The Florida Addendum To Income form is a document used in family law cases when a court has ordered income deduction for support payments. This addendum must accompany the Income Withholding for Support form to comply with Florida law requirements. Proper completion and submission of this form are essential for ensuring that support payments are deducted correctly from an obligor's income.
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The Florida Addendum to Income Withholding Order is a crucial document in family law, particularly when it comes to enforcing child support and alimony payments. This form is used when a court mandates that support payments be deducted directly from an individual's income. It complements the federal Income Withholding for Support form, ensuring that all necessary provisions required by Florida law are included. Properly completing this addendum involves specific steps, such as attaching it to the federal form and filing it with the circuit court clerk in the relevant county. Once filed, a copy must be sent to the obligor's employer via certified mail, ensuring that all parties are informed of their responsibilities. The addendum outlines the obligations of employers, detailing how much should be deducted from the obligor's income and the timeline for these deductions. It also addresses penalties for non-compliance and provides guidance on how to handle unique situations, such as bonuses or one-time payments. Understanding the nuances of this form can help ensure that support payments are collected and distributed efficiently, safeguarding the financial well-being of those relying on these funds.
INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM 12.996(d), FLORIDA ADDENDUM TO INCOME WITHHOLDING ORDER (07/13)
When should this form be used?
This form should be used when the court has ordered that support be paid by income deduction and OMB Form 0970-0154, Income Withholding for Support, has been used. This form must be added to the OMB form to provide provisions required for income deduction orders by Florida law.
This form should be typed or printed in black ink. It should be attached to the OMB form and filed with the clerk of the circuit court in the county in which your action is pending.
What should I do next?
A copy of this form and a copy of the OMB Income Withholding for Support form, signed by the judge, should be sent to the o ligor’s payor by certified mail, return receipt requested. The return receipt
should be sent to the person who prepared this form, so that it can be filed with the court with Florida Family Law Rules of Procedure Form 12.996(c), Notice of Filing Return Receipt.
Where can I look for more information?
Before pro eedi g, you should read Ge eral I for atio for “elf-Represe ted Litiga ts fou d at the beginning of these forms. The words that are in bold underline in these instructions are defined there. For further information see sections 61.13 and 61.1301, Florida Statutes.
Special Instructions...
When filling out an Income Withholding for Support form, please note the following additional instructions for that form:
1.The Remittance Identifier is the County Code for the county the case was heard in followed by the Case Number. A list of county codes is included with these instructions.
2.The FIPS code may be found on the attached list. Use the code for the County in which the case is pending.
Remember, a person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out these forms, that person must give you a copy of a Disclosure from Nonlawyer, Florida Family Law Rules of Procedure Form 12.900(a), before he or she helps you. A nonlawyer helping you fill out these forms
Instructions for Florida Family Law Rules of Procedure Form 12.996(d), Florida Addendum to Income Withholding Order (07/13)
also must put his or her name, address, and telephone number on the bottom of the last page of every form he or she helps you complete.
