ÿWPC¢  
      !5     ¥ÞDv)}‡¼â„;Gkñ	‚~LVÔ-ÕC%pêjŸ—œvÃg¨ý@öÈ|ZO×Ià³i=Çßj°iˆœ%‡E¬}5øõyJ¦H1]}L!*5ÌkÖ8Ÿ}96SX×Pgq00yiõw¾vÚêJzTY¾·¤­ÆL«{¹Ïìã[ˆ<Êi!ÏÌ>hƒ?¯ªÊKˆáØOYõÖVþ¸vå=8„9ì•¿uã/aF‹´881;U·ˆ©·˜µ,ì*$ý1¾aªöC÷<‡u3×Âkýâ:PXúB¬SÈ¡Ç¨NÔ7d'þ§tw6X!÷9”«p”Ïà‘¯ë#Vuõâ)ÜŸ°mîaõ@¯ÂòYâ¸¡í(àª-i¬m‹§Ñ¹†š4;{^Ðê¥†r'<öµ­±DRÄüˆ'ëŽd} (GŒØÁ s|y W/Ýï‘jIhfb²TÝÕN•…öRÑ8Ç‘·XR¤æ†È_r¶BÑ:X¿jr\–'Ò½Ã”@Bâö.>ße¹ôúø&Ißï”]oX
›ìšî,Bà¾¶WSdjBÛ[§†OµÉÌzH0ñÙv'«Dê·ƒõ	êÌþUÏA_’es™v[“šµbèlTÈêÍÈ“JÚK $            U   >   ø     v  6  0   h   ¬  0   `     0   >   t  0   t   ²   U   (   &   U   J   N            N        ˜            ˜     .                                             	B      Î  	B   +   ë  	D   /   	  	D   +   E	            E	            E	        p	  0   š   €	  #   É  
   U   N   ã  	%      1  M      7     (   ;  N      c            c  ^      e  w      q  4      u        ‰  	m      ‹   ô\	  	   `  ‹& T i m e s   N e w   R o m a n         
 '           Ø0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
            K J C    0    K J C   
 .      
       
       
           h                    ÿÿ: 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       `                    ÿÿ: 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       (                  ¿Š$       Ú    Ú0Ú
   
 Ú    \                 ÿÿ: B o d y   T e x t   I n   B o d y   T e x t   I n d e n t   Ó   X ÓÓ   X Ó                 $ ‹ L Y N N         ³ ˜kI  A   `  ‹2 W P   T y p o g r a p h i c S y m b o l s          	     
   $   Ñ    £ ÑÑ   £ ÑÑ   î Ñ                   d    '     S i n g l e 1         ÿÿÿd    )     1                        d x    d  '                              d x    d#| x            (   r               6$ ¡   ¡   Ô   .  .  ÔÔ    ÔÔ     ÔÓ      ÓÔ €  ô¸¨ ò  X X   ÔÔ €  ô¸¨ ò ò ô¸¨ Ô ˜\ \ K J C D C 0 1 \ S A V I N   9 0 6 0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              È È È È È È È È 0                                                                                                                                                                 ( @øÐ  	   Z  ‹6 T i m e s   N e w   R o m a n   R e g u l a r           X   ;                                         R’Þ<Z         Ë{/;    ê:i¢× +00             ÿU‹ÿ  ÀÀÀÝ
 ƒ  6! ÝÔ   .  .  ÔÔ    ÔÔ     ÔÓ      ÓÔ €  ô;+ ò  X X   ÔÔ €  ô;+ ò ò ô;+ ÔÝ    ÝÔ_        ÔÑ   ° ÑÑ     ÑÓ   
 ÓÓ    
