Fillable PETITION FOR EX PARTE INCOME WITHHOLDING ORDER (Maricopa County Telecommunications)

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PETITION FOR EX PARTE INCOME WITHHOLDING ORDER (Maricopa County Telecommunications)

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PETITION FOR EX PARTE
INCOME WITHHOLDING
ORDER
(WITHHOLD INCOME WITHOUT
ADVANCE NOTICE or HEARING)
1
To start automatic payroll deduction of
support payments, OR to volunteer for
payroll deduction of support payments owed
by You
Forms and Instructions
© Superior Court of Arizona in Maricopa County
ALL RIGHTS RESERVED
DRWA1 – 5108 - 050115
SELF-SERVICE CENTER
PETITION AND PAPERS FOR
EX PARTE “INCOME WITHHOLDING ORDER”
FOR INCOME WITHHOLDING ORDER
WITHOUT ADVANCE NOTICE OR
HEARING
OR TO VOLUNTEER TO START INCOME WITHHOLDING DEDUCTION
FOR MONEY YOU OWE
CHECKLIST
You may use the forms and instructions in this packet if . . .
You have a court order for child support and/or spousal maintenance (alimony)
payments but you do not already have an order for payroll deduction* of those
pay
ments, AND / OR
You are entitled to receive support; there is past due support owing, and you want to
receive payments on that past due amount on a regular schedule, when the person
r
equired to make those payments gets paid, OR
You are court-ordered to make child support and/or spousal maintenance (alimony)
payments and you want to voluntarily request an order for payroll deduction* of those
pay
ments, known in the courts as an
“Income Withholding Order”.
*NOTE: This “Ex Parte Income Withholding Order” may also be used in situations where a
per
son is asking for automatic deduction (assignment) of income payments other than payroll,
such as lottery winnings, worker’s compensation, or other income.
READ ME: Consulting a lawyer before filing documents with the court may help
prevent unexpected results. A list of lawyers you may hire to advise you on handling
your own case or to perform specific tasks, as well as a list of court-approved mediators
can be found on the Self-Service Center website.
© Superior Court of Arizona in Maricopa County DRWA1k-041212
ALL RIGHTS RESERVED
Page 1 of 1
SELF-SERVICE CENTER
TO ENFORCE A COURT ORDER FOR SUPPORT
PETITION FOR EX PARTE INCOME WITHHOLDING ORDER
FOR THE PARTY MAKING THE REQUEST
This packet contains court forms and instructions to file to enforce a court order for support. Items
in BOLD are forms that you will need to file with the Court. Non-bold items are instructions or
procedures. Do not copy or file those pages!
Order File Number Title # pages
1 DRWA1k Checklist: Use these forms if . . . 1
2 DRWA1t Table of Contents (this page) 1
3 DRWA11i
Instructions: How to request an
“Ex Parte Income Withholding
Order”
3
4 DRWA11f “Petition for Ex Parte Income Withholding Order” 2
5 DRS88f “Current Employer or Other Payor Information Sheet” 1
The documents you have received are copyrighted by the Superior Court of Arizona in
Maricopa County. You have permission to use them for any lawful purpose. These
forms shall not be used to engage in the unauthorized practice of law. The Court
assumes no responsibility and accepts no liability for actions taken by users of these
documents, including reliance on their contents. The documents are under continual
revision and are current only for the day they were received. It is strongly recommended
that you verify on a regular basis that you have the most current documents.
© Superior Court of Arizona in Maricopa County DRWA1t-041212
ALL RIGHTS RESERVED
Page 1 o
f 1
SELF-SERVICE CENTER
INSTRUCTIONS FOR PETITION FOR INCOME WITHHOLDING
ORDER
EX PARTE (WITHOUT NOTICE)
DEFINITIONS:
“Obligee” is the person or agency entitled to receive support payments.
“Obligor” is the person ordered to make support payments.