FIPS and County Codes
COUNTY
FIPS
COUNTY CODE
ALACHUA
12001
01
LAKE
12069
35
BAKER
12003
02
LEE
12071
36
BAY
12005
03
LEON
12073
37
BRADFORD
12007
04
LEVY
12075
38
BREVARD
12009
05
LIBERTY
12077
39
BROWARD
12011
06
MADISON
12079
40
CALHOUN
12013
07
MANATEE
12081
41
CHARLOTTE
12015
08
MARION
12083
42
CITRUS
12017
09
MARTIN
12085
43
CLAY
12019
10
MONROE
12087
44
COLLIER
12021
11
NASSAU
12089
45
COLUMBIA
12023
12
OKALOOSA
12091
46
DADE
12025
13
OKEECHOBEE
12093
47
DESOTO
12027
14
ORANGE
12095
48
DIXIE
12029
15
OSCEOLA
12097
49
DUVAL
12031
16
PALM BEACH
12099
50
ESCAMBIA
12033
17
PASCO
12101
51
FLAGER
12035
18
PINELLAS
12103
52
FRANKLIN
12037
19
POLK
12105
53
GADSDEN
12039
20
PUTNAM
12107
54
GILCHRIST
12041
21
ST. JOHNS
12109
55
GLADES
12043
22
ST. LUCIE
12111
56
GULF
12045
23
SANTA ROSA
12113
57
HAMILTON
12047
24
SARASOTA
12115
58
HARDEE
12049
25
SEMINOLE
12117
59
HENDRY
12051
26
SUMTER
12119
60
HERNANDO
12053
27
SUWANNEE
12121
61
HIGHLANDS
12055
28
TAYLOR
12123
62
HILLSBOROUGH
12057
29
UNION
12125
63
HOLMES
12059
30
VOLUSIA
12127
64
INDIAN RIVER
12061
31
WAKULLA
12129
65
JACKSON
12063
32
WALTON
12131
66
JEFFERSON
12065
33
WASHINGTON
12133
67
LAFAYETTE
12067
34
IN THE CIRCUIT COURT OF THE _____________________ JUDICIAL CIRCUIT,
IN AND FOR ______________________________ COUNTY, FLORIDA
Case No: ________________________
Division: ________________________
_________________________________,
Petitioner,
and
Respondent.
FLORIDA ADDENDUM TO INCOME WITHHOLDING ORDER
THE PAYOR, {name}__________________________, IS HEREBY NOTIFIED that, under sections 61.13
and 61.1301, Florida Statutes, you have the responsibilities and rights set forth below with regard to the Income Withholding Order/Notice for Support.
1.The Income Withholding Order/Notice for Support is enforceable against employers specifically listed upon the form as well as all subsequent employers/payors of Obligor, {name}____________________________, {address}__________________________________.
2. You are required to dedu t fro the o ligor’s i o e the a ou t spe ified i the i o e withholding order, and in the case of a delinquency the amount specified in the notice of delinquency, and to pay that amount to the State of Florida Disbursement Unit. The amount actually deducted plus all administrative charges shall not be in excess of the amount allowed under section 303(b) of the Consumer Credit Protection Act, 15 U.S.C. Section 1673(b), as amended.
3. You must implement the income deduction no later than the first payment date which occurs more
than 14 days after the date the income deduction order was served on you, and you shall conform the a ou t spe ified i the i o e ithholdi g order to the o ligor’s pay y le. The ourt should
request at the time of the order that the payment cycle will reflect that of the obligor.
4. You must forward, within 2 days after each date the obligor is entitled to payment from you, to the
“tate of Florida Dis urse e t U it, the a ou t dedu ted fro the o ligor’s i o e, a state e t as to whether the amount totally or partially satisfies the periodic amount specified in the income withholding order, and the specific date each deduction is made. If the IV-D agency is enforcing the order, you shall make these notifications to the agency.
5. If you fail to dedu t the proper a ou t fro the o ligor’s i o e, you are lia le for the a ou t you should have deducted, plus costs, interest, and reasonable attorneys’ fees.
Florida Family Law Rules of Procedure Form 12.996(d), Florida Addendum to Income Withholding Order (07/13)
6. You ay olle t up to $5 agai st the o ligor’s i o e to rei urse you for the administrative costs for the first income deduction and up to $2 for each deduction thereafter.
7.The Income Withholding Order/Notice for Support is binding on you until further notice by court order or until you no longer provide income to the obligor.
8.When you no longer provide income to the obligor, you shall notify the obligee,
{name}_________________________, {address}__________________________________________,
a d pro ide the o ligor’s last k o address a d the a e a d address of the o ligor’s ew payor, if known, utilizing the form contained within the Income Withholding Order/Notice for Support. If you violate this provision, you are subject to a civil penalty not to exceed $250 for the first violation or $500 for any subsequent violation. If the IV-D agency is enforcing the order, you shall make these notifications to the agency instead of the obligee. Penalties shall be paid to the obligee or the IV-D agency, whichever is enforcing the income deduction order.
