Title: - In Re: Amendments To The Florida Family Law Rules Of Procedure Form 12.996(D)

State: florida

Issuer: Florida Supreme Court

Document:

Supreme Court of Florida 
 
 
____________ 
 
No. SC12-618 
____________ 
 
 
IN RE:  AMENDMENTS TO THE FLORIDA FAMILY LAW RULES OF 
PROCEDURE ̶ FORM 12.996(d). 
 
[July 3, 2013] 
 
 
PER CURIAM. 
 
Previously in this case, the Court adopted new form 12.996(d), Florida 
Addendum to Income Withholding Order.  In Re: Amendments to Florida Family 
Law Rules of Procedure—Form 12.996(d), 94 So. 3d 558 (Fla. 2012). 1
                                         
 
1.  We have jurisdiction.  See art. V, § 2(a), Fla. Const. 
  This new 
form is intended to supplement a federally approved income withholding form, 
“Income Withholding for Support,” OMB 0970-0154, in order to comply with 
Florida statutory requirements that the federal form does not satisfy.  Id. at 559.  
After adoption of the form, interested persons were permitted a comment period.  
Id.  Two comments were filed, and the Committee filed its response.    
 
 
- 2 - 
 
Upon consideration of the comments and the Committee’s response, we 
amend the instructions to form 12.996(d) to provide further information to 
attorneys and pro se litigants to assist in filling out the federal form that form 
12.996(d) is meant to accompany.  Specifically, language is added to the 
instructions to explain the terms “Remittance Identifier” and “FIPS code”—terms 
that are used in the federal form—and a list of FIPS and County Codes is added.2
 
The comments filed in this case and the Committee’s response raise multiple 
issues with regard to the usage of the federal form and the Florida forms relating to 
income deduction, and according to the Committee’s response, in some instances,  
certain forms are rejected by some circuit courts.  The issues with regard to the 
usage of the federal form and the Florida forms are beyond the scope of the Court’s 
consideration in this matter, which involves only the adoption of form 12.996(d).  
Accordingly, we refer these issues back to the Committee for further study and 
recommendations.  We also emphasize that all forms adopted by this Court must 
be accepted in all Florida courts.       
 
 
Form 12.996(d), Florida Addendum to Income Withholding Order, is hereby 
amended as reflected in the appendix to this opinion.  The form is fully engrossed 
                                         
 
2.  A typographical error in the note above paragraph 17 of the form is 
corrected.  We decline to amend paragraph 13 of the form as shown in the 
legislative format version of the proposed amendments attached to the 
Committee’s response to the comments.   
 
- 3 - 
and ready for use.  The amended form will also be available on the Florida State 
Courts website at www.flcourts.org/gen_public/family/forms_rules/index.shtml.  
The amendments to the form shall become effective immediately upon release of 
this opinion.  
 
It is so ordered. 
 
POLSTON, C.J., and PARIENTE, LEWIS, QUINCE, CANADY, LABARGA, 
and PERRY, JJ., concur.  
 
 
THE FILING OF A MOTION FOR REHEARING SHALL NOT ALTER THE 
EFFECTIVE DATE OF THESE AMENDMENTS.  
 
Original Proceedings – The Florida Family Law Rules Committee 
 
John F. Harkness, Jr., Executive Director, The Florida Bar, Tallahassee, and 
Matthew Burns Capstraw, Chair, Longwood, Florida,  
 
 
for Petitioner 
 
 
 
 
 
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APPENDIX 
 
Instructions for Florida Family Law Rules of Procedure Form 12.996(d), Florida Addendum to Income Withholding 
Order (07/13) 
 - 5 -  
INSTRUCTIONS 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) 
 - 6 -  
also must put his or her name, address, and telephone number on the bottom of the last page of every 
form he or she helps you complete. 
 
