Income withholding orders/termination of employment/income status (Employers and other income withholders)

Income Withholding for Support (IWO)

⚠️ Notice: This information collection may be referencing outdated material.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 1 Income withholding orders/termination of employment/income status (Employers and other income withholders) Form
0970_0154_Instructions_Sample_Form_OCSS_071223.pdf Instruction
0970_0154_Instructions_Sample_Form_OCSS_071223.pdf Instruction
1 IWO Form 0970_0154_IWO_Form_OCSS_062123.docx Form
1 IWO Form 0970_0154_IWO_Form_OCSS_062123.docx Form

Information Collection (IC) Details

IC Title:	Income withholding orders/termination of employment/income status (Employers and other income withholders)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	1	IWO Form	0970_0154_IWO_Form_OCSS_062123.docx		Yes	Yes	Fillable Printable
Instruction			0970_0154_Instructions_Sample_Form_OCSS_071223.pdf		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,277,952	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	10,236,396	-1,161,184	11,397,580
Annual IC Time Burden (Hours)	341,213	-38,706	379,919
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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