Statements Of Mailing Exhibits 1 And 2 (Re Order For Income Withholding)
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Statements Of Mailing Exhibits 1 And 2 (Re Order For Income Withholding) Form. This is a Hawaii form and can be use in Family Court Statewide.
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Tags: Statements Of Mailing Exhibits 1 And 2 (Re Order For Income Withholding), Hawaii Statewide, Family Court
STATE OF HAWAI‘I
FAMILY COURT
__________ CIRCUIT
STATEMENT OF MAILING
EXHIBITS “1” AND “2”
(Re: Order for Income Withholding)
CASE NUMBER
FC-D NO.
This document is prepared by
u
PLAINTIFF
(Full Name)
Plaintiff
u
Atty. for Plaintiff
_________________________________________________
Name
_________________________________________________
VS.
_________________________________________________
Address
_________________________________________________
DEFENDANT
(Full Name)
City, State, Zip
_________________________________________________
Phone
STATEMENT OF MAILING
I REPRESENT THAT I caused one certified copy of the Order for Income Withholding to be mailed by certified
or registered mail, return receipt requested to:
_________________________________________________________________________________
Child Support Payor’s Employer
_________________________________________________________________________________
Employer’s Address
_________________________________________________________________________________
City/State/Zip
At the time of mailing, the receipt attached hereto as Exhibit “1” was postmarked and dated. Thereafter, the
return receipt attached as Exhibit “2” was received.
DATE
11/98
PLAINTIFF’S SIGNATURE
STATEMENT OF MAILING/EXHIBITS “1” AND “2”
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EXHIBIT “1”
EXHIBIT “2”
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