Throughout these instructions the terms “employer,” “wages,” and “paycheck” are used. However,
this Petition for Income Withholding Order Ex Parte (without notice) may also be used in situations
where a person is asking for an assignment of the Obligor’s other monies such as lottery winnings,
worker’s compensation or other income.
COMPLETE THIS FORM TO PETITION FOR AN EX PARTE INCOME WITHHOLDING ORDER
IF:
• You are the Obligee and there is an Arizona order establishing a support obligation or
spousal support (maintenance) obligation, including past-due amounts, OR
•
You are the Obligor and you want to begin a voluntary Income Withholding Order.
TO COMPLETE THIS FORM AND FILE THE PETITION YOU WILL NEED:
•
Information from the Order(s) you want to enforce
• Attach a certified copy of the Order establishing the support obligation to the petition, if that
order was issued in an Arizona county other than the one where you will file this request.
•
Attach a certified copy of the most recent order requiring payment on past-
due support
amounts to the petition, if that order was entered in an Arizona county other than the one
where you will file this request.
NOTE: These forms do not apply if your support order is not from Arizona. In that case, you may
want to contact the state child support enforcement agency where your order was entered, the
Department of Economic Security child support enforcement agency, in Arizona, or a private attorney
regarding enforcement.
© Superior Court of Arizona in Maricopa County DRWA11i- 102213
ALL RIGHTS RESERVED
Page 1 of 3
FOLLOW THESE INSTRUCTIONS:
• TYPE OR PRINT NEATLY USING BLACK INK.
• Match each numbered step in the instructions with the item on the attached form that has
the same number.
1. Type or print the name, address and telephone number of the person filing the Request.
Include your ATLAS number if your case is a title IV-D case. (An attorney who is filing the Request
must also list the name of the person represented and the attorney’s State Bar number.)
2. Type or print the first, middle and last name of the person shown as the Petitioner on the order that
established the support obligation. Type or print the first, middle and last name of the person
shown as the Respondent on the order that established the support obligation.
3. Type or print the case number assigned to your case on this page and at the top of each
additional page. If the order was issued in a county other that they one where you are filing this
petition, leave this line blank.
4. Type or print the date the order that established the support obligation was signed by a Judicial
Officer.
5. Type or print the first, middle and last name of the obligor (person ordered to pay support).
6. Type or print the name of the Court which established the support obligation.
7. Type or print the name of the County and State where the court is located.
8. Enter all amounts previously ordered. The amounts you enter should reflect monthly payments.
9. Check all boxes that apply.
10. The requesting person must sign on the appropriate line in front of a Clerk of Superior Court or
Notary Public affirming the contents of the Petition are true to the best of their knowledge. You
must have picture identification with you.
WHEN YOU HAVE COMPLETED THIS FORM:
• File the petition with the Clerk of the Superior Court. There is a filing fee for this process. Check
with the Court of Court for the current filing fee amount. A list of current fees is available from the
Self Service Center and from the Clerk of Court’s website.
© Superior Court of Arizona in Maricopa County DRWA11i- 102213
ALL RIGHTS RESERVED
Page 2 of 3
• There may be additional fees, including an appearance fee if this is the first time you have filed
papers in this case. If you cannot afford the filing fee and/or the fee for having the papers served by
the Sheriff or by publication, you may request a deferral (payment plan) when you file your papers
with the Clerk of the Court. Deferral Applications are available at no charge from the Self-Service
Center. You may file your petition at any one of the following locations:
The Clerk of the Superior Court
Central Court Building
201 West Jefferson, 1st floor
Phoenix, Arizona 85003
The Clerk of the Superior Court
Northwest Court Facility
14264 West Tierra Buena Lane
Surprise, Arizona 85374
• If one of the parties is using the child support services of the Division of Child Support Service
(DCSS) a copy of the petition and a copy of the “Income Withholding Order” must be mailed to:
Attorney General, Child Support Enforcement,
P.O. Box 6123, Site Code 775C,
Phoenix, AZ 85005.
