Form JD-CV-3 "Wage Execution Proceedings - Application, Order, Execution" - Connecticut

What Is Form JD-CV-3?

This is a legal form that was released by the Connecticut Superior Court - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on February 1, 2015;
  • The latest edition provided by the Connecticut Superior Court;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form JD-CV-3 by clicking the link below or browse more documents and templates provided by the Connecticut Superior Court.

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Download Form JD-CV-3 "Wage Execution Proceedings - Application, Order, Execution" - Connecticut

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APPWEX
WAGE EXECUTION PROCEEDINGS
STATE OF CONNECTICUT
APPLICATION, ORDER, EXECUTION
*APPWEX*
SUPERIOR COURT
www.jud.ct.gov
JD-CV-3 Rev. 2-15
WAGEEX
C.G.S. §§ 31-58(j), 52-350a, 52-361a, 52-356d,
Employer: See Page 2 for instructions
29 U.S.C. 206(a)(1)
*WAGEEX*
Instructions
Judgment Creditor or Attorney
Clerk
Proper Officer
1. Unless filing electronically, prepare original and four copies.
1. Issue execution by signing original.
1. Leave one signed copy with employer.
2. Attach form JD-CV-3a to this form, or include with execution
2. Enter any court ordered limitation at the bottom of
2. Make return on signed original.
as one PDF electronic form.
section II on page 2.
3. Leave one copy of Modification and Exemption
3. Present original and 3 copies to clerk of court.
3. Return original and 2 copies if on paper.
Claim form (JD-CV-3a) with employer and fill in
4. Keep one copy for your file.
4. Retain/scan copy for court file.
"Date of Service" on form.
Name and mailing address of Judgment Creditor or Attorney
(To be completed by Judgment Creditor or Attorney)
ADA NOTICE
The Judicial Branch of the State
of Connecticut complies with the Americans
with Disabilities Act (ADA). If you need a
reasonable accommodation in accordance
with the ADA, contact a court clerk or an ADA
contact person listed at www.jud.ct.gov/ADA.
Address of court (Number, street, and town)
Date of judgment
Docket number
G.A.
J.D.
Housing Session
(
)
Fold
Name(s) and address(es) of Judgment Creditor(s)
Name(s) and address(es) of Judgment Debtor(s)
Name and address of employer of Judgment Debtor (If known)
?
Telephone number of employer (if known)
1. Amount of judgment (Include where applicable, prejudgment interest and attorney's fees)
2. Amount of costs and fees
3. Total amount of judgment, costs and fees (Add 1 and 2)
4. Total amount paid (If any)
?
5. Total amount unpaid (Subtract 4 from 3)
6. Application fee for wage execution (If not waived by the court)
7. Application fees paid for prior executions on this judgment
?
Check if applicable
Postjudgment interest was
?
9. Total of lines 5, 6, 7 and 8
?
8. Other Court ordered postjudgment costs and fees
ordered by the Court
The above-named Judgment Creditor(s) recovered a judgment against the above-named Judgment Debtor(s). The Judgment Debtor(s) has/have
failed to pay the total amount due on that judgment.
Pursuant to the Connecticut General Statutes, the Court listed above entered an order that the judgment be paid by the above-named
Judgment Debtor(s) in the following installment payments:
The amount of
was ordered to be paid in
(weekly, monthly, or other) installment payments. *See Note below
(Note: This is not the amount the employer must pay. Employer must pay the amount of execution calculated on page 2 of this form.
The court ordered that installment payments begin on
(commencement date)
The Judgment Debtor(s) failed to comply with the Installment Payment Order
Therefore, the Judgment Creditor(s) applies/apply for this execution upon the wages of the Judgment Debtor(s) for the remaining amount
due on the judgment shown in line 9 above
For Court Use Only
Signed (Judgment Creditor or Attorney)
On (Date)
Telephone Number
File date
u
To: Any Proper Officer
By the authority of the State of Connecticut, you are ordered to cause any wages due to the Judgment
Debtor(s), not exceeding the Amount of Execution calculated on page 2, to be paid to the Judgment
Creditor(s) until the judgment is satisfied, including postjudgment interest as ordered by the court, if
applicable, plus the application fee(s) and other Court ordered postjudgment costs and fees, and your own
fees or until the execution is modified or set aside.
Serve this execution within one year of this date, and make return of service to this courtwithin thirty days
from satisfaction of the execution.
