On August 11, 2017 a
ORDER/NOTICE TO WITHHOLD INCOME FOR C/S (CC:C/S)
was filed
involving a dispute between
and
for MODIFICATION-CUSTODY
in the District Court of Tarrant County.
Preview
233-623981-17
FILED
INCOME WITHHOLDING FOR SUPPORT TARRANT COUNTY
1/4/2018 2:46 PM
THOMAS A. WILDER
IB] INCOME WITHHOLDING ORDER/NOTICE FOR SUPPORT (IWO) DISTRICT CLERK
D AMENDED IWO
D ONE-TIME ORDER/NOTICE FOR LUMP SUM PAYMENT
D TERMINATION OF IWO Date: December 4, 2017
IBJ Child Support Enforcement (CSE) Agency D Court D Attorney D Private Individual/Entity (Check One)
NOTE: This IWO must be regular on its face. Under certain circumstances you must reject this IWO and return It to the
sender (see IWO instructions www.acf.hhs.gov/css/resource/income-wlthholding-for-support-instructions). If you receive this
document from someone other than a state or tribal CSE agency or a court, a copy of the under1ying support on:ler must be
attached.
...x,. a. ,s________
StatefTribefTerritory T...:e Remittance ID (include w/payment) - - - - - - - - - - -
Clty/County/Dist.fTribe Tarrant On:ler ID 233-623981-17
Private Individual/Entity Case ID --------------------
Oocar Electric Delivery I IC RE: PAI QMTNQS, TSMAEI Q
Employer/Income Withholders Name Employee/Obligors Name (Last, First, Middle)
11S West 7th Street
Employer/Income Withholders Address Employee/Obligors Social Security Number
Fort Worth, TX 76012
Employee/Obligors Date of Birth
PALOMINOS SONIA
Custodial Party/Obligee's Name (Last, First, Middle)
Employer/Income Withholders FEIN 75-2967830
Child(ren)'s Name(s) (Last, First, Middle) Child(ren)'s Birth Date(s)
PALOMINOS. ALEXA N 08/25/2015
ORDER INFORMATION: This document is based on the support on:ler from Texas (StatefTribe).
You are required by law to deduct these amounts from the employee/obligors income until further notice.
$ J 47 5 00 Per month current child support
$ ' Per past-due child support - Arrears greater than 12 weeks? D Yes D No
$ Per current cash medical support
$ Per past-due cash medical support
$ Per current spousal support
$ Per past-due spousal support
$ Per other (must specify) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
for a Total Amount to Withhold of$ 1,475 00 per month
AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Order Information. If
your pay cycle does not match the ordered payment cycle, withhold one of the following amounts:
$ 340 3 g per weekly pay period $ 737 50 per semimonthly pay period (twice a month)
$ 680 77per biweekly pay period (every two weeks)$ ..l..475 00 per monthly pay period
$ Lump Sum Payment: Do not stop any existing IWO unless you receive a termination on:ler.
Document Tracking ID _ _ _ _ _ _ _ _ _ _ _ __
Income \Mthholding for Support (IWO) OMS 0970-0154 Expiration Date: 08/31'2020 Page 1 of 4
Employer's Name:oncor Electric Delivery I ,I C Employer FEIN:
-------
Employee/Obliger's Name:pALOMINOS ISMAEL O SSN:
----------
Case Identifier: Order Identifier.
------------~ -------------------
REMITTANCE INFORMATION: If the employee/obligors principal place of employment is_,T.,,e..,x.,,as,__ _ _ _ _ __
(StatefTribe), you must begin withholding no later than the first pay period that occurs days after the date
of . Send payment wtthin _2_ business days of the pay date. If you cannot wtthhold the full amount of
support for any or all orders for this employee/obliger, wtthhold __ % of disposable income for all orders. If the obliger is
a non-employee, obtain wtthholding limtts from Supplemental Information. If the employee/obligors principal place of
employment is not (StatefTribe), obtain wtthholding limttations, time requirements,
and any allowable employer fees from the jurisdiction of the employee/obligors principal place of employment. State-
specfic withholding limtt information is available at www.acf.hhs.gov/css/resourcelstate-income-wtthholding-contacts-and-
program-requirements. For tribe-specific contacts, payment addresses, and withholding limitations, please contact the
tribe at www.acf.hhs.gov/sitesldefault/fileslprograms/cssltribal agency contacts printable pdf.pdf or
https://www.bia.gov/tribalmap/DataDotGovSamplesltld map.html.
For electronic payment requirements and centralized payment collection and disbursement facility information [State
Disbursement Unit (SOU)], see www.acf.hhs.gov/css/employers/employer-responsibilities/payments.
Include the Remtttance ID wtth the payment and if necessary this locator code:
Remit payment to Texas State Disbursement Unit (SOU) (SDU!Tribal Order Payee)
at PO Box 659791, San Antonio, Texas 78265-9791 (SOU/Tribal Payee Address)
O Return to Sender (Completed by Employer/Income Withholder). Payment must be directed to an SOU in
accordance with sections 466(b)(5) and (6) of the Social Security Act or Tribal Payee (see Payments to SOU below). If
payment is not directed to an SDU!Tribal Payee or this IWO is not regular on its face, you must check this box and return
the IWO to the sender.
