The “application for issuance of earnings withholding order” shall be executed under oath and shall include all of the following:
(a) The name, the last known address, and, if known, the social security number of the judgment debtor.
(b) The name and address of the judgment creditor.
(c) The court where the judgment was entered and the date the judgment was entered.
(d) Whether the judgment is based in whole or in part on a claim for elder or dependent adult financial abuse and, if in part, how much of the judgment arises from that claim.
(e) The date of issuance of a writ of execution to the county where the earnings withholding order is sought.
(f) The total amount required to satisfy the order on the date of issuance (which may not exceed the amount required to satisfy the writ of execution on the date of issuance of the order plus the levying officer’s statutory fee for service of the order).
(g) The name and address of the employer to whom the order will be directed.
(h) The name and address of the person to whom the withheld money is to be paid by the levying officer.