On (Date)
Signed (Assistant Clerk of said court)
u
Page 1 of 2
WAGE EXECUTION PROCEEDINGS
Print Form
Reset Form
APPWEX
WAGE EXECUTION PROCEEDINGS
STATE OF CONNECTICUT
APPLICATION, ORDER, EXECUTION
*APPWEX*
SUPERIOR COURT
www.jud.ct.gov
JD-CV-3 Rev. 2-15
WAGEEX
C.G.S. §§ 31-58(j), 52-350a, 52-361a, 52-356d,
Employer: See Page 2 for instructions
29 U.S.C. 206(a)(1)
*WAGEEX*
Instructions
Judgment Creditor or Attorney
Clerk
Proper Officer
1. Unless filing electronically, prepare original and four copies.
1. Issue execution by signing original.
1. Leave one signed copy with employer.
2. Attach form JD-CV-3a to this form, or include with execution
2. Enter any court ordered limitation at the bottom of
2. Make return on signed original.
as one PDF electronic form.
section II on page 2.
3. Leave one copy of Modification and Exemption
3. Present original and 3 copies to clerk of court.
3. Return original and 2 copies if on paper.
Claim form (JD-CV-3a) with employer and fill in
4. Keep one copy for your file.
4. Retain/scan copy for court file.
"Date of Service" on form.
Name and mailing address of Judgment Creditor or Attorney
(To be completed by Judgment Creditor or Attorney)
ADA NOTICE
The Judicial Branch of the State
of Connecticut complies with the Americans
with Disabilities Act (ADA). If you need a
reasonable accommodation in accordance
with the ADA, contact a court clerk or an ADA
contact person listed at www.jud.ct.gov/ADA.
Address of court (Number, street, and town)
Date of judgment
Docket number
G.A.
J.D.
Housing Session
(
)
Fold
Name(s) and address(es) of Judgment Creditor(s)
Name(s) and address(es) of Judgment Debtor(s)
Name and address of employer of Judgment Debtor (If known)
?
Telephone number of employer (if known)
1. Amount of judgment (Include where applicable, prejudgment interest and attorney's fees)
2. Amount of costs and fees
3. Total amount of judgment, costs and fees (Add 1 and 2)
4. Total amount paid (If any)
?
5. Total amount unpaid (Subtract 4 from 3)
6. Application fee for wage execution (If not waived by the court)
7. Application fees paid for prior executions on this judgment
?
Check if applicable
Postjudgment interest was
?
9. Total of lines 5, 6, 7 and 8
?
8. Other Court ordered postjudgment costs and fees
ordered by the Court
The above-named Judgment Creditor(s) recovered a judgment against the above-named Judgment Debtor(s). The Judgment Debtor(s) has/have
failed to pay the total amount due on that judgment.
Pursuant to the Connecticut General Statutes, the Court listed above entered an order that the judgment be paid by the above-named
Judgment Debtor(s) in the following installment payments:
The amount of
was ordered to be paid in
(weekly, monthly, or other) installment payments. *See Note below
(Note: This is not the amount the employer must pay. Employer must pay the amount of execution calculated on page 2 of this form.
The court ordered that installment payments begin on
(commencement date)
The Judgment Debtor(s) failed to comply with the Installment Payment Order
Therefore, the Judgment Creditor(s) applies/apply for this execution upon the wages of the Judgment Debtor(s) for the remaining amount
due on the judgment shown in line 9 above
For Court Use Only
Signed (Judgment Creditor or Attorney)
On (Date)
Telephone Number
File date
u
To: Any Proper Officer
By the authority of the State of Connecticut, you are ordered to cause any wages due to the Judgment
Debtor(s), not exceeding the Amount of Execution calculated on page 2, to be paid to the Judgment
Creditor(s) until the judgment is satisfied, including postjudgment interest as ordered by the court, if
applicable, plus the application fee(s) and other Court ordered postjudgment costs and fees, and your own
fees or until the execution is modified or set aside.
Serve this execution within one year of this date, and make return of service to this courtwithin thirty days
from satisfaction of the execution.
On (Date)
Signed (Assistant Clerk of said court)
u
Page 1 of 2
WAGE EXECUTION PROCEEDINGS
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Important Notice To Employer
You are being served with a wage execution, a court order requiring you to withhold non-exempt wages from a person employed by you. This execution is being served on you
because your employee, the Judgment Debtor (on page 1), has had a judgment entered against him/her by the Superior Court requiring him/her to pay judgment, costs and fees to
the Judgment Creditor (on page 1) and has not made payment of the total amount of the judgment plus any costs and fees as shown on page 1. This notice is to inform you of the
actions you must take in order to comply with the law regarding wage executions. Please read each section carefully.
