Income Withholding Order form for Child Support and Combined Child and Spousal Support - LDSS-5037 (Non-IV-D IWO)
Important Note: This is the the actual Form - Use the LDSS-5039 as a Guide when filling it out.
If you or your spouse is to receive child support only or combined child support and maintenance (spousal support), and if no child support services are already being provided through a local district Support Collection Unit (see Instructions on page 11 about whether and how to apply for such services), you or your spouse may ask the Court to issue an Income Withholding Order or the Court may decide to issue such an order on its own. In either case, the Income Withholding Order/Notice form is the form promulgated by the NYS Office of Temporary and Disability Assistance pursuant to CPLR §§5241 and 5242 and must be used. No other form of Income Withholding Order can be used. If you are the person making the payment, you are the employee/obligor (or debtor). If you are the person receiving the payment, you are the custodial party/obligee (or creditor).
Follow the instructions in LDSS 5039, including the numbered instructions for IWO Form LDSS-5037.