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DR Form 201 Revised 1/10 BUTLER COUNTY COMMON PLEAS COURT DIVISION OF DOMESTIC RELATIONS WITHHOLDING ORDER/QUALIFIED MEDICAL CHILD SUPPORT ORDER INFORMATION SHEET DATE: REQUESTED BY: CASE NO. OBLIGED
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What is withholding orderqualified medical child?
A withholding orderqualified medical child is a court order that requires an employer or a payer to deduct a specific amount from an employee's or a payer's income to cover health insurance premiums for a qualified medical child.
Who is required to file withholding orderqualified medical child?
The employer or the payer is required to file a withholding orderqualified medical child.
How to fill out withholding orderqualified medical child?
To fill out a withholding orderqualified medical child, you need to provide information about the employee or the payer, the court order details, and the amount to be deducted for health insurance premiums.
What is the purpose of withholding orderqualified medical child?
The purpose of a withholding orderqualified medical child is to ensure that health insurance premiums for a qualified medical child are paid by deducting a specific amount from an employee's or a payer's income.
What information must be reported on withholding orderqualified medical child?
On a withholding orderqualified medical child, you must report information such as the employee or the payer's name, social security number, court order details, and the amount to be deducted for health insurance premiums.
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