I. You must notify the employee — Your employee has certain legal rights which
executions are to be satisfied in the order in which you are served with them. (Income
may allow him/her to request the court to change or stop this execution upon his/her
withholdings and voluntary wage deductions for support of a family, if there are any,
wages. A notice of his/her rights and how to get a hearing in court is attached to the
must be paid before this execution. Family support income withholdings and voluntary
second copy of the wage execution given to you by the officer. You must complete
wage deductions are issued on Form JD-FM-1.)
your portion of the wage execution and your portion of the exemption and modification
V. Maximum amount deducted — The maximum amount which can be legally
claim form and deliver or mail, postage prepaid, a copy of these papers to your
withheld from your employee's wages is 25% of his/her disposable earnings for each
employee immediately so that your employee can make any claims allowed by law.
week. The amount to be withheld to pay this execution may be less than 25%, but it
can never be more. The computations you complete below will allow you to calculate
II. Execution not effective for 20 days — This execution is not effective until after
the exact amount which should be withheld from this employee's wages.
20 days from the day the officer served these papers on you. No money should be
Unless the court orders that this execution is to be for a smaller amount, you must
deducted from your employee's wages until the first wages you pay to your employee
withhold and pay over the maximum amount which you figure out using the
after the 20-day period ends. If your employee elects within the 20-day period to
computations below. Your employee has a right to request the court to reduce the
make a claim to the court that his/her wages are partially or totally exempt from
amount withheld, but until you receive notice that the court has agreed to allow the
execution to pay this judgment or he/she seeks to have the amount of this execution
amount to be reduced, you must withhold the maximum amount.
changed, wages are not to be withheld from the employee until the court decides the
claims or determines the rights of your employee in this case. If you are not notified
VI. Your duty to comply with this execution — You have a legal duty to make
that your employee has filed papers with the court, the execution is to be enforced
deductions from your employee's wages and pay any amounts deducted as required
after 20 days from the date of service on you.
by this execution. If you do not, legal action may be taken against you. If you are
found to be in contempt of a court order, you may be held liable to the Judgment
III. Stay of execution — No earnings claimed to be exempt or subject to a claim for
Creditor for the amounts of wages which you did not withhold from your employee.
modification may be withheld from any employee until determination of the claim by
VII. Discipline against your employee — You may not discipline, suspend or
the court.
discharge your employee because this wage execution has been served upon you. If
you do unlawfully take action against your employee, you may be liable to pay him all
IV. Only one execution issued under section 52-361a of the General Statutes is
of his lost earnings and employment benefits from the time of your action to the time
to be satisfied at a time — You must make deductions from your employee's wages
that the employee is reinstated.
and pay over the withheld money against only one execution issued under General
The law allows you to take disciplinary measures against the employee if you are
Statutes section 52-361a at a time. If you are served with more than one execution
served with more than 7 wage executions against his/her wages in any calendar year.
issued under General Statutes section 52-361a against this employee's wages, the
Section I. Calculation Of Employee's Disposable Earnings
"Disposable Earnings" means that part of the earnings of an individual remaining after the deduction from those earnings of amounts to be
withheld for payment of federal income and employment taxes, normal retirement contributions, union dues and initiation fees, group life
insurance premiums, health insurance premiums, and federal tax levies.
1. Employee's gross compensation per week..........................................................................
2. Federal income tax withheld ........................................................
3. Federal employment tax..............................................................
4. Normal retirement contribution .....................................................
5. Union dues and initiation fees ......................................................
6. Group life insurance premium ......................................................
7. Health insurance premium.................................. .........................
8. Other federal tax levies ...............................................................
9. Total allowable deductions (Add lines 2-8) ......................................
10. Weekly Disposable Earnings (Subtract line 9 from line 1).......................................................
Section II. Calculation Of Employee's Disposable Earnings
To be calculated by employer
Column 1
Column 2
$
A-1. Weekly disposable earnings (from line 10 above)
$
A-2. 25% of disposable earnings for week
$
B-1. Weekly disposable earnings (from line 10 above)
Forty times the higher of the current federal minimum
$
B-2.
hourly wage or state full minimum fair wage.
$
Amount by which line B-1 exceeds B-2
Amount of Execution
(Employer must pay the lesser of the two amounts in column 2 unless the court
$
ordered limitation set forth below is a lesser amount, in which case the employer must pay that lesser amount)
Court ordered limitation (If any, to be entered by clerk)
JD-CV-3 Rev. 2-15
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