Form 225B Rev 5/16 The Family Court of the State of Delaware In and For New Castle Kent Sussex County VERIFIED NOTICE FOR INTERSTATE 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 NPA NON IV-D Based on information provided by do hereby allege the following: ,I , 1. An Order was entered on by requiring respondent to pay $ per ($ current support plus $ toward arrears) payable to . [A copy of each Court Order is attached]. 2. Petitioner has not received a payment on this order for with the date of the last payment being . Current arrears are estimated at $ . A sworn statement from the obligee or a certified statement from the agency specifying the amount of arrearages is attached. 3. Respondent is employed by: Name of Employer Employer Address City/State/Zip Code 4. Respondent is receiving unemployment compensation benefits. 5. Respondent is in default of the current Order in accordance with the law of [ ] and prays that an income attachment issue to the respondent's employer(s) pursuant to 13 Del. C. Chapter 4. [A copy of the applicable withholding law is attached]. Withholding of income stays in effect as long as the order of support upon 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 225b Page 2 PETITIONER FILE NO. 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 AND SUBSCRIBED before me this date, Date Clerk of Court/Notary Public Respondent ------------------------------------------------------------------------------------------------------------------------------------------------------------------------ Based on my review of the facts contained in the Petitioner's Affidavit Affidavit I hereby ORDER: Income Attachment in the amount of $ per arrears) with a consumer credit protection limit of No contest to attachment entered. Petitioner's Affidavit and Respondent's ($ current support plus % shall issue to obligor's employer because: 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. A Hearing be scheduled on at am/pm before Judge/Commissioner . Additional findings (see attached disposition). Date Written Order Issued Judge/Commissioner/ American LegalNet, Inc. www.FormsWorkFlow.com