FIPS and County Codes 
 
COUNTY 
ALACHUA 
BAKER 
BAY 
BRADFORD 
BREVARD 
BROWARD 
CALHOUN 
CHARLOTTE 
CITRUS 
CLAY 
COLLIER 
COLUMBIA 
DADE 
DESOTO 
DIXIE 
DUVAL 
ESCAMBIA 
FLAGER 
FRANKLIN 
GADSDEN 
GILCHRIST 
GLADES 
GULF 
HAMILTON 
HARDEE 
HENDRY 
HERNANDO 
HIGHLANDS 
HILLSBOROUGH 
HOLMES 
INDIAN RIVER 
JACKSON 
JEFFERSON 
LAFAYETTE 
 FIPS 
 12001 
 12003 
 12005 
 12007 
 12009 
 12011 
 12013 
 12015 
 12017 
 12019 
 12021 
 12023 
 12025 
 12027 
 12029 
 12031 
 12033 
 12035 
 12037 
 12039 
 12041 
 12043 
 12045 
 12047 
 12049 
 12051 
 12053 
 12055 
 12057 
 12059 
 12061 
 12063 
 12065 
 12067 
COUNTY CODE 
01 
02 
03 
04 
05 
06 
07 
08 
09 
10 
11 
12 
13 
14 
15 
16 
17 
18 
19 
20 
21 
22 
23 
24 
25 
26 
27 
28 
29 
30 
31 
32 
33 
34 
COUNTY 
LAKE 
LEE 
LEON 
LEVY 
LIBERTY 
MADISON 
MANATEE 
MARION 
MARTIN 
MONROE 
NASSAU 
OKALOOSA 
OKEECHOBEE 
ORANGE 
OSCEOLA 
PALM BEACH 
PASCO 
PINELLAS 
POLK 
PUTNAM 
ST. JOHNS 
ST. LUCIE 
SANTA ROSA 
SARASOTA 
SEMINOLE 
SUMTER 
SUWANNEE 
TAYLOR 
UNION 
VOLUSIA 
WAKULLA 
WALTON 
WASHINGTON 
 
FIPS 
12069 
12071 
12073 
12075 
12077 
12079 
12081 
12083 
12085 
12087 
12089 
12091 
12093 
12095 
12097 
12099 
12101 
12103 
12105 
12107 
12109 
12111 
12113 
12115 
12117 
12119 
12121 
12123 
12125 
12127 
12129 
12131 
12133 
 
COUNTY CODE 
35 
36 
37 
38 
39 
40 
41 
42 
43 
44 
45 
46 
47 
48 
49 
50 
51 
52 
53 
54 
55 
56 
57 
58 
59 
60 
61 
62 
63 
64 
65 
66 
67 
Florida Family Law Rules of Procedure Form 12.996(d), Florida Addendum to Income Withholding Order (07/13) 
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IN THE CIRCUIT COURT OF THE _____________________ JUDICIAL CIRCUIT, 
IN AND FOR ______________________________ COUNTY, FLORIDA 
 
 
 
Case No: ________________________ 
 
Division: ________________________ 
 
_________________________________, 
Petitioner, 
and 
 
_________________________________, 
Respondent. 
 
 
FLORIDA ADDENDUM TO INCOME WITHHOLDING ORDER 
 
THE PAYOR, {name}__________________________, IS HEREBY NOTIFIED that, under sections 61.13 
and 61.1301, Florida Statutes, you have the responsibilities and rights set forth below with regard to the 
Income Withholding Order/Notice for Support. 
 
1. The Income Withholding Order/Notice for Support is enforceable against employers specifically 
listed upon the form as well as all subsequent employers/payors of Obligor, 
{name}____________________________, {address}__________________________________. 
 
2. You are required to deduct from the obligor’s income the amount specified in the income 
withholding order, and in the case of a delinquency the amount specified in the notice of 
delinquency, and to pay that amount to the State of Florida Disbursement Unit.  The amount 
actually deducted plus all administrative charges shall not be in excess of the amount allowed under 
section 303(b) of the Consumer Credit Protection Act, 15 U.S.C. Section 1673(b), as amended. 
 
