IWO Form Non-IV-D a for Spousal Support Only               
This is the actual form to be filled out, signed by the Court or counsel or a private entity as Issuer.  It is the same as the form approved by the Office of Management and Budget but has been designed for use in New York State by the NYS Office of Temporary and Disability Assistance.  To make it easier to complete the form, some of the fields have been pre-filled.  While not required, this form is recommended for use in New York State for Spousal Support Only IWO’s.  On IWO Form Non-IV-D a (for Spousal Support Only), areas not applicable to Spousal Support Only have been grayed out.  In addition to graying out fields not applicable to the Spousal Support Only IWO, the other difference is that Spousal Support Only IWOs are payable to the obligee, not the New York State Child Support Processing Center (SDU). The Spousal Support Only IWO order (IWO Form Non-IV-D a) must be served on the employer, employee/obligor, and the obligee. Spousal Support Only IWO orders (IWO Form Non-IV-D a) should NOT be served on the New York State Child Support Processing Center.

When filling out this form, see instructions for the Numbered Reference Copy (IWO Non-IV-D b).  It is for reference only. The reference form is the same as the actual IWO Form above with one important difference: The blanks are numbered and keyed to the instructions below. This reference form should be used as a guide to filling out the actual IWO Form, and is for reference only.

Important Note: The NYS Office of Temporary and Disability Assistance advises that the Federal Office of Child Support Enforcement has confirmed that if the IWO is issued by a Court, a copy of the underlying order need not be attached to the IWO even in instances where the IWO is served by a litigant or his/her representative acting on the Court’s instructions. See Field 1(f) on the first page of the IWO and Fields 26-29 on the second page of the IWO which identify the Issuer.    If you have continuing questions about this instruction, you may contact the New York State Child Support Customer Service Helpline at  1-888-208-4485 (TTY: 1-866-875-9975) Monday through Friday 8:00 a.m.  -  7:00 p.m.