Proof Of Service Notice Withhold Income For Support
Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Proof Of Service Notice Withhold Income For Support Form. This is a Illinois form and can be use in Lake Local County.
Tags: Proof Of Service Notice Withhold Income For Support, 171-51, Illinois Local County, Lake
IN THE CIRCUIT COURT OF THE NINETEENTH JUDICIAL CIRCUIT
LAKE COUNTY, ILLINOIS
Petitioner,
vs.
Respondent.
)
)
)
)
)
)
)
)
)
Gen No.
Proof of Service of Notice to Withhold Income
Service on Employer/Payor:
(date of service), a copy of the attached Notice to Withhold Income for
On
(date of notice to withhold) was served on:
Support dated
Name of employer/payor:
Address:
Ordinary Mail – First Class
Certified Mail
Personal Delivery (insert name to whom delivery was made)
Facsimile Transmission (Attach proof of transmission)
Other Electronic Means (describe)
By:
Service on Obligor:
(date of service), a copy of the attached Notice to Withhold Income for
On
(date of notice to withhold) was served by ordinary mail on:
Support dated
Name of Obligor:
Address:
VERIFICATION BY CERTIFICATION
Under penalties provided by law pursuant to Section 1-109 of the Code of Civil Procedure, the undersigned
certifies that the statements set forth in this instrument are true and correct.
Served this
day of
, 20
By:
Signature
Prepared by:
Attorney's Name: _
Address:
City:
Phone:
State:
Zip Code:
Fax:
ARDC:
• The Notice to Withhold Income may be served on the employer/payor or on its superintendent, manager or other
agent.
• At the same time that a Notice to Withhold Income is served on an employer/payor, it must be served on the obligor
by ordinary mail addressed to his/her last known address. A copy of the Notice to Withhold should also be sent to the
obligor’s attorney of record, if any.
• Proof of Service of a Notice to Withhold Income on the employer/payor and on the obligor must be filed with the Clerk
of the Circuit Court, at 18 N County Street, Waukegan, Illinois.
171-51 (Rev. 08-08)
American LegalNet, Inc.
www.FormsWorkflow.com
