HomeMy WebLinkAbout203032 10/25/2011 CITY OF CARMEL, INDIANA VENDOR: L2370 Page 1 of 1
s 0 ONE CIVIC SQUARE I N S C C U —ASFE CHECK AMOUNT: $55.00
CARMEL, INDIANA 46032 PO BOX 6271
INDIANAPOLIS IN 46206 -6271 CHECK NUMBER: 203032
CHECK DATE: 10125/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 4264660 55.00 OTHER EXPENSES
THE EMPLOYEES LISTED BELOW OWE THE 2011 INDIANA ANNUAL SUPPORT FEE.
The remittance for the Annual Support Fee must be mailed separately to the special ASFE P O Box address listed
below.
If one or more of the persons listed are no longer employed or have never been employed by your company, that
information can be mailed with the payment or faxed to 317- 234 -4767.
Retain a copy for your records and /or to send with additional payments
in case multiple payments are necessary to pay the entire amount due.
Employer Name: CITY OF CARMEL Make Check payable to:
DBA: INSCCU ASFE
FEIN: 356000972 P O Box 6271
Indianapolis IN 46206 -6271
Employee's Name Employee's Date of Last Day ISET ase# Amount Amount
SSN Worked or Due Paying
Never Employed per case per case
DRIVER, CHARLES XXX -XX -3584 ASFE4264660 $55.00
PACE, PAUL V. XXX -XX -9563 ASFE5157675 $55.00
Order to Withhold Income
for the 2011 Indiana Annual Support Fee
Indiana Department of Child Services
State Child Support Bureau
Per Indiana Statutes IC- 33- 37 -5 -6 and IC- 31 -16 -15
#BWNNXZL
09/10/2011
#9781 9996 43R#
CITY OF CARMEL
ONE CIVIC SQUARE
ATTN KAREN HUFFMAN
CARMEL IN 46032
F
This is an Order to Withhold Income for the 2011 Annual Support Fee. This fee is charged to non- custodial parents pursuant to
Indiana siatute. You are required by law, IC-33-37-5-6 and IC 31- 16 -15, to deduct these amounts from the emp!oyee's income. The
deduction should be made from the next payroll, or as soon thereafter as practical. You may remit either in check form, which should be
forwarded to the Indiana State Central Collection Unit (INSCCU), or electronically (please see instructions below). This deduction is in
addition to any other child support or support- related payments you may be deducting.
General information:
This is a once a year fee deduction that should be made AFTER all other child support payments are deducted. If the child
support obligation deducted each pay period always exceeds the CCPA limits, you cannot withhold the fee. The child
support obligation, your fee, plus the ASFE combined, cannot exceed the CCPA limits.
Even if you are not currently withholding child support for the employee (e.g. the non custodial parent is paying directly),
the ASFE fee still needs to be withheld. Employees with questions should contact the KIDS line at 317 -233 -5437 or 800-
840 -8757.
A separate payment is required for this fee; do not combine the fee with regular child support payments.
You may retain a two dollar ($2.00) fee from the employee's income for this withholding.
If you need the full SSN provided to you, please call 317- 232 -0327 or 1- 800 -292 -0403 option 1.
Paving via Check:
Please complete the list on the reverse of this letter and send it with the payment to the address listed on the reverse. A
copy of this list MUST accompany the payment, unless payments are sent electronically.
Please note that the P. O. Box for the fee payments is different than for regular child support payments.
If possible, please combine the Annual Support Fees withheld from all employees listed in a single check.
Paving Electronically:
The fee can be paid by using the Child Support Bureau's FREE Employer Online Payment System. If you're not currently
using the site to process your regular child support payments, we can set you up to process the fees only. For more
information concerning this process, please call 317 -232 -0327 or 1-800-292-0403, option 1.
The fee CAN NOW also be sent electronically (ACH) but you must follow these instructions. Set up the fee as a
separate child support deduction and add ASFE to the beginning of the ISETS case number as shown on the reverse of this
document. ADP clients must use the P O Box 6219 as the payee address and add ASFE to the beginning of the ISETS
case number, as only payments with this address will go electronically to Indiana. Ceridian clients must assign the
garnishment INSDUI for the payments to go electronically.
Consumer Credit Protection Act (CCPA): Federal law requires states to limit the amount which can be collected by income withholding
to 60% of disposable earnings per pay period, or 50% of disposable earnings if your employee is supporting another spouse or
dependent child (current family). If earnings are not sufficient to make the full payment (which may include the $2.00 fee), partial
deductions should be made up to the CCPA limit.
If you have any questions, please contact the Child Support Bureau, EMPLOYER MAINTENANCE UNIT (EMU) at 317 -232 -0327 or
1- 800 -292 -0403 or EMU i DCS.fN.eov
SIGNATURE
Cynthia Longest
Deputy Director
Department of Child Services
Child Support Bureau
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
�y 2 71 Terms
`IJ 71 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
rr
6
6a>
Totals
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in acebrdance
with IC 5- 11- 10 -1.6.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
U Board Members
D E PT INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
o h °I`1' S�S bill(s) is (are) true and correct and that the
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materials or services itemized thereon for
which charge is made were ordered and
received except
/o o
/7
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund