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Fill and Sign the State of North Carolina Notice of Hearing Setoff Debt Collection Form

Fill and Sign the State of North Carolina Notice of Hearing Setoff Debt Collection Form

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Date Signature Of Taxpayer Social Security No. STATE OF NORTH CAROLINA WAIVER OF RIGHT TO CONTEST SETOFF DEBT COLLECTION G.S. 105A-8 AOC-A-914M, New 6/991999 Administrative Office of the Courts Name And Address Of Taxpayer County I, the undersigned taxpayer, have read the "Notice Of C laim To Income Tax Refund." I waive the opportunity to contest the validity of the Ad ministrative Office of the Courts' claim to my income tax refund, as explained in that notice. I consent to the immediate setoff of that claim against my tax refund. I understan d that by signing this waiver and returning it to the Administrat ive Office of the Courts, I waive all remedies available to me under the North Carolina Setoff Debt Collection Act. I also understand that upon receipt of the waiver, the Admin istrative Office of the Courts will apply the tax refund to the current amount owed, including interest, on all judgments incl uded in its claim. Upon receipt of that certified debt, the Admin istrative Office of the Courts will apply the amount so ce rtified from my income tax refund, and will send me any remaining ba lance of the refund. WAIVER

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