PROOF OF SERVICE ON EMPLOYER (Wage Garnishment)

[Pages:1]ATTORNEY OR PARTY WITHOUT ATTORNEY

Attorney for Judgment Creditor

NAME OF COURT:

PLAINTIFF:

DEFENDANT:

PROOF OF SERVICE ON EMPLOYER (Wage Garnishment)

LEVYING OFFICER FILE NO.:

COURT CASE NO.:

I, __________________________________, declare: I am a Registered Process Server and was instructed to serve process in the above-referenced matter on the following person or entity. I was on the dates herein mentioned over the age of eighteen years and not a party to the above-entitled action. I am authorized to serve legal process in the State of California. The following facts are within my personal knowledge and if sworn as a witness I can and will truthfully and competently testify thereto. I delivered a copy of the following

Original and a copy of Earnings Withholding Order Employee Instructions 2 Employer Return forms Blank Financial Statement form Blank Claim of Exemption form and Writ of Execution

Confidential Statement of Judgment Debtor's SSN

EMPLOYER: ADDRESS:

DATE/ TIME:

MANNER OF SERVICE:

Personal Service Substituted Service Other:

by delivery to

I declare under penalty of perjury under the laws of the State of California that the forgoing is true and correct and this declaration is executed on ___________________________ at _____________________________, California.

___________________________________________________ RPS:

PROOF OF SERVICE ON EMPLOYER

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