Reply to an attachment of earnings application (Family Court)

Published date21 March 2018
Subject MatterFamily law forms
Form for replying to an
attachment of earnings application
Read the notes on the notice of application before
completing this form.
Tick the correct boxes and give as much information as you
can. The court will make an order based on the information
you give on this form. You must give full details of your
employment and your income and outgoings. Enclose a copy
of your most recent pay slip if you can.
Make your oer of payment in box 10. You will get some idea
of how much to oer by adding up your expenses in boxes 6,
7, 8 and 9 and taking them from your total income (box 5).
Send this completed and signed form immediately to the
court oce shown on the notice of application.
You should keep your copy of the notice of application
unless you are making full payment. (This does not apply to
maintenance applications).
For details of where and how to pay see notice of application.
1. Personal details
3. Employment
4. Bank account and savings
FE17 Statement of means - attachment of earnings (04.17) © Crown copyright 2017
2. Dependants (people you look after nancially)
Name of court
Claim no.
Application no.
Mr Mrs Miss Ms
Other (specify)
Married/Civil partnership Single
Children (under 19) Others (give details)
Age Date of Birth
(If more continue on a separate sheet)
I am employed as a
self employed as a
a pensioner
a. employment
My employer is
Employer’s address
Address of employer’s
head oce (if dierent
from above)
My works number and/or
pay reference is
Jobs other than main job
(give details)
b. self employment
Length of time
self employed
c. unemployment
Length of time
Give details of
any outstanding
I have a bank account
The account is in credit by £
The account is overdrawn by £
I have a savings account or building society account
The amount in the account is £
years months
years months
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