Form 4-6 - Temporary Order Of Support (And Referral To Support Magistrate) (Page 2 of 9) in pdf

Form 4-6 - Temporary Order Of Support (And Referral To Support Magistrate) Page 2

Form 4-6 Page 2

SERVICE, OR IF THE ORDER WAS RECEIVED BY MAIL, WITHIN 35 DAYS OF THE

MAILING OF THE ORDER.

The above-named Petitioner having filed a petition in this Court, dated

alleging that the above-named Respondent is chargeable with the support of

, (and)

; and

Respondent having appeared before this Court to answer the petition and to show why an

order of support and other relief requested in the petition should not be granted, and having been

advised by the Court of the right to counsel, and Respondent having Q denied Q admitted the

allegations of the petition; and

The name, address and telephone number of Respondent’s current employer(s) are:

NAME

ADDRESS

TELEPHONE

NOW, after examination and inquiry into the facts and circumstances of the case and G upon

application of the Petitioner G upon the Court's own motion, it is

ORDERED that the above-named Respondent, upon notice of this order, pay or cause to be

paid to [check applicable box]: G Petitioner G Support Collection Unit at

G weekly G every two weeks G monthly Gtwice per month

, the sum of $

G quarterly, such payments to

commence on

allocated as follows: for and toward the support of

, spouse, the

G weekly G every two weeks G monthly Gtwice per month G quarterly

sum of $

G weekly G every

and for and toward the support of the child(ren), the sum of $

two weeks G monthly Gtwice per month G quarterly:

Name

Las 4 Digists of Soc. Sec. #

Date of Birth

Amount

Spouse:

Child(ren):

Total

and it is further

ORDERED that, pursuant to Domestic Relations Law §236B(1)(a), payments for the

support of the spouse shall terminate upon death of the spouse, upon the spouse’s valid or invalid

marriage or upon modification in accordance with Domestic Relations Law §236B(9) or 248; and it is

further

G ORDERED that commencing on _________________the above-named Respondent,

upon notice of this Order, pay or cause the above amount(s) to be paid to [check applicable box]:

G Petitioner by cash, check or money order.

Form 4-6 - Temporary Order Of Support (And Referral To Support Magistrate) Page 2

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