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Judgment Creditor (person who money is paid to) must fill out this section and attach to one copy of the wage execution application (JD-CV-3). Exemption and Modification Claim Form, Wage Execution.Exemption And Modification Claim Form Wage Execution Form. This is a Connecticut form and can be use in Civil Statewide. Directly with the IRS OR submit the enclosed exemption claim form back to OSC. If no modification is received from IRS, the full levy is entered. The garnishment form contains a worksheet with a formula which the employer needs to complete regarding your disposable earnings. The employee can request a modification of the garnishment to a more affordable periodic amount than the formula provides. Garnishment Hardship Application. Form. New Garnishment Forms added February 10, 2021: Click the appropriate icon to open or save.