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Notice And Order To Income Payor To Withhold Income (Child Support) Form. This is a Indiana form and can be use in Marion Local County.
Tags: Notice And Order To Income Payor To Withhold Income (Child Support), Indiana Local County, Marion
STATE OF INDIANA
COUNTY OF MARION
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IN RE THE MARRIAGE OF:
________________________
Petitioner
And
_________________________
Respondent
IN THE MARION SUPERIOR COURT
CIVIL DIVISION, ROOM NO. ______
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CAUSE NUMBER____________________
NOTICE AND ORDER TO INCOME PAYOR TO WITHHOLD INCOME
TO:____________________
________________________
Amounts Withheld are payable to:
State Central Unit
P.O. Box 7130
Indianapolis, IN 46206-7130
________________________
Remittance Must Include:
(1) Obligor’s Name: ______________________________
(2) Obligor’s Social Security # (last 4 digits only): _____
(3) Custodial Parent’s Name: _______________________
(4)Clerk’s Account Number: _______________________
1.
The above named obligor owes a duty of child support.
2.
Pursuant to I.C. 31-16-15-1 et. seq. you are hereby ordered to withhold
________________________ Dollars ($_________) per week for current support and
___________________________Dollars ($________) per week on arrearage (or the
equivalent based on your pay period) from the income of the obligor for a total amount of
_________________________Dollars ($__________) up to the maximum permitted
under 15 U.S.C. 1673(b) which is (50%)(55%)(60%)(65%) (circle one) of the obligor’s
aggregate disposable earnings as defined by 15 U.S.C. 1672.
3.
You may retain a Two Dollar ($2.00) fee from the obligor’s income each time income
withheld is forwarded to the State Central Unit. The total sum of the amount to be
withheld plus this fee may not exceed the maximum amount permitted under 15 U.S.C
1673(b), or _____% of the obligor’s income.
4.
You must forward the withheld income to the State Central Unit at the address listed in
this notice at the time the obligor is paid.
5.
This withholding order is binding upon the income payor until further notice.
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6.
The obligor may recover from the income payor in a civil action an amount not less than
One Hundered Dollars ($100.00), if the income payor discharges the obligor from
employment, refuses the obligor employment, or disciplines the obligor because the
income payor is required to forward income under this order.
7.
The income payor is liable for any amount that the income payor fails to forward under
this order.
8.
Amounts withheld under this Order have priority over any secured or unsecured
garnishment claims on income except claims for Federal, State and Local Taxes.
9.
If the income payor is required to withhold income from more than one (1) obligor the
income payor may combine, in a single payment, the withheld amounts for all obligors
who have been ordered to pay, but the income payor must identify the portion of the
single payment that is attributable to each individual obligor.
10.
If there is more than one (1) Order for withholding child or spousal support against a
single obligor, the income payor shall comply on a pro-rata basis, and shall honor all
withholdings to the extent that the total amount withheld does not exceed the limits
imposed under 15 U.S.C. 1673 (b):
a. Fifty percent (50%) of disposable earnings if the individual is supporting a spouse
or dependent (other than a spouse or child with respect to whose support such
order is issued); or
b. Sixty percent (60%) of disposable earnings if the individual is not supporting a
spouse or dependent child described above; however,
c. Fifty percent (50%) figure above shall be fifty-five percent (55%) and the sixty
percent (60%) figure above shall be sixty-five percent (65%), if and to the extent
that such earnings are subject to garnishment to enforce a support order with
respect to a period which is prior to the twelve (12) week period which ends with
the beginning of such work week.
11.
The income payor shall implement withholding no later than the first pay period that
occurs after fourteen (14) days following the date this notice was mailed.
12.
The income payor shall notify the Court when the obligor terminates employment within
ten (10) days after termination, and shall provide the obligor’s last known address and the
name and address of the obligor’s new employment, if known.
So ordered this __________day of ________________________, 200________.
______________________________
Judge, Marion County, Superior Court
Civil Division Room ________.
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