Form 6-1-2 (Ag) - Income & Expense Form - Family Maintenance Enforcement Program (Page 3 of 3) in pdf

FAMILY MAINTENANCE ENFORCEMENT PROGRAM

PAYMENT PROPOSAL FORM

Name:

_____________________________________________

FMEP Case #:

______________

A voluntary payment arrangement is a plan – developed in cooperation between you and the FMEP –

for you to pay the arrears in addition to making your ongoing maintenance payments.

To set up a payment arrangement:

1. Complete the Income & Expense Form.

2. Attach copies of your:

last 3 pay stubs if you are employed or;

last 3 income stubs if you receive pension or disability benefits or;

last 3 bank statements if you are self-employed;

and your most recent income tax return.

3. Complete the section below:

Write down what you see as a reasonable payment amount, how often it will be paid

(monthly, biweekly etc.) and when the payments are to start. The amount must be

enough to cover both your ongoing maintenance and to reduce the arrears in a

reasonable amount of time.

Choose how to send your payments:

o through Online, Telephone or ABM Banking. This method allows you to either send

individual payments, or set up payments to be automatically sent on a regular basis.

You set this up through your financial institution - the payee name is ‘Family

Maintenance Enf (BC)’ and your personalized FMEP account number is your case

number the first four letters of your last name, or;

a series of post-dated cheques made payable to recipient with your case number on

the cheques.

4. Mail or fax your completed forms with the other documents requested to the FMEP office

handling your case:

Box 80449

Box 830

Box 5100

Burnaby BC V5H 3X9

Kamloops BC V2C 5N1

Victoria BC V8R 6N3

Fax (604) 678-5679

Fax (250) 434-6033

Fax (250) 220-4050

Your proposed payment must be enough to cover both your ongoing maintenance and to

reduce your arrears in a reasonable amount of time.

I agree to pay $ ________________ per _______________

(weekly, bi-weekly, semi-monthly or monthly)

The first payment will start on _______________________________

Day

Month

Year

I will send payments by:

PC/Telephone Banking

Post-Dated Cheques

Other ________________

_______________________________________________________

_________________________________

Signature

Date

We will review your payment proposal and let you know as soon as possible whether it is acceptable.

The information on this form is collected pursuant to the Family Maintenance Enforcement Act for the purpose of monitoring and enforcing

your maintenance order or agreement. To obtain information about privacy protection, contact the FMEP office handling your case.

6-1-2 (AG)

Aug 2007

Form 6-1-2 (Ag) - Income & Expense Form - Family Maintenance Enforcement Program Page 3

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