Financial Statement Form PDF Details

In the world of legal and financial proceedings, particularly in the area of wage garnishment and enforcement of judgment, the Financial Statement form WG-007/EJ-165 plays a pivotal role. This document is meticulously structured to gather comprehensive fiscal information from an individual, potentially subject to wage garnishment due to outstanding judgments. It demands disclosure of not only the individual's income and expenses but also a detailed account of their assets, including cash, real estate, vehicles, and other significant personal property. A critical element of this form is its requirement for information on dependents, highlighting those who rely on the individual or their spouse for financial support. This aspect underscores the legal system's consideration for the broader impact of financial judgments on families. Additionally, the form navigates through monthly obligations ranging from household expenses to debts owed, providing a transparent snapshot of the individual's financial health. It also considers other significant financial factors such as existing earnings withholding orders or wage assignments for support. Importantly, the requirement for spousal signature, unless living separately, adds a layer of validation to the provided information, ensuring accuracy and integrity in the documentation presented to the court or levying officer. This form stands as a critical tool in balancing the enforcement of financial judgments with the real-world financial state and obligations of individuals, embodying a detailed approach to understanding and assessing one's financial capability in the shadow of legal obligations.

QuestionAnswer
Form NameFinancial Statement Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesfinancial enforcement judgment, wg 007, wg 007 ej 165, financial statment

Form Preview Example

WG-007/EJ-165

SHORT TITLE:

LEVYING OFFICER FILE NO.

COURT CASE NO.

FINANCIAL STATEMENT

(Wage Garnishment—Enforcement of Judgment

NOTE: If you are married, this form must be signed by your spouse unless you and your spouse are living separate and apart. If this form is not signed by your spouse, check the applicable box on the reverse in item 9.

1. The following persons other than myself depend, in whole or in part, on me or my spouse for support:

 

 

 

MONTHLY TAKE-HOME

NAME

AGE

RELATIONSHIP TO ME

INCOME & SOURCE

a.

 

Spouse

 

b.

 

 

 

c.

 

 

 

d.

 

 

 

e.

 

 

 

2.My monthly income

a.My gross monthly pay is:.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a. $

b.My payroll deductions are (specify PURPOSE and amount):

(1 ) Federal and state withholding, FICA, and SDI

$.

(2)

 

$

(3)

 

$

(4)

 

 

$

 

My TOTAL payroll deduction amount is (add (1) through (4)):

b. $

 

 

c. My monthly take-home pay is (a minus b):

c. $

d. Other money I get each month from (specify source):

 

 

 

 

 

is

d. $

 

 

 

 

 

 

e. TOTAL MONTHLY INCOME (c plus d)

e. $

 

 

 

 

 

 

3. I, my spouse, and my other dependents own the following property:

a. Cash

 

3a. $

b. Checking, savings, and credit union accounts (list banks):

 

 

 

(1)

 

 

 

$

 

 

(2)

 

 

 

$

 

 

(3)

 

 

 

$

 

b. $

 

 

 

 

c. Cars, other vehicles, and boat equity (list make, year of each):

 

 

 

(1)

 

 

 

$

 

 

(2)

 

 

 

$

 

 

(3)

 

 

 

$

 

c. $

d. Real estate equity

 

d. $

e. Other personal property (jewelry, furniture, furs, stocks, bonds, etc.) (list separately):

 

e. $

Page 1 of 2

Form Adopted by the Judicial Council

of California

WG-007/EJ-165 [Rev. January 1, 2007]

FINANCIAL STATEMENT

(Wage Garnishment—Enforcement of Judgment)

Code of Civil Procedure, §§ 706.124, 703.530 www.courtinfo.ca.gov

FINANCIAL STATEMENT
(Wage Garnishment—Enforcement of Judgment)

WG-007/EJ-165

SHORT TITLE:

LEVYING OFFICER FILE NO.

COURT CASE NO.

4.The monthly expenses for me, my spouse, and my other dependents

a.

Rent or house payment and maintenance

4 a. $

 

 

b.

Food and household supplies

b. $

 

 

c.

Utilities and telephone

c. $

 

 

d.

Clothing

d. $

 

 

e.

Medical and dental payments

e. $

 

 

f.

Insurance (life, health, accident, etc.)

f. $

 

 

g.

School, child care

g. $

 

 

h.

Child, spousal support (prior marriage)

h. $

 

 

I.

