Author: Janice Grubbs
Ala. Admin. Code r. 660-3-16-.09
Statutory Authority:Code of Ala. 1975, §§ 30-3-60 through 30-3-71, 30-3-197(a)(5) and (7), 30-3A-501 through 30-3A-506; 45 CFR 303.100; 42 U.S.C. 666(b) and (c).
State of Alabama
Child Support Enforcement Division
Department of Human Resources
Re:
SSN:
Case No:
Dear Sir or Madam:
Enclosed are several documents pertaining to withholding income for the purpose of child support. The Order/Notice to Withhold Income for Child Support requires that you withhold the designated amount from the wages of the above-named employee and transmit it to the specified address. The order is issued in accordance with Public Law 104-193,Section 314, (42 U.S.C. 666) and Code of Alabama 1975, § 30-3-197 which authorizes the state Title IV-D agency to order that income withholding be implemented.
Included in this packet is the Employer's Answer to the Order/Notice to Withhold Income for Child Support. We need you to complete this form at your earliest convenience and return it to the above address. The Child Support Enforcement Division is not subject to the restrictions of the Privacy Act ( PL 93-579 and 5 U.S.C. 552a). The information will be used solely for the purpose of enforcing the civil and criminal laws of the State of Alabama regarding Child Support.
Your employee has the right to be notified of this action. Please give the individual a copy of the Order/Notice to Withhold Income for Child Support, as well as the Obligor Notice of Right to Administrative Review and the Request for Administrative Review forms that are included in this packet.
If you have any questions concerning this request, please contact me at (). Thank you for your cooperation.
Sincerely,
STATE OF ALABAMA
DEPARTMENT OF HUMAN RESOURCES
CHILD SUPPORT ENFORCEMENT
____________
Date of Notice: ____________
NOTICE OF DECISION REGARDING ADMINISTRATIVE IWO REVIEW
Based on your written request for an administrative review the following determination has been made:
Based on your allegation that there is a mistake in the amount of delinquent support, Child Support Enforcement (CSE) has reviewed the facts and agrees that there is an error.
Based on your allegation that there is a mistake in the amount of delinquent support, CSE has reviewed the facts and finds no error.
Based on a mistake in identity, CSE has reviewed the facts and agrees that there is an error.
Based on your allegation that ____________, CSE has reviewed the facts and agrees that there is an error.
Based on your allegation that ____________, CSE has reviewed the facts and finds no error.
Based on your allegation that the amount of current support set forth in the administrative Order/Notice to Withhold Income For Child Support is not the same as the current support in the underlying order of support, CSE has reviewed the facts and agrees that there is an error.
Based on your allegation that the amount of current support set forth in the administrative Order/Notice to Withhold Income For Child Support is not the same as the current support in the underlying order of support, CSE has reviewed the facts and finds no error.
As a result, the administrative Order/Notice to Withhold Income for Child Support:
Will remain in effect
Will be withdrawn
ATTENTION OBLIGOR
If you disagree with these findings and want an administrative hearing, you must submit a written request to the above address within 30 days of the date on the notice to prevent further action on the case. Reason for request must be specified.
OMB NO.: 0970-0154
EXPIRATION DATE: 12/31/00
ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS
If checked you are required to provide a copy of this form to your employee.
1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect, please contact the requesting agency listed below.
2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor.
3.* Reporting the Paydate/Date of Withholding: You must report the paydate/date of withholding when sending the payment. The paydate/date of withholding is the date on which amount was withheld from the employee's wages. You must comply with the law of the state of employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the child support payments.
4. Employee/Obligor with Multiple Support Withholdings: If there is more than one Order/Notice to Withhold Income for Child Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Order/Notices to the greatest extent possible. (see #9 below)
5. Termination Notification: You must promptly notify the payee when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this order/notice to the agency identified below.
EMPLOYEE'S/OBLIGOR'S NAME: ____________
EMPLOYEE'S CASE IDENTIFIER: ____________ DATE OF SEPARATION:
LAST KNOWN HOME ADDRESS: ____________
NEW EMPLOYER'S ADDRESS: ____________
6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below.
