Edc 111 Form PDF Details

The Illinois Department of Revenue EDC-111, Response to Levy form, is a critical document for employers when they receive a levy notice pertaining to an employee's wages. As an official response tool, it requires comprehensive details about the debtor, including their name, address, if wages or other compensation is paid to them, and the involvement in any exemptions due to bankruptcy protection, employment status, or other specific conditions. This form guides the employer through a process to determine the levy amount to be withheld from the employee's wages, taking into account any prior obligations such as child support payments. Employers are required to complete this form diligently, ensuring all calculations for the levy withholdings are accurate, based on the employee's gross wages and any applicable deductions. Furthermore, this document must be accompanied by the corresponding payment to the Illinois Department of Revenue and a duplicate sent to the debtor, ensuring transparency and adherence to state laws. Employers must also acknowledge their responsibility to continue these levy payments and form submissions at specified intervals until the levy's balance is fully paid, highlighting the importance of this form in fulfilling legal obligations toward garnishment orders.

QuestionAnswer
Form NameEdc 111 Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesFICA, illinois form edc 111w, ae form in edc, illinois form edc 111

Form Preview Example

Illinois Department of Revenue

EDC-111 Response to Levy - Employer

Taxpayer ID (SSN): __ __ __ - __ __ - __ __ __ __

Employer name : ______________

Step 1: Provide the following debtor information

1Debtor’s name ________________________________________

2 Debtor’s present or last know phone number and address

(_____) _____-______

_______________________________

Phone number

Street

 

___________________

_______________________________

City

State

ZIP

3Do you pay the debtor any wages, salary, or other compensation?

Yes. If yes, continue to Line 4.

No. If no, complete one of the following lines and skip to Step 3.

As of __ __ /__ __ / __ __ __ __, I no longer employ this debtor.

Month Day Year

Other reason: ___________________________________

4Financial institution for direct deposit to debtor, if applicable.

___________________________________________________

___________________________________________________

City

State

ZIP

5Information that may help us locate this debtor.

___________________________________________________

6Determine if your payments to the debtor are exempt from this levy. Are your payments any of the following:

to the debtor who is currently under bankruptcy protection.

Write bankruptcy number and court. _________________________

to the debtor who is an officer, employee, elected official of any state other than Illinois.

wages to “seamen” as defined in federal law 46 U.S.C. 10101. pension and retirement benefits.

7Did you mark any box in Line 6?

Yes. If yes, skip to Step 3. Your payments are exempt.

No. If no, continue to Step 2.

Step 2: If you pay the debtor funds, complete this section

8If you are first required to withhold child support, write the amount of court-ordered child support that was due each

week.

$ ___________

9Complete Columns A - H each week to determine the levy amount to withhold.

 

Column A

Column B

Column C

Column D

Column E

Column F

Column G

Column H

 

Write the amount

Multiply

Write the total

Subtract

Multiply Illinois

Subtract

Compare Column

Subtract Line 8

 

of gross

Column A

amount of

Column C from

minimum hourly

Column E from

B and F; write the

(amount above)

 

weekly wages

by 15% (0.15)

FICA, federal tax,

Column A

wage by 45

Column D

smaller amount

from Column G

 

 

 

and state tax

 

 

 

 

(if negative, write

 

 

 

required to be

 

 

 

 

“0”)

 

 

 

withheld

 

 

 

 

 

wk 1

$ ___________ $ ___________

$ ___________ $ ___________

$ ___________

$ ___________ $ ___________ $ ___________

wk 2

$ ___________ $ ___________

$ ___________ $ ___________

$ ___________

$ ___________ $ ___________ $ ___________

wk 3

$ ___________ $ ___________

$ ___________ $ ___________

$ ___________

$ ___________ $ ___________ $ ___________

wk 4

$ ___________ $ ___________

$ ___________ $ ___________

$ ___________

$ ___________ $ ___________ $ ___________

wk 5

$ ___________ $ ___________

$ ___________ $ ___________

$ ___________

$ ___________ $ ___________ $ ___________

10Total Column H and write the amount. Make your remittance payable to “Illinois Department of Revenue.”

