F.C.A. §448; Art. 5-B C.P.L.R.5241, 5242 (a) [NOTE: Personal Information Form 4-5/5-1d, containing social security numbers of parties and dependents, must be filed with this Petition] FAMILY COURT OF THE STATE OF NEW YORK COUNTY OF ....................................................................................... In the Matter of a Proceeding for Support Under Article of the Family Court Act1 Petitioner, Form 4-8b (Petition to Correct Income Withholding Order for Support Enforcement) 6/2012 Docket No. PETITION TO CORRECT INCOME WITHHOLDING ORDER FOR SUPPORT ENFORCEMENT -againstRespondent. ....................................................................................... TO THE FAMILY COURT: The undersigned respectfully alleges that: 1.a. is a creditor as defined in 2 C.P.L.R. Section 5241 (a) (3), Gwho resides at OR Gwhose official address is [specify]: b. C.P.L.R. Section 5241 (a) (2) who resides at is a debtor as defined in . 2. On [specify date]: , an Income Withholding Order (IWO) for Support Enforcement was issued by the GSheriff GClerk of the Court, County , GAttorney for the creditor against the debtor that required [specify]: an Gemployer Gincome payor , to deduct certain sums from income due or thereafter due the debtor under Order of Support dated by the Court of County, State of New York. 1 Use caption as in original support proceeding. Unless the Court has ordered the address to be confidential on the ground that disclosure would pose an unreasonable health or safety risk. See Family Court Act §154-b; Form 21 (available at www.nycourts.gov). 2 American LegalNet, Inc. www.FormsWorkFlow.com Form 4-8b Page 2 [Delete if inapplicable]: 3.a. (Upon information and Belief) The Income Withholding Order for Support Enforcement contains a defect, irregularity, error or omission, in that {specify]: and should be corrected as follows [specify]: b. The Income Withholding Order for Support Enforcement contains a mistake of fact as defined in C.P.L.R Section 5241(a)(8) in that [specify]: and should be corrected as follows [specify]: 4. No previous application has been made to any judge or court, including a Native American tribunal, or is presently pending before any judge or court, for the relief requested in this petition (except [specify]: ). WHEREFORE, applicant requests an order correcting the [check applicable box]: Gdefect, irregularity, error or omission G mistake of fact in the Income Withholding Order for Support and for such other and further relief as the law provides. Applicant Print or Type name Signature of Attorney, if any Attorney's Name (Print or Type) Dated: , . Attorney's Address and Telephone Number American LegalNet, Inc. www.FormsWorkFlow.com