 ÓÑ    X° ÑÓ     ÓÔ €  X`ª  X ò ô;+ ÔÔ €  XÑ X  X X`ª ÔÔ   ÿ      ÔÔ ‡  ô/T ò X XÑ ÔÑ €  ?î  Ñ(Adopted€7/10)Ô# †  XÑ X ò ô/T7  # ÔÔ €  &òÈ % X XÑ ÔÔ €  &Ä‚ % % &òÈ ÔÔ      ÿ   ÔÐ   	 X      ÐÓ    ÓÌòòTo€be€used€on€and€after€July€1,€2010.óóÐ   	 µ]   ÐÌÌà@    ââ ì àòòWRITTEN€EXPLANATION€OFˆÐ   	 Ú‚   Ðà@    Ú	Ú	 ì à€GARNISHEEððS€COMPUTATION€OF€EARNINGS€WITHHELDóóˆÐ   	 ‘9   Ðà@    $ ì à(Chapter€61)ˆÐ   	 Hð   ÐÌÌJudgment€Creditor:à0    ¸ àà     àJudgment€CreditorÐ    m	
 ¸(#¸(#  ÐÌJudgment€Debtor:à0    ¸ àà     àJudgment€DebtorÐ    Û
ƒ ¸(#¸(#  ÐÌGarnishee:à0    `	 àà    ¸ àà0    `	(#`	(# àGarnisheeÐ    Iñ	 (#(#  Ðà     àà0    `	 àà0    ¸`	(#`	(# àà0    ¸(#¸(# àGarnisheeÔ €  &”z % % &Ä‚ Ô=Ô €  &Ä‚ % % &”z Ôs€addressÐ     ¨
 (#(#  Ðà     àà0    `	 àà0    ¸`	(#`	(# àà0    ¸(#¸(# àGarnisheeÔ €  &”z % % &Ä‚ Ô=Ô €  &Ä‚ % % &”z Ôs€countyÐ    Ái (#(#  Ðà     àà0    `	 àà0    ¸`	(#`	(# àà0    ¸(#¸(# à{GarnisheeÔ €  &”z % % &Ä‚ Ô=Ô €  &Ä‚ % % &”z Ôs€fax€phone€number€(if€known)}Ð    ‚* (#(#  Ðà     àà0    `	 àà0    ¸`	(#`	(# àà0    ¸(#¸(# à{GarnisheeÔ €  &”z % % &Ä‚ Ô=Ô €  &Ä‚ % % &”z Ôs€e„mail€address€(if€known)}Ð    Cë (#(#  ÐÌCourt€Case€No:à0    `	 àà0    ¸`	(#`	(# àà0    ¸(#¸(# àCase€No.Ð    »c (#(#  ÐÌÌ1.€€If€the€judgment€debtor€(employee)€terminated€employment€before€the€first€day€of€the€payroll€period€forÐ   	 àˆ   Ðwhich€this€form€is€made,€complete€the€following€section€and€sign€and€date€the€form€at€the€bottom.Ð   	 —?   ÐÌThe€Judgment€debtor€(employee)€terminated€employment€on€_________________________Ð   	 ­   Ð€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€(date)Ð   	 ¼d   ÐÌ2.€€If€the€above€paragraph€does€not€apply€you€must€complete€the€rest€of€this€form.Ð   	 *Ò   ÐÌ3.€€Read€carefully€the€attached€Instructions€to€Garnishee.Ð   	 ˜@   ÐÌ4.€€You€must€complete€this€form€for€each€payroll€period€for€the€judgment€debtor,€that€ends€while€theÐ   	 ®!   Ðgarnishment€order€remains€in€effect.€€Only€one€form€needs€to€be€completed€for€each€payroll€period€for€theÐ   	 ½e"   Ðjudgment€debtor.Ð   	 t#   ÐÌ5.€€This€Written€Explanation€form€covers€the€following€pay€period:Ð   	 âŠ%   ÐÌà     àstart€date:à    ¸ à_____________________Ð   	 Pø'   Ðà     àend€date:à0    ¸ à_____________________Ð    ¯( ¸(#¸(#  ÐÌ6.€€The€normal€pay€period€for€employee€is€(designate€one):Ð   	 u *   Ðweekly€_____€€€€€€every€two€weeks€_____€€€€€€semi-monthly€_____€€€€€€€monthly€_____.€€€€€€€€€€€€€€€€Ð   	 ,!Ô+   ÐÓ'   ° 0  x Ð (#°   œX' ÓÌ7.€€Total€gross€earnings€due€for€the€pay€period€covered€by€this€form€are:Ð   	 š"B -   Ð€à     àà      ƒ .    à$_____________.Ð   	 Q#ù .   ÐÌ8.€€Amounts€required€by€law€to€be€withheld€for€the€pay€period€or€periods€covered€are:Ð   	 ¿$g"0   ÐÌÓ   X   Ó(1)€€Federal€social€security€taxà      ƒ .  ¸¸/  à$_____________.