Assignment of Wages

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					Assignment of Wages
This Assignment of Wages can be used by an individual or business that is in debt and
wants payments to be paid directly to the creditor or lender. Customize the name of the
parties, the wage amount that will be assigned, the reason for the debt, and more. This
document can be used by individuals or small businesses that want to pay off debts by
assigning wages to go directly to the creditor. Also, this document can be used by
individuals or small businesses that want to collect wages from debtors or borrowers.
                                      ASSIGNMENT OF WAGES

THIS ASSIGNMENT OF WAGES is made on ____________________ [Instructions: Insert
the date of this assignment] by ____________________, [Instructions: Insert the name of the
party    assigning     wages]    (hereinafter referred   to  as    the    “Assignor”)    of
___________________________________ [Instructions: Insert the Assignor’s address] in
favor of ____________________, [Instructions: Insert the name of the party receiving the
assignment]        (hereinafter     referred    to     as     the       “Assignee”)      of
___________________________________. [Instructions: Insert the Assignee’s address]

WHEREAS, for and in consideration of the mutual covenants contained in this Agreement, and
other good and valuable consideration, the undersigned Assignor agrees as follows:

1. ASSIGNMENT

The undersigned Assignor does hereby assign to Assignee $____________________
[Instructions: Insert the dollar amount of the Assignor’s wages that are being assigned] out
of wages to be earned and payable to Assignor by ____________________ [Instructions: Insert
the name of the Assignor’s employer] of __________________________ [Instructions: Insert
the employer’s address] for work to be performed by Assignor as ____________________
[Instructions: Insert the Assignor’s occupation or job title] during the period of
____________________ [Instructions: Insert the start date of the assignment] and
____________________. [Instructions: Insert the end date of the assignment]

2. SATISFACTION

This assignment is given to Assignee to satisfy a debt of $____________________,
[Instructions: Insert the amount of Assignor’s debt to Assignee] with interest on such debt
from ____________________ [Instructions: Insert the date the debt became due] at the rate
of ______% [Instructions: Insert the interest rate] per annum, for ____________________
[Instructions: Insert how this debt was accrued] actually furnished by Assignee to Assignor
amounting to $____________________. [Instructions: Insert the original debt amount]

3. PROPER AGE

The undersigned Assignor does hereby certify that they are an adult above the age of twenty-one
(21) years.

4. ASSIGNMENT AUTHORIZATION

The undersigned does hereby authorize its Employer, during the period stated in this
Assignment, to pay the claim to Assignee until the full amount owed by the undersigned set forth
above is fully paid.

5. AUTHORIZATION AND APPOINTMENT




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The undersigned hereby authorizes Assignee to take all legal measures that may be proper or
necessary for the complete recovery of the claim assigned, and to receive any money that may
become due, and pursuant to such authorization. The undersigned does hereby appoint Assignee
as attorney-in-fact to collect all checks or money payable to Assignor under this Assignment, and
to endorse Assignor’s name to any checks or other negotiable instruments payable to Assignor
and issued by Assignor’s present Employer for the term of this Assignment, until the claim of
Assignee is fully satisfied.

IN WITNESS WHEREOF, Assignor has signed this assignment on the _____ day of
__________________, 20___. [Instructions: Insert the date Assignor will sign this
assignment]


ASSIGNOR



______________________________




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Description: This Assignment of Wages can be used by an individual or business that is in debt and wants payments to be paid directly to the creditor or lender. Customize the name of the parties, the wage amount that will be assigned, the reason for the debt, and more. This document can be used by individuals or small businesses that want to pay off debts by assigning wages to go directly to the creditor. Also, this document can be used by individuals or small businesses that want to collect wages from debtors or borrowers.