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MC:NM0402E
Bar Code Area 125193918
FS#: 125193918
Central File Maintenance
P.O. Box 12048
AUSTIN, TX 78711-2048
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GREG ABBOTT
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100 N HOUSTON ST Date: 08/20/04
Custodial Parent: CINDY PUGA
FORT WORTH, TX 76196 Non-Custodial Parent: JAVIER PUGA
Attorney General Case #: 0009519259
Cause#: 231-331746-02
Dear THOMAS A. WILDER
Enclosed please find the following documents reguarding the above referenced case:
1. Notice of Administrative Writ of Withholding and;
2. Order/Notice to Withhold Income for Child Support (Administrative Writ of Withholding).
Please file these documents under the above referenced cause number.
Feel free to contact me if you have any questions regarding this matter.
Sincerely,
JENNIFER B. CRAWFORD
CHILD SUPPORT UNIT 0402E
6100 WESTERN PLACE #405
FTWORTH, TX 76107
(817) 731-9811
Enclosures
December 2000 Form3L039
ORDER/NOTICE TO WITHHOLD INCOME FOR CHILD SUPPORT
(ADMINISTRATIVE WRIT OF WITHHOLDING)
0 Original 1tl Amended 0 Termination
State of Texas
Co./City/Dist. of TARRANT COUNTY
Tribunal/Case Number 231-331746-02
Employer's/Withholder's Name Child(ren)'s Name(s) DOB SSN
O'DONNELL'S LANDSCAPE SERVICES
CASANDRA MARIE PUGA 02/02/00 631-70-1849
Employer's/Withholder's Address
2140 E SOUTHLAKE BLVD
STEL607
SOUTHLAKE, TX 76092-651665
Employer/Withholder's Federal EIN Number:
RE: PUGA, JAVIER
Employee's/Obligor's Name (Last, First, MI)
Employee's/Obligor's Social Security Number 634-80-2224
Employee's/Obligor's Case Identifier 0009519259
PUGA, CINDY ANN
Obligee Name (Last, First, MI)
If checked, you are required to enroll the child(ren) indentified above in any health insurance coverage available tu the
employee's/obligor's through his/her employment.
ORDER INFORMATION: This Order/Notice is based on the support order from TX.
You are required by law to deduct these amounts from the employee's/obligor's income until further notice.
$ 276.00 monthly current child support
$ 105.00 monthly past-due child support - Arrears 12 weeks or greater? li'1Yes 0 No
$Q.OO monthly current medical support
$ 0.00 monthly past-due medical support
r --
-$-
spousal support
other (specifY).-:--:;----,-.-----
for a total of$
381.00 illoiiiii!y to be forwarded to the payee below.
You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered
payment cycle, withhold one of the following amounts:
$ 87.92 per weekly pay period. $ 190.50 per semimonthly pay period (twice a month).
$ 175.85 per biweekly pay period (every two weeks). $ 381.00 per monthly pay period.
REMITTANCE INFORMATION: When remitting payment, provide the pay date/date of withholding and the case identifier. If
the employee's/obligor's principal place of employment is Texas, begin withholding no later than the first pay period following
the date on which this Order/Notice was delivered to the employer. Send payment on the same day of the pay date/date of
withholding. The total withheld amount, including your fee, cannot exceed 50% of the employee's/obligor's aggregate disposable
weekly earnings. -
If the employee's/obligor's principal place of employment is not Texas, for limitations on withholding, applicable time
requirements, and any allowable employer fees, follow the laws and procedures of the employee's/obligor's principal place of
employment (see #4 and #10, ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS).
If remitting payment by EFT/EDI, call before first submission.Use this FIPS code: - - - - - - - -
Bank routing code: Bank account number:------
Make check payable to (Payee and Case Identifier): Send check to: TX CHILD SUPPORT SDU
P 0 BOX 659791
OFFICE OF THE ATTORNEY GENERAL
AG Case# 0009519259
Cause# 231-331746-02 SAN ANTONIO TX 78265-9791
PIN#
Authorized by /J-f/ #'7f--- Print Name and Title: Richard C. Hoffman .. . Date: 08/19/2004
Deputy Attorney General for Farmhes and Chtldren
IMPORTANT: The person completing this form is advised that the information on this form may be shared with the obligor.
OMB: 0970-0154
June 2004 Fonn3NOOI
ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS
If checked, you are required to provide a copy of this form to your employee. If your employee works in a state that is
0 different from the state that issued this order, a copy must be provided to your employee even if the box is not checked.
1. We appreciate the voluntary compliance of Federally recognized Indian tribes, tribally-owned businesses, and Indian-owned
businesses located on a reservation that choose to withhold in accordance with this notice.
2. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same
income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect, please
contact the State Child Support Enforcement Agency or party listed in number 12 below. '
3. Combining Payments: You can combine withheld amounts from more than one employee's/obligor's income in a single
payment to each agency/party requesting withholding. You must, however, separately identify the portion ofthe
single payment that is attributable to each employee/obligor.
4. Reporting the Paydate/Date of Withholding: You must report the paydate/date of withholding when sending the payment. The
paydate/date of withholding is the date on which the amount was withheld from the employee's wages. You must comply with
the law of the state of employee's/obligor's principal place of employment with respect to the time periods within which you
must implement the withholding order and forward the support payments.
5. Employee/Obligor with Multiple Support Withholdings. If there is more than one Order/Notice to Withhold Income for Child
Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State
withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor
all Order/Notices to the greatest extent possible. (See #10 below.)
