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WG-021Mandatory

Confidential Supplement to Application for Earnings Withholding Order for Taxes (State Tax Liability)

California · Judicial Council of California · Effective January 1, 2007

This form is a private document that provides the Social Security Number of a person who owes state taxes. It is meant to be kept secret and should not be filed with public court records.

The court describes it as: Tells the court, employer, and levying officer the Social Security Number of a person who owes state taxes.

Open the official PDFfrom Judicial Council of California

Where this fits in a case

Start a case

Stage: Start a case

This form is used when a person needs to provide the Social Security Number of the person who owes state taxes, as a supplement to an Application for Earnings Withholding Order for Taxes.

Either party may file.

Official instructions

How-to guides published by the court for this form.

Common questions

What is this form for?
This form is a confidential supplement that provides the Social Security Number of the person who owes state taxes.
Where should I file this form?
The form states that it should not be filed in a public court file.
Is this form attached to the main application?
No, this supplement should be kept separate from the Application for Earnings Withholding Order for Taxes.

Revision history

No changes recorded since we started tracking this form on October 9, 2026. The current version took effect January 1, 2007.

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