Transportation & auto expenses (insurance, gas, repair) (list car payments in item 5)

i. $

 

 

j. Installment payments (insert total and itemize below in item 5)

j. $

 

 

k. Laundry and cleaning

k. $

 

 

l.

Entertainment

l. $

m. Other (specify):

 

 

 

 

 

 

 

m. $

 

 

 

 

 

 

 

n. TOTAL MONTHLY EXPENSES (add a through m):

n. $

 

 

 

 

 

 

 

5. I, my spouse, and my other dependents owe the following debts:

CREDITOR'S NAME

 

 

 

OWED BY

FOR

MO. PAYMENTS

BALANCE OWED

(State person's name)

6.Other facts which support this Claim of Exemption (i.e., unusual medical needs, school tuition, expenses for recent family emergencies, or other unusual expenses to help your creditor and the judge understand your budget) (describe): (If more space is needed, attach page labeled Attachment 6.)

7.

8.

9.

An earnings withholding order is now in effect with respect to my earnings or those of my spouse or dependents named in item 1 (specify each person's name and monthly amount):

A wage assignment for support is now in effect with respect to my earnings or those of my spouse or dependents named in item 1 (specify each person's name and monthly amount):

My spouse has signed below.

I have no spouse.

My spouse and I are living separate and apart.

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Date:

(TYPE OR PRINT NAME)

(TYPE OR PRINT NAME OF SPOUSE) WG-007/EJ-165 [Rev. January 1, 2007]

(SIGNATURE)

(SIGNATURE OF SPOUSE)

Page 2 of 2

How to Edit Financial Statement Form Online for Free

In case you want to fill out statement ej 165, you don't need to download and install any kind of software - just make use of our PDF tool. We at FormsPal are committed to giving you the perfect experience with our tool by regularly presenting new capabilities and improvements. With all of these updates, using our tool gets better than ever! Here is what you would want to do to begin:

Step 1: Click on the orange "Get Form" button above. It is going to open up our editor so you can start filling out your form.

Step 2: With the help of our state-of-the-art PDF file editor, it is easy to accomplish more than merely complete blank form fields. Try each of the features and make your documents appear sublime with customized text added in, or fine-tune the file's original content to excellence - all supported by the capability to insert any graphics and sign the file off.

With regards to the fields of this precise document, this is what you should consider:

1. To get started, while filling out the statement ej 165, begin with the page containing subsequent blank fields:

Ways to complete financial statement wage stage 1

2. The subsequent part would be to fill out these blanks: My TOTAL payroll deduction amount, c My monthly takehome pay is a, d Other money I get each month, e TOTAL MONTHLY INCOME c plus d, I my spouse and my other, a Cash a, b Checking savings and credit, and c Cars other vehicles and boat.

Part # 2 in filling in financial statement wage

3. This next part is all about e Other personal property jewelry, Form Adopted by the Judicial, of California, WGEJ Rev January, FINANCIAL STATEMENT, Wage GarnishmentEnforcement of, Code of Civil Procedure, and Page of - type in each of these blank fields.

financial statement wage conclusion process described (step 3)

Be extremely mindful when filling in WGEJ Rev January and Page of, since this is the section in which many people make a few mistakes.

4. Filling in SHORT TITLE, LEVYING OFFICER FILE NO, COURT CASE NO, The monthly expenses for me my, a Rent or house payment and, a b c d e f g h i j k, n TOTAL MONTHLY EXPENSES add a, and I my spouse and my other is crucial in the next stage - don't forget to devote some time and be attentive with each blank!

Step no. 4 of filling in financial statement wage

5. Lastly, the following final segment is what you will need to finish before finalizing the form. The fields in question include the following: OWED BY, CREDITORS NAME, FOR, MO PAYMENTS, BALANCE OWED, State persons name, Other facts which support this, emergencies or other unusual, An earnings withholding order is, A wage assignment for support is, My spouse has signed below, I have no spouse, My spouse and I are living, I declare under penalty of perjury, and Date.

Completing part 5 of financial statement wage

Step 3: Look through all the information you've typed into the blanks and hit the "Done" button. Get your statement ej 165 as soon as you sign up for a free trial. Immediately use the pdf within your FormsPal account page, along with any modifications and adjustments being automatically synced! FormsPal is committed to the personal privacy of all our users; we make sure that all information used in our editor stays secure.