Ð   	 -&Õ#2   Ð(2)€€Federal€income€taxà      ƒ .  ¶¶&  à$_____________.Ð   	 ä&Œ$3   Ð(3)€€State€income€taxà      ƒ .  ÿÿ$  à$_____________.Ð   	 ›'C%4   Ð(4)€€Railroad€Retirement€Taxà      ƒ .  WW+  à$_____________.Ð   	 R(ú%5   ÐÓ     X ÓÌTOTAL€DEDUCTIONSà      ƒ .  ÇÇ  à$_____________.Ð   	 À)h'7   ÐÓ   X   Ó€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€(Deduct€only€those€items€listed€above)Ð   	 w*(8   ÐÓ     X ÓÌ9.€€Disposable€earnings€for€the€pay€period€covered€are:€à      ƒ .  ‹‹B  à$_____________.Ð   	 å+):   Ð€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€(7€minus€8)Ð   	 œ,D*;   ÐÌSee€the€attached€Instructions€to€Garnishee€to€determine€amount€of€disposable€earnings€to€be€withheld.Ð   	 
.²+=   ÐÌ10.€€I€am€subtracting€from€the€disposable€earnings€in€9€pursuant€to€an€income€withholding€order€forÐ   	 x/ -?   Ðsupport€the€amount€of€à      ƒ .  ..   à$_____________.Ð   	 /0×-@   ÐÑ   ?î  Ñâ
       âÑ    £X ÑÑ   £ ÑÑ   î£ Ñâ
       âÑ
   
 ÑÌ11.€€I€am€subtracting€from€the€disposable€earnings€in€9€pursuant€to€a€lien€which€has€priority€overÐ   	 Z·    Ðgarnishments€under€the€law€the€following€amount:€€type€of€lien€______________à      ƒ .  øøW  àÐ   	 n   Ðà     àà      ƒ .    à$_____________.Ð   	 È%   ÐÌ12.€€In€accordance€with€the€instructions€accompanying€this€form,€I€have€determined€that€the€amountÐ   	 6“   Ðwhich€may€be€paid€to€employee€is€à      ƒ .  §§+  à$_____________.Ð   	 íJ   ÐÌ13.€€I€am€holding€from€the€amount€in€12€an€administrative€fee€in€the€amount€of€à      ƒ .  uuY  à$_____________.Ð   	 [¸   ÐÌSee€attached€Instructions€to€Garnishee€for€amount€of€the€administrative€fee€that€can€be€retained.Ð   	 É	&
   ÐÌ14.€€After€paying€to€the€employee€the€amount€stated€in€12€less€the€administrative€fee€in€13,€and€deductingÐ   	 7”   Ðany€amount€shown€in€10€and€11,€I€am€holding€the€remainder€of€the€employee's€disposable€earnings€in€theÐ   	 îK	   Ðamount€of€à      ƒ .  ËË  à$_____________.Ð   	 ¥
   ÐÌ15.€€I€will€pay€the€amount€held€in€14€to€the€following€judgment€creditors:Ð   	 p   ÐÌÓ*   ° Ü X° 0  x Ð (#* Óà    Ü àCase€No.à    `	 àà    ¸ àNameà     àà0    h àà0    Àh(#h(# àAddressà0    pÀ(#À(# àà0    Èp(#p(# àà0     È(#È(# àAmountÐ    Þ  (# (#  ÐÌA.___________€à    ¸ à_______________à    À à_____________________à0      à$____________Ð    ïL  (# (#  Ðà    Ü àà0     àà0    `	(#(# àà0    ¸`	(#`	(# àà0    ¸(#¸(# àà0    h(#(# àà0    Àh(#h(# à_____________________Ð    ¦ À(#À(#  Ðà    Ü àà0     àà0    `	(#(# àà0    ¸`	(#`	(# àà0    ¸(#¸(# àà0    h(#(# àà0    Àh(#h(# à_____________________Ð    ]º À(#À(#  ÐÌB.