Fillable IN THE INTEREST OF CHILDREN Figure: 1 TAC (Attorney General of Texas)

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IN THE INTEREST OF CHILDREN Figure: 1 TAC (Attorney General of Texas)

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Figure: 1 TAC §55.111
Form 1619A NOTICE OF APPLICATION FOR JUDICIAL WRIT OF WITHHOLDING November 2014
CAUSE NUMBER ________________
IN THE INTEREST OF
_________________ ________________
_________________ ________________
CHILDREN
§ IN THE ___________________ COURT
§
§ OF
§ _________________ COUNTY, TEXAS
NOTICE OF APPLICATION FOR JUDICIAL WRIT OF WITHHOLDING
_______________________, Obligor, is hereby given notice pursuant to Texas Family Code
Chapter 158, Subchapter D, that his employer will be required to withhold the amounts specified
below for payment of his current support and periodic medical support obligation, and for any overdue
support arrearage, as follows:
OBLIGOR: __________________ OBLIGEE: __________________
CHILDREN
1. _________________
2. _________________
3. _________________
4. _________________
5. _________________
6. _________________
Current Support Due:
$ ________ monthly
Periodic Medical Support Due:
$ ________ monthly
Total Arrearage, including
$ ________ accrued interest:
$ ________ As of: ________
Amounts to be withheld from Obligor’s wages upon service of writ:
On Current Support:
monthly
monthly
On Periodic Medical Support:
On Arrearage Owed:
$ ________
$ ________
$ ________ monthly
The writ or order to withhold from your wages applies to each current or subsequent
Figure: 1 TAC §55.111
Form 1619A NOTICE OF APPLICATION FOR JUDICIAL WRIT OF WITHHOLDING November 2014
employer or period of employment.
Your employer will be notified to begin deducting from your pay the amounts specified above if
you do not contest this withholding by filing a Motion to Stay issuance and delivery of Judicial Writ of
Withholding within 10 days after the receipt of this Notice.
Your grounds for successfully contesting the issuance of a writ of withholding are limited to a
mistake of fact. If you claim you are not the person who owes the child support, are not in arrears, or
the arrearage amount,
including accrued
interest, is incorrect, you can request a hearing by
completing a Motion to Stay issuance and delivery of Judicial Writ of Withholding, and filing the
Motion to Stay with the clerk of the court within 10 days of receipt of this Notice.
Your timely filing of the attached Motion to Stay will prevent the issuance and delivery of the
Judicial Writ of Withholding to your employer until a hearing is held.
If you contest this withholding, you will be afforded an opportunity to present your case to the
court within 30 days of your filing the Motion to Stay. The hearing will be limited to the disputed
issues as stated on the Motion to Stay.
At the c
ourt hearing, the court will decide the contested delinquency, and will either enter an
order for income withholding or decide that an order for income withholding as asked for in this Notice
should not be entered.
__________________ has repeatedly failed to pay support in accordance with the underlying
support order, and it is anticipated that additional arrears will accrue between the filing of the Notice
and the date of a possible hearing.
Should a Motion to Stay be filed, and a hearing conducted, the court will be requested to
confirm all arrearage amounts then due.
VERIFICATION
I, the undersigned, swear under oath that the above Notice of Application for Judicial Writ of
Withholding is true and correct.
__________________________________
Signature
State of Texas
County of __________________
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Figure: 1 TAC §55.111
Form 1619A NOTICE OF APPLICATION FOR JUDICIAL WRIT OF WITHHOLDING November 2014
SUBSCRIBED AND SWORN TO BEFORE ME, the undersigned Notary Public, by
___________________________ , this ______ day of ____________________ ,20____.
______________________________________
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IN THE INTEREST OF CHILDREN Figure: 1 TAC (Attorney General of Texas)

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Completed 28 March 2022

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