Orange — Claim of Exemption for Wage Garnishment

Source: https://www.occourts.org/system/files/shc-cpj-02.pdf

SUPERIOR COURT OF CALIFORNIA Self-Help Services COUNTY OF ORANGE www. occo u rts. org/self-help

CLAIM OF EXEMPTION FOR WAGE GARNISHMENT

SELF-HELP FORM PACKET

SHC-CPJ-02 (Rev. 01/01/2026)

Self-Help Services can review your completed forms before you file them with the Court. To request review of your completed forms:

1. Complete the attached forms in black ink.
2. Scan your completed forms and save as a single PDF file.
3. Go to www.occourts.org/self-helP- (click the blue button labeled Click Here to Contact Self-Help Services), attach the PDF, and complete the online request form. Make sure to select CIVIL as the case type on the form.

www.occourts.org/self-h e Ip

RETURN TO LEVYING OFFICER. DO NOT FILE WITH COURT WG-006

ATTORNEY OR PARTY WITHOUT ATTORNEY: STATE BAR NO.: FOR LEVYING OFFICER USE ONLY NAME: (Levying Officer Name and Address)

FIRM NAME:

STREET ADDRESS:

CITY: STATE: ZIP CODE:

TELEPHONE NO.: FAX NO.:

EMAIL ADDRESS:

ATTORNEY FOR (name):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

PLAINTIFF/PETITIONER: LEVYING OFFICER FILE NUMBER:

DEFENDANT/RESPONDENT:

CLAIM OF EXEMPTION FOR COURT USE ONLY
(Wage Garnishment)

Instructions for completing this form: Read Employee Instructions (form WG-003) before completing this form. If you check the box for item 3b or 3c, you must attach a properly completed Financial Statement (form EJ-165) to this Claim of Exemption. You can get a copy of form EJ-165 for free by asking the levying officer or going to courts.ca.gov/rules-forms/find-your-court-forms or your court's self-help center. If you check the box for item 3a, you do not need to complete form EJ-165. You also do not need to complete item 4. You must give the levying officer this completed original form and one copy of the completed form. You should save at least one copy of the form for your records. CASE NUMBER: Do not file this form with the court.

1. My name is:

2. Please send all papers to

   me my attorney

   at the address shown above another address (specify):

3. I am making this claim of exemption because (check a, b, or c): a. My earnings are below the legal minimum amount for an earnings withholding order. (Your earnings cannot be withheld unless you earn more than a minimum amount set by law (Code Civ. Proc., § 706.050). You earn less than the legal minimum amount if, after mandatory deductions: If you are paid at least once a week: You earn less than 48 times the applicable minimum hourly wage each week. "The applicable minimum hourly wage" means either the California hourly minimum wage or the hourly minimum wage in the city or county where you work, whichever is higher. If you are paid once every two weeks: You earn less than 96 times the applicable minimum hourly wage each pay period. If you are paid twice a month: You earn less than 104 times the applicable minimum hourly wage each pay period. If you are paid once a month: You earn less than 208 times the applicable minimum hourly wage each pay period.)

b. I need all my earnings to support myself or my family. A completed Financial Statement (form EJ-165) is attached to this
claim. (You do not need to complete form EJ-165 if you checked the box for item 3a.)

c. I need $ each pay period to support myself or my family. A completed Financial Statement
(form EJ-165) is attached to this claim.

Judicial Council of California, courts.ca.gov Rev. January 1, 2026, Optional Form Claim of Exemption WG-006, Page 1 of 2 Code Civ. Proc., §§ 706.122, 706.123, 706.124 (Wage Garnishment)

WG-006 SHORT TITLE: LEVYING OFFICER FILE NO. COURT CASE NO.

4. I am willing for the following amount to be withheld from my earnings each pay period during the withholding period. I understand that this amount will be withheld each pay period if the judgment creditor accepts this offer by not opposing my Claim of Exemption (check one; you do not need to complete item 4 if you checked the box for item 3a):

a. None
b. Withhold $ each pay period.

