Form 225A Rev 1/17 The Family Court of the State of Delaware In and For New Castle County Kent County Sussex County VERIFIED NOTICE FOR ATTACHMENT OF INCOME Petitioner Name Street Address (including Apt) P.O. Box Number City/State/Zip Code Attorney Name D.O.B. v. Respondent Name Street Address (including Apt) P.O. Box Number City/State/Zip Code Attorney Name D.O.B. DCSS # File Number Petition Number IV-D NON IV-D The Petitioner hereby alleges the following: 1. The Court on ($ / / entered an order requiring respondent to pay the petitioner $ toward arrears) each and every $ . current support plus 2. Petitioner has not received a payment on this order for one calendar month with the date of the last payment being / / Current arrears are estimated at $ . 3. Respondent is employed by: Name of Employer Employer Address City/State/Zip Code 4. 5. Respondent is receiving unemployment compensation benefits. Respondent is in default of this Order and prays that an income attachment issue to the respondent's employer(s) pursuant to 13 Del. C. 513, including the statutorily required additional amount toward the arrears as allowed by law, and that withholding stays in effect as long as the order of support on which it is based, or any modification thereof, remains in effect. I affirm under penalty of perjury that the above information is true and correct to the best of my knowledge. Sworn to subscribed before me this ______ day of ______________________, _________ Petitioner/DCSS Clerk of Court/Notary Public Date I further affirm that a true and correct copy of the Verified Notice for Attachment of Income and an Affidavit to Contest Income Attachment was placed in the U.S. Mail on / / and sent to the last known address of the respondent, being: Street Address (including Apt) P.O. Box Number City/State/Zip Code Sworn to subscribed before me this ______ day of ______________________, _________ Petitioner/DCSS Clerk of Court/Notary Public Date American LegalNet, Inc. www.FormsWorkFlow.com Form 225A Rev 1/17 Petitioner File Number RESPONDENTS AFFIDAVIT TO CONTEST INCOME ATTACHMENT A SUPPORT OBLIGOR MAY CONTEST INCOME ATTACHMENT BY FILING THIS AFFIDAVIT AT THE FAMILY COURT WITHIN 10 DAYS OF THE DATE THE VERIFIED NOTICE WAS FILED, IF THE RESPONDENT BELIEVES THAT HE/SHE IS NOT IN DEFAULT OF THE SUPPORT OBLIGATION. YOU SHOULD ATTACH COPIES OF SUPPORTING DOCUMENTS IF YOU BELIEVE THAT THEY ARE HELPFUL TO YOUR POSITION. YOU MUST ALSO MAIL A COPY OF THE COMPLETED AFFIDAVIT TO THE PETITIONER. The Court shall, upon consideration of the Affidavit(s), determine whether an issue of material fact exists and shall, in accordance with that determination, either schedule a hearing or issue the attachment. RESPONDENT/OBLIGOR wishes to dispute the imposition of an income attachment on the following ground(s) pursuant to 13 Del C. 513(b)(3): Mistaken identity (the Respondent is not the right person). The payments have been made as Ordered. The Court did not have jurisdiction over me at the time the Support Order was entered. The Court does not have jurisdiction in this case. Other: Please detail the facts which support your application for a hearing: Sworn to subscribed before me this ______ day of ______________________, _________ Respondent Clerk of Court/Notary Public Date Based on my review of the facts contained in the I hereby ORDER: Petitioner's Affidavit Petitioner's Affidavit and Respondent's Affidavit $ Income Attachment in the amount of $ per ($ current support plus Arrears) with a consumer credit protection limit of % Shall issue to obligor's employer because: No contest to attachment entered The Affidavit to Contest Income Attachment raised no issue of material fact under this statute. Respondent is free to seek relief raised in the Affidavit to Contest Income Attachment by filing a separate petition Income attachment will be payable to DCSS. Until the income attachment takes effect, or at any time full payment is not secured by income attachment, Obligor is to make payment to the Division of Child Support Services at P.O. Box 12831, Wilmington, DE 19850 or online at https://deipay.dhss.delaware.gov/iPayOnline/. A Hearing be scheduled on / / at am/pm before Judge/Commissioner . Additional findings (see attached disposition). So Ordered this Date: Judge/Commissioner American LegalNet, Inc. www.FormsWorkFlow.com