9.You shall not discharge, refuse to employ, or take disciplinary action against an obligor because of the requirement for income deduction. A violation of this provision subjects you to a civil penalty not to exceed $250 for the first violation or $500 for any subsequent violation. Penalties shall be paid to the obligee or the IV-D agency, whichever is enforcing the income deduction, if any alimony or child support obligation is owing. If no alimony or child support obligation is owing, the penalty shall be paid to the obligor.
10.The obligor may bring a civil action in the courts of this state against a payor who refuses to employ,
discharges, or otherwise disciplines an obligor because of income deduction. The obligor is entitled to reinstatement of all wages and benefits lost, plus reasonable attorneys’ fees and costs incurred.
11.In a Title IV-D case, if an obligation to pay current support is reduced or terminated due to the emancipation of a child and the obligor owes an arrearage, retroactive support, delinquency, or costs, income deduction continues at the rate in effect immediately prior to emancipation until all arrearages, retroactive support, delinquencies, and costs are paid in full or until the amount of withholding is modified.
12.All notices to the obligee shall be sent to the address provided in this notice to payor, or any place thereafter the obligee requests in writing.
13.An employer who employed 10 or more employees in any quarter during the preceding state fiscal year or who was subject to and paid tax to the Department of Revenue in an amount of $20,000 or more shall remit support payments deducted pursuant to an income deduction order or income deduction notice and provide associated case data to the State Disbursement Unit by electronic
means approved by the department. Payors who are required to remit support payments
ele tro i ally a fi d ore i for
atio
o
ho
to do so y a essi g the “tate Dis urse e t U it’s
website at www.floridasdu.com a
d li
ki
g o
Pay e ts. Pay ent options include Expert Pay,
Automated Clearing House (ACH) credit through your financial institution, www.myfloridacounty.com , or Western Union. Payors may contact the SDU Customer Service Employer telephone line at 1-888-883-0743.
14.The amount of arrears owed, if any, is $____________. You must withhold an additional twenty
percent (20%) or more of the ongoing periodic obligation towards same at the rate of $________
per ____________ until full payment is made of any arrearage, attorneys’ fees and costs—provided that no deduction shall be applied to attorneys’ fees and costs until the full amount of any arrearage is paid. If a delinquency accrues after the order establishing, modifying, or enforcing support has been entered and there is no existing order for repayment of the delinquency or a pre-existing arrearage, a payor shall deduct $________per _____________ (which represents an additional
twenty percent (20%) of the current support obligation, or other amount agreed to by the parties) until the delinquency and any attorneys’ fees and costs are paid in full. No deduction may be applied to attorneys’ fees and costs until the delinquency is paid in full.
15.Pursuant to sections 61.13 and 61.1301, Florida Statutes, the amounts listed for payment on the Income Withholding Order must be varied by the employer/payor for bonus income, or similar one- time payment:
You shall deduct [Choose only ONE] ( ) the full amount, ( ) _______%, or ( ) none of the
income which is payable to the obligor in the form of a bonus or other similar one-time payment, up to the amount of arrearage reported in the Income Deduction Order or the
remaining balance thereof, and forward the payment to the State of Florida Disbursement Unit. For purposes of this subparagraph, o us ea s a pay e t i additio to a o ligor’s usual
compensation and which is in addition to any amounts contracted for or otherwise legally due and shall not include any commission payments due an obligor.
16.Child Support Reduction/Termination Schedule. Child support amount listed on the IWO shall be automatically reduced or terminated as set forth in the following schedule:
Please list
Insert in this
Insert in
children
column the
this column
by initials
day, month,
the amount
from eldest to
and year the
of child
youngest
child support
support for
obligation
all minor
terminates for
each
remaining
designated
(including
child (see
instructions)
child).
Child 1
From the effective
child support for Child 1 and
(Eldest)
date of this Income
all other younger child(ren)
Initials & year
Deduction Order
should be paid in the
of birth:
UNTIL the following
following monthly amount:
date:
Child 2
After the date set
child support for Child 2 and
forth in the row
above until the
following date:
Child 3
child support for Child 3 and
Child 4
child support for Child 4 and
Child 5
child support for Child 5 and
(Continue on additional pages for additional children)
NOTE: This change only relates to the amount of the child support obligation portion of the payments listed in the first page of the Income Withholding Order. If there is a child support arrearage in a Title IV-D case, the amount will not be reduced due to the child no longer being eligible for support pursuant to paragraph 11 above.