3. You must implement the income deduction no later than the first payment date which occurs more 
than 14 days after the date the income deduction order was served on you, and you shall conform 
the amount specified in the income withholding order to the obligor’s pay cycle.  The court should 
request at the time of the order that the payment cycle will reflect that of the obligor. 
 
4. You must forward, within 2 days after each date the obligor is entitled to payment from you, to the 
State of Florida Disbursement Unit, the amount deducted from the obligor’s income, a statement as 
to whether the amount totally or partially satisfies the periodic amount specified in the income 
withholding order, and the specific date each deduction is made.  If the IV-D agency is enforcing the 
order, you shall make these notifications to the agency. 
 
5. If you fail to deduct the proper amount from the obligor’s income, you are liable for the amount you 
should have deducted, plus costs, interest, and reasonable attorneys’ fees. 
 
6. You may collect up to $5 against the obligor’s income to reimburse you for the administrative costs 
for the first income deduction and up to $2 for each deduction thereafter. 
 
Florida Family Law Rules of Procedure Form 12.996(d), Florida Addendum to Income Withholding Order (07/13) 
 - 8 -  
7. The Income Withholding Order/Notice for Support is binding on you until further notice by court 
order or until you no longer provide income to the obligor. 
 
8. When you no longer provide income to the obligor, you shall notify the obligee, 
{name}_________________________, {address}__________________________________________, 
and provide the obligor’s last known address and the name and address of the obligor’s new payor, 
if known, utilizing the form contained within the Income Withholding Order/Notice for Support.  If 
you violate this provision, you are subject to a civil penalty not to exceed $250 for the first violation 
or $500 for any subsequent violation.  If the IV-D agency is enforcing the order, you shall make these 
notifications to the agency instead of the obligee.  Penalties shall be paid to the obligee or the IV-D 
agency, whichever is enforcing the income deduction order. 
 
9. You shall not discharge, refuse to employ, or take disciplinary action against an obligor because of 
the requirement for income deduction.  A violation of this provision subjects you to a civil penalty 
not to exceed $250 for the first violation or $500 for any subsequent violation.  Penalties shall be 
paid to the obligee or the IV-D agency, whichever is enforcing the income deduction, if any alimony 
or child support obligation is owing.  If no alimony or child support obligation is owing, the penalty 
shall be paid to the obligor. 
 
10. The obligor may bring a civil action in the courts of this state against a payor who refuses to employ, 
discharges, or otherwise disciplines an obligor because of income deduction.  The obligor is entitled 
to reinstatement of all wages and benefits lost, plus reasonable attorneys’ fees and costs incurred. 
 
11. In a Title IV-D case, if an obligation to pay current support is reduced or terminated due to the 
emancipation of a child and the obligor owes an arrearage, retroactive support, delinquency, or 
costs, income deduction continues at the rate in effect immediately prior to emancipation until all 
arrearages, retroactive support, delinquencies, and costs are paid in full or until the amount of 
withholding is modified. 
 
12. All notices to the obligee shall be sent to the address provided in this notice to payor, or any place 
thereafter the obligee requests in writing. 
 
13. An employer who employed 10 or more employees in any quarter during the preceding state fiscal 
year or who was subject to and paid tax to the Department of Revenue in an amount of $20,000 or 
more shall remit support payments deducted pursuant to an income deduction order or income 
deduction notice and provide associated case data to the State Disbursement Unit by electronic 
means approved by the department.  Payors who are required to remit support payments 
electronically can find more information on how to do so by accessing the State Disbursement Unit’s 
website at www.floridasdu.com and clicking on “Payments.”  Payment options include Expert Pay, 
Automated Clearing House (ACH) credit through your financial institution,  
www.myfloridacounty.com , or Western Union.  Payors may contact the SDU Customer Service 
Employer telephone line at  1-888-883-0743. 
 
