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Employee Change of Information and Return of Notice of Withholding (Illinois)

This is a supplemental letter form for the Divorce with Minor Children packet (Illinois) that notifies an employer of an employee's change of information and return of the Notice of Withholding document. The form provided here is simply a sample of what the actual form looks like.

EMPLOYEE CHANGE OF INFORMATION AND RETURN OF NOTICE OF WITHHOLDING

Person serving the order for withholding should put their name and address in this box.

Mail this form and a copy of the Notice for Withholding to:

______________________________

______________________________

______________________________
(your name & address)

ATTENTION EMPLOYER:

When an employee, subject to a Notice for Withholding, is no longer employed by you, please complete this form to the best of your ability and forward it along with a copy of the order for withholding to the above address. This is required by statute.

EMPLOYEE NAME: ______________________________

NEW EMPLOYER INFORMATION: (IF AVAILABLE)

NAME: _______________________________________

ADDRESS: ___________________________________

CITY: _______________________________________

STATE & ZIP CODE: ___________________________

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