Michigan > Statewide > Domestic Relations > Support
Instructions For Notice Or Order Of Income Withholding (Federal) OMB-0970-0154 - Michigan
| Instructions For Notice Or Order Of Income Withholding (Federal) Form. This is a Michigan form and can be used in Support Domestic Relations Statewide . |
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Instructions to complete the Order/Notice to Withhold Income for Child Support or Notice of an Order to Withhold Income for Child Support The Order/Notice to Withhold Income for Child Support (Order/Notice) or Notice of an Order to Withhold Income for Child Support (Notice) is a standardized form used for income withholding in tribal, intrastate, interstate, and intergovernmental cases. Please note that information provided on this form may be shared with the obligor. When completing the form, please include the following information. The following information 1a 1g refers to the government agency, non-government entity, or individual completing and sending this form to the employer. 1a. Check whether this is an Order/Notice to Withhold Income for Child Support or a Notice of an Order to Withhold Income for Child Support. Attorneys, individuals, and non-governmental entities must submit a Notice of an Order to Withhold and include a copy of the income withholding order unless, under a state's law, an attorney in that state may issue an income withholding order/notice. In that case, the attorney may submit an Order/Notice to Withhold and include a copy of the state law authorizing the attorney to issue an income withholding order/notice. Check the appropriate status of the Order or Notice. Date this form is completed and/or signed. Name of the state, tribe or territory sending this form. This must be a governmental entity. Name of the county, city, district, or reservation sending this Order or Notice, if appropriate. This must be a governmental entity. Check and indicate the non-governmental entity or individual sending this Order or Notice. Complete this item only if a non-governmental entity or individual is submitting this Order or Notice. Identifying case number used by the entity or individual sending this Order or Notice. In a IV-D case, this must be the IV-D case number. 1b. 1c. 1d. 1e. 1f. 1g. The following information in 2 and 3 refers to the obligor, obligor's employer, and case identification. 2a. Employer's/Withholder's name. 2b-c. Employer's/Withholder's mailing address, city, and state. (This may differ from the Employee's/Obligor's work site.) 2d. Employer's/Withholder's nine-digit federal employer identification number (if available). Include three-digit location code. 1 OMB 0970-0154 American LegalNet, Inc. www.FormsWorkflow.com 3a. 3b. 3c. Employee's/Obligor's last name, first name, and middle initial. Employee's/Obligor's Social Security Number (if known). The case identifier used by the order issuing state or tribe for recording payments. (Should be the same as #21.) In a IV-D case, this must be the IV-D case number. Custodial Parent's last name, first name, and middle initial (if known). 3d. ORDER INFORMATION - The following information in 4 -14e refers to the dollar amounts taken directly from the child support order. 4. Name of the state or tribe that issued the support order. 5a-b. Dollar amount to be withheld for payment of current child support, time period that corresponds to the amount in #6a (such as month, week, etc.). 6a-b. Dollar amount to be withheld for payment of past-due child support, time period that corresponds to the amount in #6a (such as month, week, etc.). 7a-b. Dollar amount to be withheld for payment of current cash medical support, as appropriate, based on the underlying order, time period that corresponds to the amount in #7a (such as month, week, etc.). 8a-b. Dollar amount to be withheld for payment of past-due cash medical support, if appropriate, based on the underlying order and the time period that corresponds to the amount in #8a (such as month, week, etc.). 9a-b. Dollar amount to be withheld for payment of spousal support (alimony), if appropriate, based on the underlying order, time period that corresponds to the amount in #9a (such as month, week, etc.). 10a-b.Dollar amount to be withheld for payment of past-due spousal support (alimony), if appropriate, based on the underlying order, time period that corresponds to the amount in #10a (such as month, week, etc.). 11a-c.Dollar amount to be withheld for payment of miscellaneous obligations, if appropriate, based on the underlying order, time period that corresponds to the amount in #11a (e.g., month, week, etc.), and description of the miscellaneous obligation. 12a. 12b. 13. 14a. Total of #5a, #6a, #7a, #8a, #9a, #10a, and # 11a. Time period that corresponds to the amount in #12a (e.g., month). Check this box if arrears greater than 12 weeks. Amount an employer should withhold if the employee is paid weekly. 2 OMB 0970-0154 American LegalNet, Inc. www.FormsWorkflow.com 14b. 14c. 14d. Amount an employer should withhold if the employee is paid every two weeks. Amount an employer should withhold if the employee is paid twice a month. Amount an employer should withhold if the employee is paid once a month. REMITTANCE INFORMATION 15. 16. The state, tribe, or territory from which this Order/Notice or Notice of an Order is sent. Number of days in which the withholding must begin pursuant to the issuing state's or tribe's laws/procedures. The effective date of the income withholding. Number of working days within which an employer or other withholder of income must remit amounts withheld pursuant to the issuing state's law. The percentage of income that may be withheld from the employee's/obligor's income. For state orders, you may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (15 U.S.C. § 1673(b)); or 2) the amounts allowed by the state of the employee's/obligor's principal place of employment. The federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: state, federal, local taxes, Social Security taxes, statutory pension contributions, and Medicare taxes. For tribal orders, you may not withhold more than the amounts allowed under the law of the issuing tribe. For tribal employers who receive a state order, you may not withhold more than the amounts allowed under the law of the state that issued the order. 20. 21. The state, tribe, or territory from which the Order or Notice is sent. Name of the State Disbursement Unit, individual, tribunal/court, or tribal child support enforcement agency specified in the underlying income withholding order to which payments are required to be sent. This form may not indicate a location other tha
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