Order For Distribution Of Temporary Award (Page 2 of 2) in pdf

Order For Distribution Of Temporary Award Page 2

WC(DO) - 379.1 (4-06)

WC CASE NO. (S) __________________

ORDER FOR DISTRIBUTION

State of New Jersey

OF TEMPORARY AWARD

Department of Labor and

__________________________________

(For Child Support)

Workforce Development

Page 2 of 2

Division of Workers Compensation

District Office: _____________________

IT IS ON THIS ___________ DAY OF ____________,______, HEREBY ORDERED THAT

1. The petitioner shall pay $___________ for Child Support arrearage(s), through the ______________

Probation Division. The employer or employer’s insurance carrier shall deduct said payment from the

petitioner’s net proceeds.

2. The employer or employer’s insurance carrier shall contact the _______________ Probation Division prior

to the distribution of proceeds to the petitioner in order to arrange for the satisfaction of the child support

judgment.

3. This order adjudicates the disbursement of net proceeds of the within award as it pertains to satisfaction of

the above referenced child support obligation. All other provisions previously entered in this or related

matters shall remain in full force and effect until further order of the court.

4. Periodic indemnity benefits due and owing from the date of the execution of the within order are subject to

the appropriate garnishment rate until such time as the child support obligations have been satisfied or

indemnity benefits exhausted. The employer or employer’s carrier shall contact the applicable Probation

Department to verify rates and amounts and shall make payments as appropriate.

5. A copy of this order shall be served upon the ______________ Probation Division by the respondent’s

attorney within 10 days from the execution of this order.

_________________________

________________________________________

Petitioner’s Attorney

Judge of Compensation

Date

__________________________

_________________________________

Petitioner

Name (Print or Type)

____________________________

Respondent’s Attorney

Order For Distribution Of Temporary Award Page 2