Florida Addendum To Income Withholding Order - Florida Circuit Court
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6INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF
PROCEDURE FORM 12.996(d), FLORIDA ADDENDUM TO
INCOME WITHHOLDING ORDER (07/13)
When should this form be used?
This form should be used when the court has ordered that support be paid by income deduction and
OMB Form 0970-0154, Income Withholding for Support, has been used. This form must be added to the
OMB form to provide provisions required for income deduction orders by Florida law.
This form should be typed or printed in black ink. It should be attached to the OMB form and filed with
the clerk of the circuit court in the county in which your action is pending.
What should I do next?
A copy of this form and a copy of the OMB Income Withholding for Support form, signed by the judge,
should be sent to the obligor’s payor by certified mail, return receipt requested. The return receipt
should be sent to the person who prepared this form, so that it can be filed with the court with Florida
Family Law Rules of Procedure Form 12.996(c), Notice of Filing Return Receipt.
Where can I look for more information?
Before proceeding, you should read “General Information for Self-Represented Litigants” found at the
beginning of these forms. The words that are in “bold underline” in these instructions are defined
there. For further information see sections 61.13 and 61.1301, Florida Statutes.
Special Instructions...
When filling out an Income Withholding for Support form, please note the following additional
instructions for that form:
1. The Remittance Identifier is the County Code for the county the case was heard in followed
by the Case Number. A list of county codes is included with these instructions.
2. The FIPS code may be found on the attached list. Use the code for the County in which the
case is pending.
Remember, a person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out
these forms, that person must give you a copy of a Disclosure from Nonlawyer, Florida Family Law Rules
of Procedure Form 12.900(a), before he or she helps you. A nonlawyer helping you fill out these forms
Instructions for Florida Family Law Rules of Procedure Form 12.996(d), Florida Addendum to Income Withholding
Order (07/13)
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