7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and any other penalties set by State law. (Section 30-3-69, Code of Alabama 1975)
8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a child support withholding. (Section 30-3-70, Code of Alabama 1975)
9.* Withholding Limits: 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; and Medicare taxes.
* NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items.
Requesting Agency: ________________
If you or your employee/obligor have any questions, contact:
by telephone at or by FAX at
or by Internet at
*EFT/EDI Information
OMB NO.: 0970-0154
EXPIRATION DATE: 12/31/00
ORDER/NOTICE TO WITHHOLD INCOME FOR CHILD SUPPORT
State Alabama Original Order/Notice
Co./City/Dist. of Amended Order/Notice
Date of Order/Notice Terminate Order/Notice
Court/Case Number
) RE: *
Employer/Withholder's Federal EIN Number Employee/Obligor's Name (Last, First, MI)
) *
Employer/Withholder's Name Employee/Obligor's Social Security Number
) *
Employer/Withholder's Address Employee/Obligor's Case Identifier
)
Custodial Parent's Name (Last, First, MI)
Child(ren)'s Name(s)
DOB
Child(ren)'s Name(s)
DOB
ORDER INFORMATION: This is an Order/Notice to Withhold Income for Child Support based upon an order for support from ________. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until ____________, even if the Order/Notice is not issued by your State.
If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ____________
$ ____________ per ____________ in current support
$ ____________ per ____________ in past-due support Arrears 12 weeks or greater?
$ ____________ per ____________ in medical support yes no
$ ____________ per ____________ in other (specify)
$ ____________ per ____________ in other (specify)
for a total of $ per ____________ to be forwarded to the payee below.
You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold:
$ ____________ per weekly pay period $ ____________ per semimonthly pay period (twice a month).
$ ____________ per biweekly pay period (every two weeks) $ ____________ per monthly pay period.
REMITTANCE INFORMATION:
You must begin withholding no later than the first pay period occurring ____________ working days after the date of this Order/Notice. Send payment within ____________ working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of the employee for the allowable amount. The total withheld amount, including your fee, cannot exceed ____________ % of the employee's/obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed: (see #9 on back)
When remitting payment, provide the paydate/date of withholding and the case identifier ____________
If remitting by EFT/EDI, use this FIPS code: *; Bank routing code:; Bank account number:
Make it payable to: ____________
Send check to: ____________
____________
____________
Authorized by: ____________
____________
Print Name ____________
*EFT/EDI Information
EMPLOYER'S ANSWER TO ORDER/NOTICE
TO WITHHOLD INCOME FOR CHILD SUPPORT
State Alabama Original Order/Notice
County Amended Order/Notice
Date of Order Terminate Order/Notice
Court Order Number ALECS Number
) RE:
Employer/Withholder's Federal EIN Number Employee/Obligor's Name (Last, First, MI)
) *
Employer/Withholder's Name Employee/Obligor's Social Security Number
) *
Employer/Withholder's Address Employee/Obligor's Case Identifier
)
Custodial Parent's Name (Last, First, MI)
AFTER READING THE ENCLOSED DOCUMENT, CHECK THE APPROPRIATE ANSWER(S) BELOW AND SIGN. PLEASE RETURN ONE COPY OF YOUR ANSWER TO THIS AGENCY AT THE ADDRESS BELOW SO THAT THEY WILL ARRIVE WITHIN FOURTEEN (14) DAYS OF THE DATE THESE DOCUMENTS WERE SERVED UPON YOU. RETAIN ONE COPY FOR YOUR RECORDS.