17.Additional information regarding the implementation of income deduction may be found at www.floridasdu.com.
IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW [fill in all blanks] This form was prepared for the: {choose only ONE} ( ) Petitioner ( ) Respondent This form was completed with the assistance of:
{name of individual}_____________________________________________________________,
{name of business}_______________________________________________________________,
{address}_______________________________________________________________________,
{city}_____________________, {state}________, {telephone number}______________________.
Completing the Florida Addendum to Income form is an essential step in ensuring compliance with court-ordered income deductions for support payments. Following the instructions carefully will help you navigate the process smoothly. Once you have filled out the form, you will need to take additional steps to ensure it is properly filed and served.
The Florida Addendum to Income Withholding Order serves as an essential document when a court mandates that child or spousal support be paid through income deduction. This form complements the OMB Form 0970-0154, which is the standard Income Withholding for Support form. By including this addendum, specific provisions required by Florida law are fulfilled, ensuring that the income deduction process is legally compliant and clearly communicated to all parties involved.
To complete the Florida Addendum to Income Withholding Order, it is important to type or print the form in black ink. After filling it out, attach it to the OMB Income Withholding for Support form. This combined document must then be filed with the clerk of the circuit court in the county where your case is being heard. Following this, a copy of both forms, signed by the judge, should be sent to the obligor’s payor via certified mail. Remember to keep the return receipt, as it needs to be filed with the court along with the Notice of Filing Return Receipt.
The payor, typically the employer, has several responsibilities once they receive the Income Withholding Order. They must:
Failure to comply can lead to legal liabilities, including costs and penalties.
If the payor does not deduct the correct amount from the obligor’s income, they may be held liable for the amount that should have been deducted. This liability can include additional costs, interest, and reasonable attorneys' fees. It is crucial for payors to adhere strictly to the amounts specified in the Income Withholding Order to avoid such penalties.
For additional information, individuals are encouraged to read the General Information for Self-Represented Litigants section found at the beginning of the forms. This section provides definitions and explanations of terms used in the instructions. Furthermore, sections 61.13 and 61.1301 of the Florida Statutes offer more detailed legal context regarding income withholding orders and obligations related to child and spousal support.
Incomplete Information: Failing to fill in all required fields can lead to delays. Ensure every section is completed accurately.
Incorrect County Code: Using the wrong county code can invalidate the form. Double-check the list of county codes to ensure accuracy.
Missing FIPS Code: Forgetting to include the FIPS code can cause issues. This code is essential for proper identification of the case.
Not Sending Copies: Failing to send copies of the form and the OMB form to the obligor’s payor can result in non-compliance. Always send these documents via certified mail.
Ignoring Signature Requirements: Not having the judge’s signature on the OMB form can render the entire process ineffective. Ensure all necessary signatures are present.
Improper Deduction Amounts: Incorrectly calculating the amount to be deducted can lead to financial penalties. Review the calculations thoroughly before submission.
Neglecting to Notify Changes: Failing to inform the obligee about changes in employment or income can lead to civil penalties. Always keep communication open and up-to-date.
The Florida Addendum To Income form is a crucial document used in cases involving income deduction for support payments. It ensures compliance with state laws and provides necessary provisions for the enforcement of income withholding orders. Along with this form, several other documents may be required to facilitate the process of income withholding. Below is a list of these documents, along with a brief description of each.
These documents work together to ensure that income withholding orders are implemented correctly and in accordance with Florida law. Understanding each document's purpose can help streamline the process and ensure compliance with court orders.
The Florida Child Support Guidelines Worksheet is a document used to calculate child support obligations in Florida. Similar to the Florida Addendum to Income form, this worksheet provides a structured format for determining the amount of support owed based on the income of both parents and the needs of the child. It ensures that all relevant financial information is considered, including income, expenses, and the number of children involved. This document is essential in family law cases where child support needs to be established or modified.
