Fill and Sign the Plaintiffobligee Form

IN THE CHANCERY COURT OF COUNTY, MISSISSIPPI , PLAINTIFF/OBLIGEE SS# OBLIGOR VS. CIVIL ACTION NO. , DEFENDANT/OBLIGEE SS# OBLIGEE ORDER FOR WITHHOLDING THE COURT FINDS, ORDERS, ADJUDGES AND DECREES: 1. [Complete and check only one] COMPLETE ONLY FOR ORIGINAL PROCEEDINGS On the day of , 20 , this Court entered a judgment directing t hat the Obligor pay child support in the amount of $ per month, payable $ per , beginning on the day of , 20 , and continuing thereafter until the c hild(ren) are emancipated. COMPLETE ONLY FOR MODIFICATION PROCEEDINGS On this date, the support order was revised and the Obligor was ordered to pay child support of $ per month, payable $ per , beginning on the day of      , 20 , and continuing thereafter until the child(ren) are emancipated. COMPLETE ONLY FOR CONTEMPT PROCEEDINGS On this date, the Court having taken evidence, finds that the Obligor is in arrears, that there are no mistakes of law or fact and that the Obligor was properly served with process and notice of these proceedings, and adjudicated the Obligor to bin in arrears totaling $ . In addition to the required child support, the Obligor was ordered to pay delinquency at the rate of $ per month, payable $ per , beginning on the day of , 20   , until the arrearage is paid in full. COMPLETER ONLY TO GRANDFATHER IN ORDER The Court by operation of law enters this Order for Withholding. 2. The Obligor is self-employed, unemployed, Employed at: . INSTRUCTIONS TO EMPLOYERS The employer shall withhold: (a) $ per month for current child support. (b) $ per month to pay off any arrearage that may now exist or exist in the future. (Note: ONLY WITHHOLD THIS ADDITIONAL AMOUNT IF A DOCUMENT CALLED A NOTICE OF DELINQUENCY ADVISING YOU OF AN ARREARAGE IS ATTACHED.) (c) $ per month for the Welfare Department to cover the administration cost of handling this money. (d) $ per withholding for the employer to cover his costs of withholding, however, the employer may waive the collection of its $ per withholding if it chooses. This fee should be retained by the employer and not be forwarded to the Welfare Department. 3. The employer is allowed 14 days from the date of receiving these documents to start withholding the amounts specified in paragraph two. After these 14 days have passed withholding must begin with the next payroll. The employer can withhold these amounts in a manner that matches his payroll and does not have to change his payroll schedule in order to comply with this Order. 4. In the event the Obligor's employment situation changes, any interested party is authorized to notify the Court by mailing a dated and signed letter to the Court containing the name and address of the new employer. This ORDER FOR WITHHOLDING shall continue in full force and effect against any subsequent employer. 5. The employer shall not withhold any amounts in excess of that allowed under Section 303(b) of the Consumer Credit Protection Act, being 15 U. S. C. A. 1673, as amended. The Obligor and his employer are informed and advised of their rights, remedies and duties as the same are recited on the attached Exhibit 1 which is made a part hereof as though fully copies and set out at length herein. (Note: These laws are attached.) 6. Within ten (10) days after each withholding is made, the employer shall send the amounts withheld to: County Welfare Department Post Office Box , Mississippi OR TO and the following information shall be noted on each remittance. Name of Obligor Chancery Court, County of Action No. Name of Obligee 7. The Court further orders and adjudges as follows (complete and check only one): This ORDER FOR WITHHOLDING shall take effect immediately. This ORDER FOR WITHHOLDING shall NOT take effect until the Obligor becomes delinquent in the payment of an amount equal to one (1) month's support and until a NOTICE OF DELINQUENCY has been duly served and the Obligor given all due process rights to contest this Order for Withholding, or, pursuant to any other proper and appropriate Order issued from this Court. ORDERED, ADJUDGED AND DECREED, on this the day of , 20 . ________________________________ CHANCELLOR Prepared and presented by: Telephone: MSB # Attorney for