___________€à    ¸ à_______________à    À à_____________________à0      à$____________Ð    Ë(  (# (#  Ðà    Ü àà0     àà0    `	(#(# àà0    ¸`	(#`	(# àà0    ¸(#¸(# àà0    h(#(# àà0    Àh(#h(# à_____________________Ð    ‚ß À(#À(#  Ðà    Ü àà0     àà0    `	(#(# àà0    ¸`	(#`	(# àà0    ¸(#¸(# àà0    h(#(# àà0    Àh(#h(# à_____________________Ð    9– À(#À(#  ÐÌC.___________€à    ¸ à_______________à    À à_____________________à0      à$____________Ð    §  (# (#  Ðà    Ü àà0     àà0    `	(#(# àà0    ¸`	(#`	(# àà0    ¸(#¸(# àà0    h(#(# àà0    Àh(#h(# à_____________________Ð    ^» À(#À(#  Ðà    Ü àà0     àà0    `	(#(# àà0    ¸`	(#`	(# àà0    ¸(#¸(# àà0    h(#(# àà0    Àh(#h(# à_____________________Ð    r À(#À(#  ÐÌD.___________€à    ¸ à_______________à    À à_____________________à0      à$____________Ð    ƒà   (# (#  Ðà    Ü àà0     àà0    `	(#(# àà0    ¸`	(#`	(# àà0    ¸(#¸(# àà0    h(#(# àà0    Àh(#h(# à_____________________Ð    :—! À(#À(#  Ðà    Ü àà0     àà0    `	(#(# àà0    ¸`	(#`	(# àà0    ¸(#¸(# àà0    h(#(# àà0    Àh(#h(# à_____________________Ð    ñN" À(#À(#  ÐÌI€will€continue€to€withhold€earnings€as€long€as€the€garnishment€order€remains€in€effect.€€As€the€earningsÐ   	 _¼$   Ðare€withheld,€I€will€promptly€pay€thereafter€the€earnings€as€they€are€withheld€to€the€judgment€creditorsÐ   	 s%   Ðentitled€thereto,€unless€I€receive€prior€to€such€payment€an€order€of€the€court€to€the€contrary.Ð   	 Í*&   ÐÌÌJudgment€Debtor€Name€&€Address:à    h à___________________Ð   	 òO)   Ðà    Ü àà0     àà0    `	(#(# àà0    ¸`	(#`	(# àà0    ¸(#¸(# àà0    h(#(# à___________________Ð    © * h(#h(#  Ðà    Ü àà0     àà0    `	(#(# àà0    ¸`	(#`	(# àà0    ¸(#¸(# àà0    h(#(# à___________________Ð    `!½+ h(#h(#  Ðà    Ü àà0     àà0    `	(#(# àà0    ¸`	(#`	(# àà0    ¸(#¸(# àà0    h(#(# à___________________Ð    "t, h(#h(#  ÐÌIf€more€space€is€needed,€attach€separate€sheet.Ð   	 …#â .   ÐÌÌPursuant€to€K.S.A.€53-601,€as€amended,€I€declare€under€the€penalty€of€perjury€that€the€foregoing€is€trueÐ   	 ª%#1   Ðand€correct.Ð   	 a&¾#2   ÐÌEXECUTED€on€___________________,€_________.Ð   	 Ï',%4   ÐÌÌÓ   ¸   Ó_______________________________Ð   	 ô)Q'7   ÐGarnisheeÐ   	 «*(8   ÐÓ     ¸ Óà    Ü àÌÌòòRETAIN€THE€ORIGINAL€OF€THIS€FORM€WITH€YOUR€NORMAL€PAYROLL€RECORDS.€Ð   	 Ð,-*;   ÐYOU€DO€NOT€NEED€TO€FURNISH€A€COPY€OF€THIS€FORM€TO€ANY€PARTY€UNLESSÐ   	 ‡-ä*<   ÐREQUESTED€TO€DO€SO.€€IF€REQUESTED€TO€FURNISH€A€COPY€OF€THIS€FORM,€MAKE€AÐ   	 >.›+=   ÐCOPY€OF€THE€ORIGINAL€AND€SEND€THE€COPY,€ALONG€WITH€THE€AFFIDAVIT,€INÐ   	 õ.R,>   ÐRESPONSE€TO€THE€REQUEST.óó