5. I am paid (check one) daily every two weeks monthly weekly twice a month other (specify):

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) (SIGNATURE)

Rev. January 1, 2026 Claim of Exemption WG-006, Page 2 of 2 (Wage Garnishment)

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 0ewelry, furniture, furs, stocks, bonds, etc. ) (list separately):

e.$ --------

Page 1 of2 Form Adopted by of California the Judicial Council FINANCIAL STATEMENT Code of Civil Procedure,§§www.courtinfo.ca.gov706.124. 703.530 WG-007/EJ-165 IRev. January 1. 2007] (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. $ I. Entertainment ............................................................................................................................ . I. $ 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: OWED BY

CREDITOR'S NAME F OR 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. D 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):

8 . D 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):

9. D My spouse has signed below. D I have no spouse. D 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) ► (SIGNATURE) (TYPE OR PRINT NAME OF SPOUSE) ► (SIGNATURE OF SPOUSE) WG-00?IEJ-165 [Rev. January 1, 2007) FINANCIAL STATEMENT Page 2 of 2 (Wage Garnishment-Enforcement of Judgment)

EJ-155 EXEMPTIONS FROM THE ENFORCEMENT OF JUDGMENTS The following is a list of assets that may be exempt from levy in enforcing a judgment.

Exemptions are found in the United States Code (USC) and in the California codes, primarily the Code of Civil Procedure (CCP).

Because of periodic changes in the law, the list may not include all exemptions that apply in your case. The exemptions may not apply in full or under all circumstances. Some are not available after a certain period of time. You or your attorney should read the statutes.

If you believe the assets that are being levied on are exempt, file the claim of exemption form that you received with the Notice of Levy packet.

AMOUNT OF EXEMPTIONS: For the exemption amount, please refer to the code section listed below for each type of property. The current amounts of certain exemptions are listed in Current Dollar Amounts of Exemptions From Enforcement of Judgments (form EJ-156). The amounts of some of the exemptions are amended every three years and become effective immediately on April 1 under the provisions of Code of Civil Procedure section 703.150.

Type of Property Code and Section Type of Property Code and Section

ABLE Accounts .... . .. .. .. ... .. . . Welf & I C§ 4 880(c) Benefit Payments (cont.) Accounts (See Deposit Accounts) Relocation Benefits ........... . CCP§ 704.180 Appliances .. . . ... .. .. . ... . .. .. . CCP§ 704.020 Retirement Benefits Art and Heirlooms . . ... . .. .. ... .. . CCP§ 704.04 0 and Contributions: Automobiles . . . .. . . ... .. .. ... .. . CCP§ 704.010 Private ................. . CCP§ 704.115 BART District Benefits ... .. . . .. ... CCP§ 704.110 Public .................. . CCP§ 704.110 Pub Util C§ 28896 Segregated Benefit Funds ... Ins C§ 104 98.5 Benefit Payments: Social Security Benefits ......... 4 2 USC§4 07 BART District Benefits . .. .. ... . CCP§ 704.110 Strike Benefits ............... . CCP§ 704.120 Pub Util C§ 28896 Supplemental Security Income ... . 4 2 USC§ 1383 Charity .................... . CCP§ 704.170 4 2 USC§ 4 07(d) Civil Service Retirement Transit District Retirement Benefits (Federal) ......... . 5 USC §834 6 Benefits (Alameda and County Employees Contra Costa Counties) ...... CCP§704.110 Retirement Benefits ....... . CCP§ 704.110 Pub Util C §25337 Unemployment Benefits Govt C§ 314 52 and Contributions .......... CCP§ 704.120 Disability Insurance Benefits .... CCP§ 704.130 Fire Service Retirement Veterans Benefits ............. 38 USC§ 5301 Benefits ................. . CCP§ 704.110 Veterans Medal of Honor Govt C§ 32210 Benefits.................. 38 USC§1562 Fraternal Organization Welfare Payments ............ CCP§ 704.170 Welf & I C §174 09 Funds Benefits ............ CCP§ 704.130 Workers Compensation ........ CCP§704.160 CCP§ 704.170 Health Insurance Benefits ...... . CCP§ 704.130 Boats ........................ . CCP§ 704.060 Irrigation System CCP§ 704.710 Retirement Benefits......... CCP§ 704.110 Books ........................ . CCP§ 704.060 Judges Survivors Benefits Building Materials (Residential) ..... CCP§ 704.030 (Federal) ................ . 28 USC § 376(n) Business: Legislators Retirement Licenses ................... . CCP§ 695.060 Benefits ................. . CCP§ 704.110 CCP§ 699.720(a) (1) Govt C§ 9359.3 Tools of Trade............... . CCP§ 704.060 Life Insurance Benefits: Cars and Trucks (including Group ................... . CCP§ 704. 100 proceeds) .................. . CCP§ 704.010 Individual ................. CCP§ 704. 100 Cash ....................... .. CCP§ 704.070 Lighthouse Keepers Cemeteries: Surviving Spouses Benefits.... 33 USC§ 775 Land Proceeds .............. . Health & SC § 7925 Longshore & Harbor Workers Plots ...................... . CCP§ 704.200 Compensation or Benefits.... 33 USC§ 916 Charity ....................... . CCP§704.170 Military Benefits: Claims, Actions and Awards: Personal Injury ................ CCP§704.14 0 Retirement................ 10 USC§14 4 0 Worker's Compensation........ CCP§ 704.160 Survivors................. 10 USC§14 50 Wrongful Death............... CCP§ 704.150 Municipal Ut

