Form 4A-304 NMRA
Form 4A-304. Wage withholding order (domestic relations actions).
STATE OF NEW MEXICO
COUNTY OF ___________________________
____________________ JUDICIAL DISTRICT
_______________________________________,
Petitioner,
v.
No. _________________
_______________________________________,
Respondent.
WAGE WITHHOLDING ORDER
(domestic relations actions)1
This matter, having come before the Court for entry of a wage withholding order and
the parties having submitted a completed Income Withholding for Support Form,2 the
Court ORDERS:
1. The provisions of the Income Withholding for Support Form, attached as Exhibit
A and signed by the Court, are incorporated by reference and adopted in full.
2. Wage withholding shall be implemented as stated in Exhibit A.
3. Exhibit A, which includes personal identifier information that is necessary to
include in the record, shall be protected in accordance with Rule 1-079 NMRA if
requested to be sealed by the parties.
IT IS SO ORDERED.
______________________
Date
_____________________________________
District judge
APPROVED:
________________________________
Mother’s
signature:
________________________________
Mailing address:
________________________________
________________________________
________________________________
Telephone:
________________________________
Father’s signature: ________________________________
Mailing address:
________________________________
________________________________
________________________________
Telephone:
________________________________