Government of Ontario: Ministry of Community and Social Services

Family Responsibility Office
P.O. Box 220
Downsview ON M3M 3A3

SUPPORT DEDUCTION ORDER INFORMATION FORM

Family Responsibility and Support Arrears Enforcement Act, 1996

Form 2

Court File No.

Name of Court

Location

NOTE: Please Print. Complete Parts A and B ONLY. Leave Parts C, D, E and F blank to be completed by court.

A. INFORMATION FOR THE FAMILY RESPONSIBILITY OFFICE

INFORMATION ON PARTIES

Family Responsibility Office Case Number (if known)

Payor

Payor Name

Birthdate (dd/mm/yyyy)

SEX M
F

Address

Street Number

Unit/Suite/Apt.

Street Name

City/Town

Province

Postal Code

Social Insurance Number

Mother's Maiden Name

Language Preference

Home Telephone Number

Work/Business Telephone Number

Cell Phone Number

Recipient

Recipient Name

Birthdate (dd/mm/yyyy)

SEX M
F

Address

Street Number

Unit/Suite/Apt.

Street Name

City/Town

Province

Postal Code

Social Insurance Number

Mother's Maiden Name

Language Preference

Home Telephone Number

Work/Business Telephone Number

Cell Phone Number

PAYOR'S EMPLOYMENT

Employer/Income Source Name

Payroll Office Address

Street Number

Unit/Suite/Apt.

Street Name

City/Town

Province

Postal Code

Self Employed (provide legal name of business and address)

Unemployed

Receiving welfare, family benefits or other form of social assistance

Receiving employment insurance benefits

Other (i.e., workers' compensation, pension, etc.)

Recipient does not know

SUPPORT ORDER INFORMATION Is the support order a variation of a previous support order?
Yes
No
If "Yes", date of previous order

The attached support deduction order relates to a support order which says that: (Payor Name) is required to pay support for the following persons:


Name	Birthdate dd/mm/yyyy	Amount Payable	Frequency	Start Date dd/mm/yyyy	End Date (if any) dd/mm/yyyy
Spouse a. a. Name	a. Birthdate	a. Amount Payable$	a. Frequency	a. Start Date	a. End Date (if any)
Other Dependants b. b. Name	b. Birthdate	b. Amount Payable$	b. Frequency	b. Start Date	b. End Date (if any)
c. c. Name	c. Birthdate	c. Amount Payable$	c. Frequency	c. Start Date	c. End Date (if any)
d. d. Name	d. Birthdate	d. Amount Payable$	d. Frequency	d. Start Date	d. End Date (if any)
e. e. Name	e. Birthdate	e. Amount Payable$	e. Frequency	e. Start Date	e. End Date (if any)
f. f. Name	f. Birthdate	f. Amount Payable$	f. Frequency	f. Start Date	f. End Date (if any)

C,D,E and F to be COMPLETED BY COURT

TYPE OF SUPORT ORDER
Temporary
Final

D. SPECIAL EXPENSES


Name of Child/Children	Birthdate dd/mm/yyyy	Amount	Frequency	Start Date dd/mm/yyyy	End Date (if any) dd/mm/yyyy
a. Name	a. Birthdate	a. Amount$	a. Frequency	a. Start Date	a. End Date (if any)
b. Name	b. Birthdate	b. Amount$	b. Frequency	b. Start Date	b. End Date (if any)
c. Name	c. Birthdate	c. Amount$	c. Frequency	c. Start Date	c. End Date (if any)
d. Name	d. Birthdate	d. Amount$	d. Frequency	d. Start Date	d. End Date (if any)
e. Name	e. Birthdate	e. Amount$	e. Frequency	e. Start Date	e. End Date (if any)
f. Name	f. Birthdate	f. Amount$	f. Frequency	f. Start Date	f. End Date (if any)

E. COST OF LIVING ADJUSTMENTS (DOES NOT APPLY TO CHILD SUPPORT)
Support is indexed in accordance with s. 34(5) of the Family Law Act
Yes
No
If other indexing, explain method of calculation:

F. ARREARS If the order is retroactive, if the order is a variation order or if the order provides for an arrears payment schedule, are arrears owing as of the date of the order?
No
Yes
If "Yes", the amount of arrears = $
and the arrears are to be paid as follows (if applicable)

PARTS A AND B COMPLETED BY: (please print) Name
Title (If solicitor for a party, identify which party)
Telephone Number