Retirement................ 10 USC§14 4 0
Worker's Compensation........ CCP§ 704.160 Survivors................. 10 USC§14 50
Wrongful Death............... CCP§ 704.150
Municipal Utility District Clothing ....................... . CCP§ 704.020
Retirement Benefits......... CCP§ 704.110
Pub Util C§ 12337 Condemnation Proceeds ........... CCP§ 704.720(b)
Peace Officers Retirement County Employees Retirement Benefits ................. . CCP§ 704.110
Benefits .................... . CCP§ 704.110 Govt C§ 31913
Pension Plans Govt C § 314 52
(and Death Benefits): Damages (See Personal Injury
Private .................. . CCP§ 704.115 and Wrongful Death)
Public ................... . CCP§ 704.110 Deposit Accounts:
Public Assistance .............. CCP§ 704.170 Deposit Accounts (generally) ... .. CCP § 704.220
Welf & I C§ 174 09 Deposit Accounts (hardship). . . ... . CCP§ 704.225
Page 1 of2

Form Adopted for Mandatory Judicial Council of California Use EXEMPTIONS FROM THE ENFORCEMENT OF JUDGMENTS Code§§ 681.030(c),of Civil Procedure,700.010 EJ-155 [Rev. September 1, 2021] www.courts.ca.gov

EJ-155 EXEMPTIONS FROM THE ENFORCEMENT OF JUDGMENTS (Continued) Type of Property Code and Section Type of Property Code and Section Deposit Accounts (cont.) Motor Vehicle (Including Escrow or Trust Funds ....... Fin C § 174 10 Proceeds) . .. ... .. ..... .. .... . CCP § 704.010 Social Security Direct CCP § 704.060 Deposits ........... ...... CCP §704.080 Municipal Utility District Direct Deposit Account: Retirement Benefits ............ . CCP§704.110 Social Security ............... CCP §704.080 Peace Officers Retirement Pub Util C §12337 Benefits ..................... . CCP§704.110 Supplemental Security Income .. . CCP §704.080 Public Benefits ............... CCP §704.080 Pension Plans: Govt C § 31913 Private ..................... . CCP§704.115 Disability Insurance Benefits ...... . CCP §704.130 Public ...................... . CCP§704.110 Dwelling House ................ . CCP § 704.74 0 Personal Effects ................ . CCP § 704.020 Earnings ...................... . CCP § 704.070 CCP § 706.050 Personal Injury Actions 15 USC§1673(a) or Damages .................. . CCP § 704.14 0 Educational Grant ............... . Ed C§21116 Prisoner's Funds ................ . CCP § 704.090 Employment Bonds .............. Lab C§4 04 Property Not Subject to Federal Emergency Management Enforcement of Money Agency (FEMA) funds . .. .. ... .. . . CCP § 704.230 Judgments .................... CCP § 704.210 Prosthetic and Orthopedic Financial Assistance: Devices ..................... . CCP § 704.050 Charity .................... . CCP § 704.170 Provisions (for Residence) ......... CCP § 704.020 Public Assistance ............. CCP § 704.170 Public Assistance ............... . CCP § 704.170 Welf & I C§ 174 09 Welf & I C§174 09 Student Aid ................. CCP § 704.190 Public Employees: Welfare (See Public Assistance) Death Benefits ............... CCP § 704.110 Fire Service Retirement . .. . CCP § 704.110 Pension .................... . CCP § 704.110 Govt C§ 32210 Retirement Benefits .......... . CCP § 704.110 Fraternal Organizations Vacation Credits .............. CCP§704.113 Funds and Benefits .. .. .. ... .. . CCP § 704.130 Railroad Retirement Benefits ........ 4 5 USC§ 231m CCP § 704.170 Railroad Unemployment Fuel for Residence .. .. ... .. .. . .. . CCP § 704.020 Insurance ................... . 4 5 USC§ 352(e) Furniture . . .. . . . .. ... .. .. . . ... .. CCP § 704.020 Relocation Benefits .............. . CCP § 704.180 General Assignment for Retirement Benefits and Benefit of Creditors .. .. .. .. ... .. CCP §1801 Contributions: Health Aids ... .. .. .. ... .. . . ... .. CCP § 704.050 Private .................... . CCP§704.115 Health Insurance Benefits .......... CCP §704.130 Public ..................... . CCP § 704.110 Home: Ins C§ 104 98.5 Building Materials ............. CCP § 704.030 Dwelling House ............. . CCP § 704.74 0 Scholarshare (Higher Education Homestead .................. CCP § 704.720 Savings) ................ CCP § 704.105 Segregated Benefit Funds .......... Ins C§ 104 98.6 CCP § 704.730 Servicemembers Property ........... 50 USC§ 523(b)

