UNITED STATES BANKRUPTCY COURT



UNITED STATES BANKRUPTCY COURT

MIDDLE DISTRICT OF FLORIDA

JACKSONVILLE DIVISION

IN RE: CASE NO.:

Chapter 13

Debtor.

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MOTION FOR WAGE DEDUCTION ORDER

COMES NOW, Debtor, , by and through her undersigned counsel and files this Motion for Entry of a Wage Deduction Order, and states the following:

1. That debtor, _________________ , Social Security No.: XXX-XX-#### employed with ___________________________________, and requests that a deduction of the wages received from said employer be withheld on a bi-weekly basis in the amount of $______ per pay period.

2. That employer be required to remit the payroll deduction to the Trustee no less frequently than once each month without additional cost to Debtor.

3. That Trustee consents to the entry of an order granting this motion.

WHEREFORE, Debtor, ______________, requests this Honorable Court

for the entry of a wage deduction order.

DECLARATION OF DEBTOR

I, ______________________, do hereby declare under penalty of perjury, that I have read the Motion for Wage Deduction Order and that it is true and correct to the best of my knowledge, understanding and belief.

_________________________________ Dated: __________________

Debtor:

CERTIFICATE OF SERVICE

I HEREBY CERTIFY that a true and correct copy of the foregoing Motion For Wage Deduction Order has been furnished within the United States by regular, postage pre-paid mail or via electronic transmission this __________ of __________________, 200____ to Douglas W. Neway, Trustee, PO Box 4308, Jacksonville, FL 32201-4308; Employer, __________________________________________________________________________________, Debtor, _____________________________________________________.

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Debtor’s Name

Debtor

Address

Address

Telephone Number

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