Fill and Sign the Mn Withholding 497312495 Form

STATE OF MINNESOTA DISTRICT COURT COUNTY OF JUDICIAL DISTRICT FAMILY COURT DIVISION In Re the Marriage of: Court File No. , Petitioner, NOTICE OF INCOME WITHHOLDING AND , Respondent, TO: and Attorney, You are hereby notified, pursuant to Minnesota Law, that fifteen (15) days from the date of this notice your employer or payor of funds will be instructed to deduct your court-ordered child support payments and payments for past due support from your income. You child support payments are more than thirty (30) days in arrears since the court issued its _____________ _____________ on _____________ . According to our records, the total child support arrearages which date back to the filing of the motion on _____________ , total $ _____________ . In addition to withholding $ _____________ per month for child support payments, 20%, or $ _____________ per month will be withheld by your employer or payor of funds until past due support is paid in full. If you believe your payments are not at least thirty (30) days in arrears, or if other mistakes of fact exist, you can delay income withholding by requesting within fifteen (15) days from the date of this notice that the court: 1. Deny income withholding on the grounds that an arrearage of at least thirty (30) days did not exist as of the date of this notice, or on other grounds, limited to mistakes of fact, and - 1 - 2. Stay service on the payor of funds until the motion to deny income withholding is heard. The forms in support of a motion to deny income withholding may be obtained from _____________ County Human Services, Child Support Division, _____________ , _____________ , Minnesota 55____. If you request a court hearing, you must serve notice upon , attorneys for the obligee. If you fail to serve notice, your employer or payor of funds will be instructed to begin withholding child support payments from your income. DATED: ______________ _______________________________ Attorney for (Address) (Address) (City, State, Zip) (Telephone Number) (Attorney Reg. No.:) - 2 -