I. DEFENDANT IS EMPLOYED. After deducting Federal Income Taxes, State Taxes, Social Security Taxes, City Taxes, and other amounts required by law to be withheld, Defendant's "Disposable Earnings" are $ ____________ per (week, bi-week, month). Employer further answers that:
(A) He/she will begin withholding from the Defendant's disposable earnings the total dollar amounts ordered for all support payments in the Court's Order, OR
(B) The total amount ordered withheld exceeds the ____________ % maximum of Defendant's Disposable Earnings indicated in the Court's Order and therefore, in keeping with the Court's order, the Employer will withhold and pay over only that percentage of the Defendant's Disposable Earnings.
II. DEFENDANT IS NOT EMPLOYED by this Employer and Employer was not indebted to the Defendant when this process was received, or when making this answer, or during the intervening time.
III. Defendant is receiving Unemployment Compensation Benefits in the amount of $ ____________ . The Department of Industrial Relations will withhold $ ____________ per ____________.
IV. Defendant is receiving Worker's Compensation Benefits in the amount of $ ____________ . The Department of Industrial Relations will withhold $ ____________ per ____________.
V. OTHER (Explain): ____________
Employer's Signature
If you or your employee/obligor have any questions, contact: ____________
by telephone at: ____________
Notary Public/Clerk/Register
PLEASE RETURN THIS ANSWER FORM TO: ____________
____________
____________
STATE OF ALABAMA
DEPARTMENT OF HUMAN RESOURCES
CHILD SUPPORT ENFORCEMENT DIVISION
Date Of Notice
Request For Administrative Review
To request a review, please complete this form and return it to the address below within fifteen (15) days of the date shown at the top of this notice. Please include written documentation to support your claim or the Child Support Enforcement Division of the Department of Human Resources (DHR) will complete the review based on information available in your case file.
You Cannot Request An Administrative Review By Telephone
(Please Print)
Name:
Last First MI
Social Security Number
Address:
()
Street Home Phone
City State Zip Code Work Phone
Reason for requesting review (check one):
[ ] THE PAST-DUE SUPPORT IS INCORRECT [ ] I DO NOT OWE SUPPORT
[ ] THE AMOUNT OF CURRENT SUPPORT SET FORTH IN THE ADMINISTRATIVE ORDER/NOTICE TO WITHHOLD INCOME FROM CHILD SUPPORT IS NOT THE SAME AS THE CURRENT SUPPORT IN THE UNDERLYING ORDER OF SUPPORT.
If you are requesting a review of a specific action taken by DHR, please indicate below:
Action:
You must include proof, such as copies of:
Canceled checks or money orders;
Child Support orders or modifications to them;
Pay stubs that show money withheld for child support;
Letters from employers who have withheld wages from your salary;
Receipts for child support payments made in cash;
Court payment records;
Bank documents showing that the levied account does not belong to you.; or Picture ID and Social Security Card to show mistaken identity.
IV-D Agency Address:
YOU WILL BE NOTIFIED BY MAIL OF THE RESULTS OF YOUR REVIEW.
PLEASE DO NOT CALL OUR OFFICE FOR THE STATUS OF YOUR REVIEW.
OMB NO.: 0970-0154
STATE OF ALABAMA
DEPARTMENT OF HUMAN RESOURCES
CHILD SUPPORT ENFORCEMENT
Date of Notice
ADMINISTRATIVE REVIEW
You have a right to an administrative review of the action taken to implement your income withholding order for the following reasons:
The amount of past-due support is incorrect.
You do not owe past-due support; or The amount of current support set forth in the administrative Order/Notice to Withhold Income for Child Support is not the same as the current support in the underlying order of support.
To request a review, complete the enclosed form entitled Request for Administrative Review and mail it to the Department of Human Resources (DHR) within 15 days of the date shown at the top of this notice. YOU CANNOT REQUEST AN ADMINISTRATIVE REVIEW BY TELEPHONE. DHR will review your case and notify you of the results in writing.
CHANGE OF ADDRESS AND EMPLOYMENT
Your are required by law to notify DHR of changes in your address or employment status. Code of Alabama 1975, Section 30-3-197(1). Failure to do so may subject you to contempt of court and will result in your not receiving timely notice of enforcement action to resolve this matter immediately.
OMB NO.: 0970-0154