6. Termination Notification: You, O'DONNELL'S LANDSCAPE SERVICES must promptly notify the Child Support
Enforcement Agency or payee when the employee/obligor no longer works for you. Please provide the information
requested and return a complete copy of this order/notice to the Child Support Enforcement Agency or payee.
EMPLOYEE'S/OBLIGOR'S NAME: JAVIER PUGA CASE IDENTIFIER: AG.No. 0009519259
DATE OF SEPARATION FROM E M P L O Y M E N T : - - - - - - - - - - - - - - - - - - - - - -
LAST KNOWN HOME A D D R E S S : - - - - - - - - - - - - - - - - - - - - - - - - - - -
NEW EMPLOYER/ADDRESS: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _~------
7. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions,
or severance pay. If you have any questions about lump sum payments, contact the person or authority below.
8. Liability: If you have any doubts about the validity of the Order/Notice, contact the agency or person listed below. If you fail
to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld
from the employee's/obligor's income and any other penalties set by State law.
9. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from
employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a child support
withholding.
10. Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit
Protection Act(15 U.S.C. § 1673(b)); 2) the amounts allowed by the State of the employee's/obligor's principal place of
employment. The Federal limit applies to the aggregate disposable weekly earnings(AD WE). ADWE is the net income left
after making mandatory deductions such as: State,Federal,local taxes, Social Security taxes,statutory pension
contribution, and Medicare taxes.
Additional Information:
11. Submitted by JENNIFER B. CRAWFORD
Office of the Attorney General
CHILD SUPPORT UNIT 0402E
6100 WESTERN PLACE #405
FTWORTH, TX76107
12. If you or your employee/obligor have any questions, contact: JENNIFER B. CRAWFORD
by telephone at (817) 731-9811or by FAX at (817) 731-9239
or by Internet_______________________________________________________________
IMPORTANT: The person completing this form is advised that the information on this form may be shared with the obligor.
OMB: 0970-0154
November 2001 Form3NOOI
NCP Name: JAVIER PUGA
CP Name: CINDY ANN PUGA
OAG Number: 0009519259
CAUSE NUMBER 231-331746-02
IN THE INTEREST OF § IN THE 231ST DISTRICT COURT
§
CASANDRA MARIE PUGA §
§ OF
§
§
§ TARRANT COUNTY , TEXAS
§
NOTICE OF ADMINISTRATIVE WRIT OF WITHHOLDING
JAVIER PUGA, Obligor, is hereby given notice pursuant to Texas Family Code Chapter 158, Subchapter F, that his
employer is immediately required to withhold the amounts specified below for payment of his current support and periodic
medical support obligation, and for any overdue support arrearage, as follows:
OBLIGOR: JAVIER PUGA OBLIGEE: CINDY ANN PUGA
SSN: 634-80-2224 SSN: 454-57-2778
Obligor's Employer: O'DONNELL'S LANDSCAPE SERVICES
2140 E SOUTHLAKE BLVD
STEL607
SOUTHLAKE, TX 76092-651665
CHILDREN
Name Sex DOB SSN DL# Birthplace
CASANDRA MARIE PUGA F 02/02/00 631-70-1849 N/A FTWORTH TX
Current Support Due: $ 276.00 monthly
Periodic Medical Support Due:$ 0.00 monthly
Total Arrearage, including
$ 164.04 accrued interest: $ 5,048.59
As of: 08/19/2004
Amounts to be withheld from Obligor's wages upon service of Writ:
On Current Support:$ 276.00 monthly
On Periodic Medical Support: $ 0.00 monthly
On Arrearage Owed:$ 105.00 monthly
NOTICE OF ADMINJSTRATNE WRIT OF WITHHOLDING Page I
March 2001 Fonn3WOOI
RIGHTS AND PROCEDURES
Attached to this notice is a copy of the Administrative Writ of Withholding issued in this matter.
JAVIER PUGA, may contest withholding on the grounds that the identity of the Obligor or the existence or amount of
arrearages is incorrect by requesting a review by the Title IV-D agency, by telephonic conference or in person, at the
telephone number and address below:
(817) 731-9811
The Office of the Attorney General
CHILD SUPPORT UNIT 0402E
6100 WESTERN PLACE #405
FTWORTH, TX 76107
After a review, the Title IV-D agency may continue the attached writ in effect or may issue a new administrative writ
modifying the amount to be withheld or terminating withholding.
If a review fails to resolve any issue in dispute, the obligor may file a motion with the court to withdraw the
administrative writ and request a hearing with the court not later than the 30th day after receiving notice of the agency's
determination. Income withholding may not be interrupted pending a hearing by the court.
Should a Motion to Withdraw be filed, and a hearing conducted, the court will be requested to confirm all arrearage
amounts then due.
If this is a reissuance of an existing withholding order on file with the court of continuing jurisdiction and the amount to
be withheld for an arrearage is not being adjusted, pursuant to Texas Family Code § 158.502, the preceding right and
procedures regarding contests, reviews and judicial intervention into this administrative withholding process do not apply.
JENNIFER B. CRAWFORD
Child Support Officer
Child Support Division
CHILD SUPPORT UNIT 0402E
6100 WESTERN PLACE #405
FTWORTH, TX 76107
Telephone No. (817) 731-9811
Fax No. (817) 731-9239
CERTIFICATE OF NOTICE
I certify a copy of this Notice of Administrative Writ of Withholding was mailed by first class to Obligor and Obligee on
08/20/04 pursuant to Texas Family Code §158.505.
Richard C. Hoffman
Deputy Attorney General for Families and Children
NOTICE OF ADMINISTRATIVE WRIT OF WITHHOLDING Page2
June 2004 Fonn3WOOI