Texas Register, Volume 36, Number 31, Pages 4863-5046, August 5, 2011 Page: 4,985
4863-5046 p. ; 28 cm.View a full description of this periodical.
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Figure: 1 TAC 55.116(b)
INCOME WITHHOLDING FOR SUPPORT
o ORIGINAL INCOME WITHHOLDING ORDER/NOTICE FOR SUPPORT (IWO)
o AMENDED IWO
o ONE-TIME ORDER/NOTICE FOR LUMP SUM PAYMENT
o TERMINATION of IWO Date:
Child Support Eifoement (CSE) Ageary :Court Attorney Pdovate IndividuaVlEntity (Check one)
NOTE: This IWO must be regular on its face. Under certain circumstances you must reject this IWO and return it to the sender
(see IWO instructions htt o hh am snewhubiaton.tmorm
If you receive this document from someone other than a State or Tribal CSE agency or a Court, a copy of the underlying order
must be attached.
State/Tribe/Territory Remittance Identifier (include w/payment)
City/CountylDist./Tribe Order Identifier
Private Individual/Entity CSE Agency Case Identifier
RE:
Employer/Income Withholder's Name Employee/Obligor's Name (Last, First, Middle)
Employer/Income Withholder's Address Employee/Obllgor's Social Security Number
Custodial Party/Obligee's Name (Last, First, Middle)
Employer/Income Withholder's FEIN
Child(ren)'s Name(s) (Last, First, Middle) Child(ren)'s Birth Date(s)
ORDER INFORMATION: This document is based on the support or withholding order from (State/Tribe).
You are required by law to deduct these amounts from the employee/obligor's income until either notice.
$ Per current child support
$ Per past-due child support - Arrears greater than 12 weeks? flYesQ No
$ Per current cash medical support
$ Per past-due cash medical support
$ Per current spousal support
$ Per past-due spousal support
$ Per other (must specify)
for a Total Amount to Withhold of $ .. per
AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Order Information. If
your pay cycle does not match the ordered payment cycle, withhold one of the following amounts:
$ per weekly pay period $ per semimonthly pay period (twice a month)
$ per biweekly pay period (every two weeks)$ per monthly pay period
$ Lump Sum Payment: Do not stop any existing IWO unless you receive a termihation order.
REMITTANCE INFORMATION: If the employee/obligor's principal place of employment is (State/Tribe),
you must begin withholding no later than the first pay period that occurs days after the date of . Send
payment within working days of the pay date. If you cannot withhold the full amount of support for any or all orders for
this employeelobligor, withhold up to % of disposable income for all orders. If the employeelobligor's principal place
of employment Is not (State/Tribe), obtain withholding limitations, time requirements, and any allowable
employer fees at http://www.acf.hhs.gov/pr ggjmas/C/se~fe i tahoye/ facntac t mar.htm for the
employeelobligor's principal place of employment.
Document Tracking Identifier OMB 0970-0154
TABLES AND GRAPHICS August 5, 2011 36 TexReg 4985
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Texas. Secretary of State. Texas Register, Volume 36, Number 31, Pages 4863-5046, August 5, 2011, periodical, August 5, 2011; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth181367/m1/71/: accessed May 21, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.