704.720 Savings) ................ CCP § 704.105 Segregated Benefit Funds .......... Ins C§ 104 98.6 CCP § 704.730 Servicemembers Property ........... 50 USC§ 523(b) Housetrailer ................. CCP § 704.710 Social Security .................. . 4 2 USC§4 07 Mobilehome ................ . CCP § 704.710 Homestead ................... . CCP § 704.720 Social Security Direct Deposit . ....... CCP § 704.080 Strike Benefits .................. . CCP§704.120 CCP § 704.730 Household Furnishings ........... . CCP § 704.020 Supplemental Security Income ... . 4 2 USC§1383(d) Insurance: 4 2 USC §4 07 Disability Insurance ........... CCP § 704.130 Student Aid .................... . CCP § 704.190 Fraternal Benefit Society ...... . CCP § 704.110 Tools of Trade .................. . CCP § 704.060 Group Life ................... CCP § 704.100 Transit District Retirement Health Insurance Benefits ..... . CCP § 704.130 Benefits (Alameda and Contra Individual .................... CCP § 704.100 Costa Counties) ............... . CCP§704.110 Insurance Proceeds-- Pub Util C §25337 Motor Vehicle .. . . .. ... .. .. . CCP § 704.010 Travelers Check Sales Proceeds ..... Fin C§ 1875 Irrigation System Unemployment Benefits and Retirement Benefits ............ CCP§704.110 Contributions ................. . CCP§704.120 Jewelry ........................ . CCP § 704.04 0 Uniforms ...................... . CCP § 704.060 Judges Survivors Benefits Vacation Credits (Public (Federal) .................... . 28 USC§ 376(n) Employees) .................. . CCP§704.113 Legislators Retirement Veterans Benefits ............... . 38 USC§ 5301 Benefits .................... . CCP § 704.110 Veterans Medal of Honor Govt C§9359.3 Benefits ...................... 38 USC§1562 Licenses ..................... . CCP § 695.060 Wages ........................ . CCP § 704.070 CCP § 720(a)( 1) CCP § 706.050 Lighthouse Keepers Surviving CCP § 706.051 Spouses Benefit . .............. 33 USC§ 775 Welfare Payments ............... . CCP § 704.170 Longshore and Harbor Workers Welf & I C §174 09 Compensation or Benefits ........ 33 USC§916 Workers Compensation Military Benefits: Claims or Awards ............. . CCP § 704.160 Retirement ................. . 10 USC§14 4 0 Survivors ................... . 10 USC§14 50 Wrongful Death Actions or Military Personnel-Property 50 USC§ 3934 Damages ..................... CCP § 704.150 EJ-155 [Rev. September 1, 2021] EXEMPTIONS FROM THE ENFORCEMENT OF JUDGMENTS Page 2 of 2 For your protection and privacy, please press the Clear This Form button after you have printed the form. Print this form Save this form