelowapplicablepercentages:   	 O7        55%0    `	 Employeealsosupportsaspouseordependentchildnotcoveredbythissupportorder   	 9   andpaymentsare12weeksoverdue.     : `	(#`	(#       60%0    `	 Employeedoesnotsupportaspouseordependentchildandpaymentsarenot12weeks   	 ="n<   overdue.    #A= `	(#`	(#       65%0    `	 Employeedoesnotsupportaspouseordependentchildandpaymentsare12weeks   	 $ ?   overdue.    %!@ `	(#`	(#       Anydisposableearningsremainingafterpaymentoftheaboveamountsshallberetaineduntil   	 /'`#B   furtherorderofthecourt.   	 (3$C        B.0    `	 ADMINISTRATIVEFEE:Fromincomeduetheemployee,youmaywithholdand   	 )%E   retaintodefrayyourcostsanadministrativefeeof$10foreachpayperiodforwhich   	 {*&F   incomeiswithheld,nottoexceed$20foreachmonthforwhichincomeiswithheld,   	 N+'G   whicheverisless.Suchadministrativefeeshallbeinadditiontotheamountrequiredto   	 !,R(H   bewithheldundertheorderforgarnishment.Iftheadditionofthisfeecausesthetotal   	 ,%)I   amountwithheldtoexceedtheamountyouaretowithholdpursuanttotheinstructions   	 -)J   above,thefeeshallbedeductedfromtheamountwithheld.    .*K `	(#`	(#     	 m/+L   _      7.Completeparagraph15bylistingthecasenumber,nameandaddressforalljudgmentcreditorswho   	       haveagarnishmentineffectagainstthejudgmentdebtorattheendofthepriormonth.Computethe   	     amounttobepaidtoeachjudgmentcreditor.Forexample,ifthereisonlyonejudgmentcreditor,payall   	 u   tothatone;iftherearetwojudgmentcreditors,payeachonehalf(1/2);iftherearethreejudgment   	 Hy   creditors,payeachonethird(1/3);etc.Thisallocationshouldbefollowedevenifsomeorallofthe   	 L   garnishmentswereineffectforlessthantheentiremonth.   	    8.SignanddatetheAnswerformunderpenaltyofperjuryonthelineprovidedatthebottomoftheform   	 	   anddeliveracopytoalljudgmentcreditorslistedin15andtothejudgmentdebtor.Youmaydelivera   	 g
   copybyregularmail,faxtransmission,electronicmail,personaldelivery,oranyotherreliabledelivery   	 :k	   method.   	 >
   9.IfyoudonotreceiveanobjectiontotheAnswerwithin10daysafteryouhavedeliveredit,senda   	 	   checktothejudgmentcreditorslistedin15fortheamountdueeachasshownin15.   	 
      XC  X % &       X XC 
