Wage Garnishment Release Form
Submit this form to request the release of a wage garnishment. All information must be accurate and complete to process your request.
Employee Full Name
*
First Name
Last Name
Employee Email Address
*
example@example.com
Employee Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Employer Name
*
Employer Contact Email
*
example@example.com
Garnishment Reference Number
*
Type of Garnishment
*
Please Select
Child Support
Tax Levy
Student Loan
Creditor Judgment
Other
Reason for Release Request
*
Please Select
Debt Satisfied
Court Order Vacated
Bankruptcy Discharge
Administrative Error
Other
Additional Comments or Documentation (if any)
Release Authorization
I hereby certify that the information provided is accurate and request the immediate release of wage garnishment as referenced above. I understand that providing false or misleading information may result in penalties. By signing below, I authorize the release of garnished wages as described in this form.
Signature of Requestor
*
Submit Release Request
Submit Release Request
Should be Empty: