Voluntary Wage Assignment

Personal Information
Employer Information

Wage Information

I am assigning wages at the rate of $120.00 per month to the Clerk of Court. My employer may deduct equal amounts from each paycheck I receive in a month, as long as the total deducted per month equals the above stated amount. The minimum deduction for wage assignments is $120.00 monthly. Any other arrangements must be approved by the County Attorney’s office.