Fill and Sign the Nm Withholding Form

DOMESTIC RELATIONS FORMS Supreme Court Approved 4A-341 November 1, 2002 4A-341 STATE OF NEW MEXICO COUNTY OF ___________________________ ____________________ JUDICIAL DISTRICT _____________________________________, Petitioner v. No. _____________ _____________________________________, Respondent WAGE WITHHOLDING ORDER 1 This matter having come before the court for entry of a wage withholding order. The parties have agreed as follows: A. Information on the paying parent: Name of parent: __________________________________ Parent's address: __________________________________ __________________________________ Social security number: __________________________________ Employer's name: __________________________________ Employer's address: __________________________________ __________________________________ B. The total support owed is $__________ per month. C. ________________________ (name of paying party) agrees to this support being withheld from wages of the above employer. IT IS ORDERED THAT: DOMESTIC RELATIONS FORMS Supreme Court Approved 4A-341 November 1, 2002 The paying parent's employer (including all future employers or income providers) shall withhold support as follows (describe amount and purpose for which wages will be withheld ): ________________________________________________ __________________________________________________________. The employer shall mail or transfer the amount withheld within seven (7) days of the date the paying parent receives a pay check to: _______________________________________________ (name of person or entity and address). IT IS SO ORDERED. ____________________ _______________________________ Date District judge APPROVED: Mother's signature: ________________________________ Address: ________________________________ ________________________________ ________________________________ Telephone: ________________________________ Father's signature: ________________________________ Address: ________________________________ ________________________________ ________________________________ Telephone: ________________________________ USE NOTE 1. See Paragraph C of Domestic Relations Form 4A-205 NMRA for an explanation of the Wage Withholding Order. [Approved, effective November 15, 2002.]