
State of Alabama
Unified Judicial System
SAMPLE
Form CS-22 Page 1 of 2 Rev. 03/ 01
WITHHOLDING ORDER
PAYMENT OF CHILD SUPPORT
Case Number
IN THE _______ _______ _______ _______ _______ _ COU RT O F ______ _______ _______ _______ ______, AL ABAMA
(Circuit or D istrict) (Name of County)
________________________________________________ v. __________________________________________________________
Plaintiff Defendant
______________________________________________________ ___________________________________________________
Obligor (Employee) Obligor’s Employer
______________________________________________________ ________________________________________________
Obligor’s Social Security Number * Employer’s Address
____________________________________________________
City State Zip Code
This Withholding Order for payment of child support is entered pursuant to the provisions of §30-3-61 or §30-3-62 or §25-4-152, Ala.
Code 1975.
It is therefore ORDERED by this Court as follows:
1. ____________________________________________________________________________ is ordered to pay the sum of:
(Name of Obligor)
$ ____________________ per ___________________ as current continuing child support; and
$ ____________________ per ___________________ toward the total arrearage of $ __________________.
Arrears 12 weeks or greater? G yes G no
2. The obligor’s present employer or any future employer or the Department of Industrial Relations is hereby ordered to withhold from
income/benefits due or to become due the obligor:
$ ______________________ per ____________________ for current continuing child support;
$ ______________________ per ____________________ for arrearages
$ ______________________ per ____________________ TOTAL.
THE TOTAL AMOUNT TO BE WITHHELD SHALL NOT EXCEED __________ % OF OBLIGOR’S DISPOSABLE EARNINGS/
BENEFITS. Should the total amount ordered withheld exceed the percentage of the defendant’s disposable earnings/benefits, the
priority of withholdings is as follows: Any federal tax lien, any child support income withholding order by earliest date of service; and
any garnishment by earliest date of service.
3. The employer/Department of Industrial Relations shall pay the total amount deducted to the Alabama Child Support Payment
Center, P. O. Box 244015, Montgomery, Alabama 36124-4015, within seven (7) days of the date the obligor is paid the paycheck
from which the support is withheld. If the obligor/employee’s pay periods are at intervals which are more frequent than once each
month, the employer may withhold at each pay period an amount cumulatively sufficient to equal the total monthly support
obligation.
4. When the total arrearage(s) have been withheld and remitted to the Alabama Child Support Payment Center, DEDUCT
ONLY CURRENT, CONTINUING SUPPORT until further instructed by this Court.
5. This Order shall be binding upon the obligor’s employer/any successor employers/Department of Industrial Relations fourteen (14)
days after service pursuant to the Alabama Rules of Civil Procedure and shall remain effective until further order of the Court.
6. A copy of this Order shall:
G Be served immed iately upon the obligor’s em ployer/Depart ment of Indust rial Relation s by G personal service or by G certified
mail.
G Remain in the Court’s file until such time as an affidavit may be made by the obligee or obligor for service of such order.
*The disclosure of your social security number is mandatory. It is based on Section 466(a)(13) of the Social Security Act [42 U.S.C. 666(a)(13)],
and it will be used under the state’s child support enforcement program to locate individuals for purposes of establishing paternity and
establishing, modifying, and enforcing support obligations.
Court Record – White Plaintiff – Green Defendant – Yellow