On your payment, write the Debtor’s name and Taxpayer ID. Mail levy payment and a copy of Form EDC-111 with each levy payment until the balance of the levy is fully paid.

•Your first levy payment is due at the close of your current payroll period.

•Additional levy payments are due to us at least once every two months.

11Is this the last payment you will be sending us?

Yes

No

Step 3: Sign below - Employer

I certify, under oath, that the above information is true to the best of my knowledge, and that a completed copy of this form has been hand-delivered or mailed first class to the debtor at the address provided in Line 2 on __ __ / __ __ / __ __ __ __ .

Month Day Year

______________________________________ (____) ___________

Signature of employer or designated agent

Phone number

Mail completed form to:

 

 

_______________________________________________________

ILLINOIS DEPARTMENT OF REVENUE

Employer name

 

PO BOX 19035

_______________________________________________________

SPRINGFIELD IL 62794-9035

 

Employer address

EDC-111 (R-3/12)

This form is authorized as outlined by Public Act 86-1268. Disclosure of this information is REQUIRED. Failure to provide information could result in personal liability of the employer.

Instructions for Form EDC-111, Levy Response

General Information

Who must complete Form EDC-111?

You must complete this form because you received a levy notice. Figure the amount of the levy payment due by completing this form.

When is Form EDC-111 and the payment due?

Send a copy of the completed form with the fi rst payment at the close of your current payroll period.

If the amount you send us does not fully pay this levy, you must send additional payments at least once every two months. These additional payments must be sent with a completed Form EDC-111.

Each time you send a payment to us, you must also mail or hand deliver one copy of Form EDC-111 to the debtor. You may photocopy this form, but it must have an original signature.

Line 10 - Payment

Total Column H and write the amount. This is the amount due.

Write the Debtor’s name and Taxpayer ID on your payment. Mail payment and a copy of Form EDC-111 at least once every two months until the balance of the levy is fully paid.

Step 3: Sign below

You must sign that your answers are true and complete. Remember to mail or hand-deliver a copy of Form EDC-111 to the debtor.

Write your name and mailing address.

Note: Keep a copy of a blank Form EDC-111 for future payments.

Instructions

Step 1: Provide the following debtor information

Please provide the requested information. If you do not know the answer to one of the questions, write “not known” on the line provided. If this is your last payment, be sure to check the box that best describes why this is your last payment. If you no longer employ the debtor, write the date the debtor left your service. Before you calculate the amount to withhold, you must determine if the debtor is entitled to any exemptions by completing Lines 6 and 7.

Step 2: Complete if you pay funds to the debtor

You must compute the amount to withhold on a weekly basis (even if your payroll is not weekly).

If you are required to withhold payments for child support, write the weekly amount of child support on Line 8. You will need this for the calculation of Column H.

Column A -

Write the debtor’s gross weekly wages.

Column B -

Multiply Column A by 15 percent (0.15) and write

 

the result.

Column C -

Write the total amount of Social Security, federal

 

tax, and state tax required to be withheld.

Column D -

Subtract Column C from Column A. The result is

 

the debtor’s disposable earnings.

Column E -

Multiply the Illinois minimum hourly wage by

 

45 and write the result. (For current rates, see

 

www.state.il.us/agency/idol/News/PDFs/mw.pdf

 

or call the Illinois Department of Labor at

 

312-793-2800.)

Column F -

Subtract Column E from Column D and write the

 

result.

Column G - Compare the amount you wrote in Column B

 

to the amount you wrote in Column F. Write the

 

smaller amount.

Column H -

Subtract the amount of child support payments on

 

Line 8 from the fi gure in Column G.

EDC-111 Instructions (R-3/12)

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