State of Alabama Unified Judicial System Form CR-7 Rev.2/95 WITHHOLDING ORDER-COSTS, FINES, ASSESSMENTS, AND RESTITUTION Case Number IN THE ______________________________________COURT OF_____________________________________, ALABAMA (Circuit, District, or Municipal) (Name of Municipality or County) STATE OF ALABAMA MUNICIPALITY OF ____________________________________ v. ____________________________________________ Defendant ____________________________________________ Defendant’s Employer ____________________________________________ Defendant’s Employer’s Address _______________________________________________ Defendant’s Social Security Number ____________________________________________ City State Zip Code ____________________________________________ Defendant’s Employer’s Telephone Number This Withholding Order is entered pursuant to the provisions of Section 15-18-143, Ala. Code 1975, and Rule 26.11, Alabama Rules of Criminal Procedures, as a means of enforcing or collecting monies ordered paid pursuant to a criminal proceeding. It is therefore ORDERED by the Court as follows: 1. The defendant is ORDERED to pay the total sum of $_____________________ for court-ordered monies. 2. The defendant’s present employer or any successive employer is hereby ORDERED to withhold from employment income due or to become due to the defendant $____________________per_______________________. The employer shall remit the total amount deducted MONTHLY to the Clerk of the above-named Court at (address)___________________ __________________________________________________________ to be distributed pursuant to the Court’s sentencing order. 3. When the restitution payments are ordered paid directly to the Clerk of this Court, there shall be paid an additional $1.00 administrative fee provided in Section 12-19-26, Ala. Code 1975, with each periodic payment of restitution. 4. This Order shall become remitted to the Clerk of the Court to satisfy the court-ordered employment income withholding $________________ has been remitted to the Clerk of the Court to satisfy the court-ordered employment income withholding obligation unless the Order has been sooner modified or terminated by the Court. When the total amount ordered by the Court has been remitted to the Clerk of the Court, the employer is released form his obligation to remit further payments. This Order is effective as to any current or future employer of the defendant. 5. The employer’s copy of this Order shall be served immediately upon the defendant’s employer OR remain in court file until defendant finds employment as required by this Court. remain in court file until a determination by the Court that the defendant has failed to comply with the Court’s Order. When the Order is served, service shall be by personal service certified mail. 6. The employer shall not discharge the defendant solely because of the Order or any other process issued as a result thereof. Any employer who violates this Order may be deemed in contempt of court and may be compelled by the Court to reinstate such employee. 7. The defendant and the employer shall promptly notify this Court or the Clerk of the Court if payments are discontinued as a result of any layoff, suspension, discharge, or resignation of such defendant, or of any change in the defendant’s employment, including the name and address, if known, of any new or successive employer. 8. Any person who willfully refuses to comply with any court order issued pursuant to Section 15-18-143, Ala. Code 1975, directing such person to withhold, deliver or pay over any employment income may be deemed in contempt of court and may be held liable to the victim for any restitution lost. 9. Any person who complies with the Order for Withholding restitution issued pursuant to Section 15-18-140, et seq., Ala. Code 1975, shall not be held liable to the defendant or other person claiming any rights derived from the defendant for wrongful withholding or wrongful conversion of any assets or income. 10. You are hereby ordered to return the enclosed Answer to Order of Withholding for Costs, Fines, Assessments, and Restitution within 14 days of service of this Order. 11. Other: ______________________________________________________________________________________ __________________________________________________________________________________________________ Done this the ________ day of _____________________, _________. ______________________________________ Judge American LegalNet, Inc. www.USCourtForms.com