• If the Petition is granted, an Income Withholding Order will be issued and the Clerk of Court
will serve the Income Withholding Order on the obligor’s employer. The obligor will be mailed a
copy of the Order by the Court. The obligor will have the right to file a Request for Hearing to
object to the Ex Parte Income Withholding Order.
© Superior Court of Arizona in Maricopa County DRWA11i- 102213
ALL RIGHTS RESERVED
Page 3 of 3
Person Filing:
Address (if not protected):
City, State, Zip Code:
Telephone:
Email Address:
ATLAS Number:
Lawyer’s Bar Number:
Representing Self, without a Lawyer or Attorney for Petitioner OR Respondent
SUPERIOR COURT OF ARIZONA
IN MARICOPA COUNTY
(2) (3) CASE NO:
Name of Petitioner (in original case)
PETITION FOR EX PARTE
INCOME WITHHOLDING ORDER
A.R.S. §25-504
Name of Respondent (in original case)
On (4) (date),(5) , the person ordered to
pay support, was ordered in (6) (name of court, example:
“Superior Court”) in (7) (location of court: county and
state) to pay:
(8)
$
monthly child support payment
$
monthly spousal maintenance payment
$
monthly child support arrearage payment
$
monthly spousal maintenance arrearage payment
(9) I request that an Ex Parte Income Withholding Order be issued because: (check all that apply)
I am the person entitled to the support or I represent the agency entitled to collect the support, and
there is no existing Income Withholding Order
FOR CLERK’S USE ONLY
© Superior Court of Arizona in Maricopa County DRWA11f - 050115
ALL RIGHTS RESERVED
WAH Page 1 of 2
Case No. _______________________
A past due obligation exists for child support, spousal support, spousal support arrears or interest
and I request payment on past due support in the amount of $ per month
I am the person required to pay the support and there is no existing Income Withholding Order,
and I hereby voluntarily request an Income Withholding Order
be issued for payment of my
obligation.
STATE OF
COUNTY OF
Subscribed and sworn to or affirmed before me this: by
(date)
.
(notary seal) Deputy Clerk or Notary Public
Signature of person requesting Assignment
Name of Agency if Applicable
© Superior Court of Arizona in Maricopa County DRWA11f - 050115
ALL RIGHTS RESERVED
WAH Page 2 of 2
CURRENT EMPLOYER* INFORMATION
You may also fill out this form online at the Family Support Center Website.
THIS FORM MUST BE COMPLETED FOR:
AN INCOME WITHHOLDING ORDER
ORDER TO STOP AN INCOME WITHHOLDING ORDER
NOTIFICATION OF A CHANGE OF EMPLOYER (or OTHER PAYOR)
CASE NUMBER: ATLAS NUMBER:
NAME OF PERSON ORDERED TO MAKE PAYMENTS:
LIST THE NAME OF THE EMPLOYER* AND THE ADDRESS OF THE PAYROLL OR FINANCIAL
DEPARTMENT (for the person named above) WHERE THE INCOME WITHHOLDING ORDER OR
STOP ORDER SHOULD BE MAILED.
EMPLOYER* NAME:
PAYROLL ADDRESS:
CITY: STATE: ZIP:
EMPLOYER* TELEPHONE:
EMPLOYER* FAX:
*or other payor or source of funds
FOR COURT USE ONLY. DO NOT WRITE BELOW THIS LINE.
WA/FSC
For Clerk’s Use Only
WA/LOG ID:
TYPE OF W/A
DATE
AMOUNT OF ORDER
EMPLOYER STATUS
ENTERED BY
NEW W/A
SUB
AG
DCSE
SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY DRS88f-041712
All Rights Reserved Page 1 of 1
CEI
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PETITION FOR EX PARTE INCOME WITHHOLDING ORDER (Maricopa County Telecommunications)

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Completed 26 October 2020

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