Income Withholding for Support Notice
An illustration is provided for your reference.
Prior Form
ORDER INFORMATION : This document is based on the support or withholding order from Illinois (State/Tribe).
You are required by law to deduct these amounts from the employee/obligor's income until further notice.
$ 100.00 Per BIWK current child support
$ 50.00 Per BIWK past-due child support - Arrears greater than 12 weeks? X Yes ¨No
$ Per current cash medical support
$ Per past-due cash medical support
$ Per current spousal support
$ Per past-due spousal support
$ 25.00___ Per BIWK _______ delinquency, totaling $ 200.00 as of 01/10/2013 ,___this amount may or may not include all of the interest that you owe.__ ___.
$ Per other (must specify) .
for a Total Amount to Withhold of $ 175.00 per BIWK .
New Form
ORDER INFORMATION : This document is based on the support or withholding order from Illinois (State/Tribe).
You are required by law to deduct these amounts from the employee/obligor's income until further notice.
$ 100.00 Per BIWK current child support
$ 75.00 Per BIWK past-due child support - Arrears greater than 12 weeks? X Yes ¨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 $ 175.00 per BIWK .
Questions? Call: 1.888.245.1938.
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