Income Withholding for Support (Order to Withhold) · Step 4 of 5

Property & Finances

current child support Write the dollar amount to take out for current child support. Per Write how often this amount is taken out, such as weekly or monthly. past-due child support - Arrears greater than 12 weeks? Write the dollar amount to take out for past-due child support that is owed. Per Write how often this past-due amount is taken out, such as weekly or monthly. Yes Check Yes if the unpaid support is more than 12 weeks behind. No Check No if the unpaid support is not more than 12 weeks behind. current cash medical support Write the dollar amount to take out for current medical support paid in cash. Per Write how often this amount is taken out, such as weekly or monthly. past-due cash medical support Write the dollar amount to take out for past-due cash medical support that is owed. Per Write how often this past-due amount is taken out, such as weekly or monthly. current spousal support Write the dollar amount to take out for current spousal support (alimony). Per Write how often this amount is taken out, such as weekly or monthly. past-due spousal support Write the dollar amount to take out for past-due spousal support that is owed. Per Write how often this past-due amount is taken out, such as weekly or monthly. other (must specify) Write the dollar amount for any other type of support not listed above. Per Write how often this other amount is taken out, such as weekly or monthly. other (must specify) Explain what the other amount is for, such as a fee. for a Total Amount to Withhold of $ Write the total dollar amount to take out by adding all the amounts above. per Write how often the total amount is taken out, such as weekly or monthly. per weekly pay period Write the dollar amount to take out if the person is paid once a week. per semimonthly pay period (twice a month) Write the dollar amount to take out if the person is paid twice a month. per biweekly pay period (every two weeks) Write the dollar amount to take out if the person is paid every two weeks. per monthly pay period Write the dollar amount to take out if the person is paid once a month. Lump Sum Payment: Write the dollar amount to take out from a one-time lump sum payment.

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