Income Withholding Order Form for Child Support and Combined Child and Spousal Support - LDSS-5037 (Non-IV-D IWO)
Important Note
This is the actual form. Use the LDSS-5039 as a guide when filling it out.
If a party is to receive child support only, or combined child support and maintenance (spousal support), and no child support services are already being provided through a local district Support Collection Unit, the party or the 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.
The person making the payment is the employee/obligor (or debtor). The person receiving the payment is the custodial party/obligee (or creditor).
Instructions
Follow the instructions in LDSS-5039, including the numbered instructions for IWO Form LDSS-5037.