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231 Pa. Code Rule 3313. Writ of Attachment of Wages. Form.

Rule 3313. Writ of Attachment of Wages. Form.

 The writ of attachment of wages shall be substantially in the following form:


Writ of Attachment of Wages, Salary or Commissions

Commonwealth of Pennsylvania :
County of
      Employer of Defendant


 You have been identified as the employer of the above-named defendant.

 You are directed to withhold the wages, salary and commissions of the defendant in your possession to satisfy the judgment against the defendant.

 You are notified that

 1. an attachment of wages, salary and commissions has been issued;

 2. you are ordered to withhold from the wages, salary and commissions of the defendant an amount per pay period which does not exceed ten (10) percent of the defendant’s net wages, salary and commissions;
 Net wages are all wages paid less only the following items: (1) any support payments made to the court, (2) federal, state and local income taxes, (3) F.I.C.A. payments and nonvoluntary retirement payments, (4) union dues and (5) health insurance premiums.

 3. the total amount attached is $

and the withholding must continue until the amount of the attachment is satisfied;

 4. the attached wages shall be sent to the prothonotary of the court of common pleas within 15 days from the close of the last pay period in each month. The check must

   a. contain the name of the employee whose wages are being withheld,

   b. be made payable to the Prothonotary, and

   c. be sent to

Court of Common Pleas
Wage Attachment Remittance




           Telephone Number

 5. you are entitled to deduct each pay period from the money collected from the defendant employee the costs incurred from the extra bookkeeping necessary to record the transaction, not exceeding $5.00 of the amount of money so collected;

 6. by law, you may not take any adverse action against the defendant because his or her wages, salary or commissions have been attached;

 7. you shall send the following notice to the prothonotary if the defendant has never been or is no longer an employee:

  I have received a Writ of Attachment in the following case:


, No.
 Plaintiff     Defendant         Year

 The following person,

, has never been
) or is no longer an employee (


 * * * * * * * * * * * * * * * * * * *

 Seal of the Court






   The provisions of this Rule 3313 adopted December 21, 2005, effective one month after the date of the Order, 36 Pa.B. 176.

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