Non-IV-D-CPs

Order to Withhold Income for Child Support and Notice of an Order to Withhold Income for Child Support

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0154 can be found here:

Documents and Forms

Document Name Document Type
Form Attachment A Non-IV-D-CPs Form
Attachment B - Income Withholding for Support Instructions.doc Instruction
Attachment A Attachment A - Income Withholding for Support, OMB Attachment A - Income Withholding for Support, OMB 0970-0154.doc Form
Attachment D - Applicable Statutes.pdf Applicable Statutes IC Document
Attachment H - Safeguarding and Disclosure of Confidential Information.pdf Disclosure IC Document

Information Collection (IC) Details

IC Title:	Non-IV-D-CPs	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	Attachment A	Attachment A - Income Withholding for Support, OMB	Attachment A - Income Withholding for Support, OMB 0970-0154.doc		Yes	No	Fillable Printable
Instruction			Attachment B - Income Withholding for Support Instructions.doc		Yes	No	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,969,044	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,969,044	1,969,044
Annual IC Time Burden (Hours)	164,087	164,087
Annual IC Cost Burden (Dollars)	5,749,608	5,749,608

Documents for IC

Title	Document	Date Uploaded
Applicable Statutes	Attachment D - Applicable Statutes.pdf	02/24/2011
Disclosure	Attachment H - Safeguarding and Disclosure of Confidential Information.pdf	02/24/2011

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.