If Required by State or Tribal Law:
Signature of Judge/Issuing Official:
Print Name of Judge/Issuing Official:
=-===;;;:;;;;:~~.:=~;;;;;;=:::~:::::~~=~~=--.=:--------
DIANE HADDOCK , '""'--
Trtle of Judge/Issuing Official: A-s---,-s_-o_(._.--~,'£:,--,=ol.~,=.--..._?c--'sr°'l..._____________
Date of Signature: I ~
If the employee/obliger worl
Document Filed Date
January 22, 2018
Case Filing Date
August 11, 2017
Category
MODIFICATION-CUSTODY
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233-623981-17 FILED INCOME WITHHOLDING FOR SUPPORT TARRANT COUNTY 1/4/2018 2:46 PM THOMAS A. WILDER IB] INCOME WITHHOLDING ORDER/NOTICE FOR SUPPORT (IWO) DISTRICT CLERK D AMENDED IWO D ONE-TIME ORDER/NOTICE FOR LUMP SUM PAYMENT D TERMINATION OF IWO Date: December 4, 2017 IBJ Child Support Enforcement (CSE) Agency D Court D Attorney D Private Individual/Entity (Check One) NOTE: This IWO must be regular on its face. Under certain circumstances you must reject this IWO and return It to the sender (see IWO instructions www.acf.hhs.gov/css/resource/income-wlthholding-for-support-instructions). If you receive this document from someone other than a state or tribal CSE agency or a court, a copy of the under1ying support on:ler must be attached. ...x,. a. ,s________ StatefTribefTerritory T...:e Remittance ID (include w/payment) - - - - - - - - - - - Clty/County/Dist.fTribe Tarrant On:ler ID 233-623981-17 Private Individual/Entity Case ID -------------------- Oocar Electric Delivery I IC RE: PAI QMTNQS, TSMAEI Q Employer/Income Withholders Name Employee/Obligors Name (Last, First, Middle) 11S West 7th Street Employer/Income Withholders Address Employee/Obligors Social Security Number Fort Worth, TX 76012 Employee/Obligors Date of Birth PALOMINOS SONIA Custodial Party/Obligee's Name (Last, First, Middle) Employer/Income Withholders FEIN 75-2967830 Child(ren)'s Name(s) (Last, First, Middle) Child(ren)'s Birth Date(s) PALOMINOS. ALEXA N 08/25/2015 ORDER INFORMATION: This document is based on the support on:ler from Texas (StatefTribe). You are required by law to deduct these amounts from the employee/obligors income until further notice. $ J 47 5 00 Per month current child support $ ' Per past-due child support - Arrears greater than 12 weeks? D Yes D No $ Per current cash medical support $ Per past-due cash medical support $ Per current spousal support $ Per past-due spousal support $ Per other (must specify) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ for a Total Amount to Withhold of$ 1,475 00 per month AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Order Information. If your pay cycle does not match the ordered payment cycle, withhold one of the following amounts: $ 340 3 g per weekly pay period $ 737 50 per semimonthly pay period (twice a month) $ 680 77per biweekly pay period (every two weeks)$ ..l..475 00 per monthly pay period $ Lump Sum Payment: Do not stop any existing IWO unless you receive a termination on:ler. Document Tracking ID _ _ _ _ _ _ _ _ _ _ _ __ Income \Mthholding for Support (IWO) OMS 0970-0154 Expiration Date: 08/31'2020 Page 1 of 4 Employer's Name:oncor Electric Delivery I ,I C Employer FEIN: ------- Employee/Obliger's Name:pALOMINOS ISMAEL O SSN: ---------- Case Identifier: Order Identifier. ------------~ ------------------- REMITTANCE INFORMATION: If the employee/obligors principal place of employment is_,T.,,e..,x.,,as,__ _ _ _ _ __ (StatefTribe), you must begin withholding no later than the first pay period that occurs days after the date of . Send payment wtthin _2_ business days of the pay date. If you cannot wtthhold the full amount of support for any or all orders for this employee/obliger, wtthhold __ % of disposable income for all orders. If the obliger is a non-employee, obtain wtthholding limtts from Supplemental Information. If the employee/obligors principal place of employment is not (StatefTribe), obtain wtthholding limttations, time requirements, and any allowable employer fees from the jurisdiction of the employee/obligors principal place of employment. State- specfic withholding limtt information is available at www.acf.hhs.gov/css/resourcelstate-income-wtthholding-contacts-and- program-requirements. For tribe-specific contacts, payment addresses, and withholding limitations, please contact the tribe at www.acf.hhs.gov/sitesldefault/fileslprograms/cssltribal agency contacts printable pdf.pdf or https://www.bia.gov/tribalmap/DataDotGovSamplesltld map.html. For electronic payment requirements and centralized payment collection and disbursement facility information [State Disbursement Unit (SOU)], see www.acf.hhs.gov/css/employers/employer-responsibilities/payments. Include the Remtttance ID wtth the payment and if necessary this locator code: Remit payment to Texas State Disbursement Unit (SOU) (SDU!Tribal Order Payee) at PO Box 659791, San Antonio, Texas 78265-9791 (SOU/Tribal Payee Address) O Return to Sender (Completed by Employer/Income Withholder). Payment must be directed to an SOU in accordance with sections 466(b)(5) and (6) of the Social Security Act or Tribal Payee (see Payments to SOU below). If payment is not directed to an SDU!Tribal Payee or this IWO is not regular on its face, you must check this box and return the IWO to the sender. If Required by State or Tribal Law: Signature of Judge/Issuing Official: Print Name of Judge/Issuing Official: =-===;;;:;;;;:~~.:=~;;;;;;=:::~:::::~~=~~=--.=:-------- DIANE HADDOCK , '""'-- Trtle of Judge/Issuing Official: A-s---,-s_-o_(._.--~,'£:,--,=ol.~,=.--..._?c--'sr°'l..._____________ Date of Signature: I ~ If the employee/obliger worl