The Florida Parenting Plan is another important document related to child support and custody arrangements. It outlines the responsibilities of each parent regarding the care and upbringing of their children. Like the Florida Addendum to Income form, the Parenting Plan must be approved by the court and takes into account the best interests of the child. It includes provisions for time-sharing, decision-making, and financial responsibilities, ensuring that both parents are aware of their obligations.
The Income Withholding Order (IWO) is a legal document that directs an employer to withhold a portion of an employee's wages for child support payments. This document is similar to the Florida Addendum to Income form in that it is a necessary step for enforcing child support obligations through income deduction. Both documents work together to ensure that payments are made consistently and in accordance with court orders, thus protecting the financial interests of the child.
The Notice of Filing Return Receipt is another relevant document, which is used to confirm that the obligor has received the income withholding order. This notice is similar to the Florida Addendum to Income form in that it serves to document compliance with court procedures. It ensures that all parties are informed and that there is a clear record of communication regarding support payments.
The Disclosure from Nonlawyer form is required when a nonlawyer assists an individual in completing legal forms. This document is similar to the Florida Addendum to Income form as it ensures transparency and compliance with legal standards. It protects the rights of the individual receiving assistance and ensures that they are fully informed of the help they are receiving, much like the instructions provided with the Addendum.
The Petition for Modification of Child Support is a legal request to change an existing child support order. This document shares similarities with the Florida Addendum to Income form as both require detailed financial information to assess the current situation. A petition for modification must demonstrate a significant change in circumstances, such as changes in income or employment, which may also be addressed in the Addendum when determining the appropriate amount of withholding.
The Affidavit of Financial Status is a sworn statement that provides a comprehensive overview of an individual's financial situation. This document is comparable to the Florida Addendum to Income form because it requires the disclosure of income, expenses, and assets. Both documents are critical in family law cases, as they provide the court with the necessary information to make informed decisions regarding support obligations.
The Request for Hearing on Child Support is a document filed to seek a court hearing regarding child support issues. Similar to the Florida Addendum to Income form, this request is part of the legal process to ensure that child support obligations are enforced or modified as necessary. It highlights the importance of judicial oversight in maintaining fair and equitable support arrangements for children.
When filling out the Florida Addendum to Income form, there are important guidelines to follow. Here is a list of things you should and shouldn’t do:
Understanding the Florida Addendum to Income form can be challenging, and there are several misconceptions that often arise. Here are five common misunderstandings:
Many people believe that the Florida Addendum to Income form is optional. In reality, it is a necessary part of the income deduction process mandated by the court. If the court orders support to be paid through income deduction, this form must be included.
Another common belief is that the form can be filled out in any color of ink. However, it must be typed or printed in black ink to ensure clarity and compliance with court requirements.
Some people think that the payor can disregard the income withholding order if they choose. This is not true. The income withholding order is legally binding, and the payor is obligated to comply with its terms.
It is a common misconception that only attorneys can assist in filling out the Florida Addendum to Income form. In fact, nonlawyers can help, but they must provide a Disclosure from Nonlawyer and include their contact information on the form.
Some individuals believe that sending the form to the payor does not require a return receipt. However, it is essential to send it via certified mail with a return receipt requested to ensure proper documentation of delivery.
The Florida Addendum To Income form is essential when the court mandates income deduction for support payments.
This form must accompany the OMB Form 0970-0154, which is the Income Withholding for Support form.
Always type or print the form using black ink for clarity and legibility.
After completing the form, it should be filed with the clerk of the circuit court in the appropriate county.
Send a signed copy of the completed form and the OMB form to the obligor’s payor via certified mail, requesting a return receipt.
Familiarize yourself with the county and FIPS codes, as they are necessary for accurately completing the form.
If you receive help from a nonlawyer in filling out the forms, ensure they provide a Disclosure from Nonlawyer.
Employers must comply with the income withholding order, including timely deductions and notifications to the State Disbursement Unit.