 
14. The amount of arrears owed, if any, is $____________.  You must withhold an additional twenty 
percent (20%) or more of the ongoing periodic obligation towards same at the rate of $________ 
per ____________ until full payment is made of any arrearage, attorneys’ fees and costs—provided 
that no deduction shall be applied to attorneys’ fees and costs until the full amount of any arrearage 
Florida Family Law Rules of Procedure Form 12.996(d), Florida Addendum to Income Withholding Order (07/13) 
 - 9 -  
is paid.  If a delinquency accrues after the order establishing, modifying, or enforcing support has 
been entered and there is no existing order for repayment of the delinquency or a pre-existing 
arrearage, a payor shall deduct $________per _____________ (which represents an additional 
twenty percent (20%) of the current support obligation, or other amount agreed to by the parties) 
until the delinquency and any attorneys’ fees and costs are paid in full.  No deduction may be 
applied to attorneys’ fees and costs until the delinquency is paid in full.  
 
15. Pursuant to sections 61.13 and 61.1301, Florida Statutes, the amounts listed for payment on the 
Income Withholding Order must be varied by the employer/payor for bonus income, or similar one-
time payment: 
 
 
You shall deduct [Choose only one] (     ) the full amount, (      ) _______%, or (       ) none of the  
 
income which is payable to the obligor in the form of a bonus or other similar one-time 
 
payment, up to the amount of arrearage reported in the Income Deduction Order or the  
 
remaining balance thereof, and forward the payment to the State of Florida Disbursement Unit. 
 
For purposes of this subparagraph, “bonus” means a payment in addition to an obligor’s usual 
 
compensation and which is in addition to any amounts contracted for or otherwise legally due 
 
and shall not include any commission payments due an obligor. 
 
16. Child Support Reduction/Termination Schedule.  Child support amount listed on the IWO shall be 
automatically reduced or terminated as set forth in the following schedule: 
 
Please list 
children  
by initials 
from eldest to 
youngest 
 
Insert in this 
column the 
day, month, 
and year the 
child support 
obligation 
terminates for 
each 
designated 
child (see 
instructions) 
 
Insert in 
this column 
the amount 
of child 
support for 
all minor 
children 
remaining 
(including 
designated 
child).   
Child 1 
(Eldest) 
Initials & year 
of birth: 
 
 
From the effective 
date of this Income 
Deduction Order 
until the following 
date: 
 
child support  for Child 1 and 
all other younger  child(ren) 
should be paid in the 
following monthly amount: 
 
Child 2 
Initials & year 
of birth: 
 
 
After the date set 
forth in the row 
above until the 
following date:  
 
child support  for Child 2 and 
all other younger  child(ren) 
should be paid in the 
following monthly amount: 
 
Child 3 
Initials & year 
of birth:  
After the date set 
forth in the row 
above until the 
 
child support  for Child 3 and 
all other younger  child(ren) 
should be paid in the 
 
Florida Family Law Rules of Procedure Form 12.996(d), Florida Addendum to Income Withholding Order (07/13) 
 - 10 -  
 
 
following date: 
following monthly amount: 
Child 4 
Initials & year 
of birth: 
 
 
After the date set 
forth in the row 
above until the 
following date: 
 
child support  for Child 4 and 
all other younger  child(ren) 
should be paid in the 
following monthly amount: 
 
Child 5  
Initials & year 
of birth: 
 
 
After the date set 
forth in the row 
above until the 
following date: 
 
child support  for Child 5 and 
all other younger  child(ren) 
should be paid in the 
following monthly amount: 
 
 
(Continue on additional pages for additional children) 
 
 
 
 
NOTE: This change only relates to the amount of the child support obligation portion of 
the payments listed in the first page of the Income Withholding Order.  If there is a child 
support arrearage in a Title IV-D case, the amount will not be reduced due to the child  
no longer being eligible for support pursuant to paragraph 11 above. 
 
 
17. Additional information regarding the implementation of income deduction may be found at 
www.floridasdu.com.  
 
 
IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW 
[fill in all blanks] This form was prepared for the: {choose only one} (    ) Petitioner  (    ) Respondent 
This form was completed with the assistance of: 
 {name of individual}_____________________________________________________________,  
{name of business}_______________________________________________________________,   
{address}_______________________________________________________________________, 
{city}_____________________, {state}________, {telephone number}______________________.