Notification of Employment Termination or Income Status. (Completed by the Employer/Income Withholder) The employer must complete this section when the employee/obligor’s employment is terminated, income withholding ceases, or if the employee/obligor has never worked for the employer. The employer/income withholder may report new payment sources such as workers’ compensation, if known. 34a-b. Employment/Income Status Checkbox. Check the employment/income status of the employee/obligor.
Notification of Employment Termination or Income Status. (Completed by the Employer/Income Withholder) If this employee/obligor never worked for you or you are no longer withholding income for this employee/obligor, you must promptly notify the CSE agency and/or the sender by returning this form to the address listed in the Contact Information section below or using OCSE’s Child Support Portal (xxxx.xxx.xxx.xxx/xxx/). Please report the new employer or income withholder, if known. This person has never worked for this employer nor received periodic income. This person no longer works for this employer nor receives periodic income. Please provide the following information for the employee/obligor: Termination date: Last known telephone number: Last known address: Final payment date to SDU/Tribal Payee: Final payment amount: New employer's or income withholder’s name: New employer's or income withholder’s address:
