Support Information Sheet
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1
2STATE OF SOUTH CAROLINA
)
IN THE FAMILY COURT
)
_____JUDICIAL CIRCUIT
COUNTY OF ________________________
)
)
)
)
SUPPORT INFORMATION SHEET
Plaintiff, )
vs.
)
)
)
Defendant. )
Docket No. ___________________________
Check appropriate box:
No spousal or child support ordered. (No other items should be completed.)
If support is ordered to be paid directly or through the Court, you must complete BOTH pages (as
applicable).
Obligation Type
Child Support
Spousal Support
Other:
_______________________
Amount
$
$
$
Collection Costs (5%)
$
$
$
Payment Frequency
Payment Start Date
___________________________, 20_____
Weekly
Bi-weekly
Monthly
Semi-monthly (1st & 16th)
Semi-monthly (15th & 30th)
Total Arrearage Amount
$
$
$
Wage Withholding
Required by S.C. Code Ann. §63-17-
1420
Ordered
Not Ordered
Name of Custodial Parent (if applicable): ___________________________________________________________
OBLIGOR’S DESIGNATION STATEMENT: PAYMENT OF COURT COSTS
I acknowledge that S.C. Code Ann. § 63-3-370 requires that I pay and the Family Court has ordered that I pay
court costs in an amount equal to five (5) percent of any support payment made through the Clerk of Court or the
centralized wage withholding system. I owe and will pay these costs in addition to my support obligation.
To meet my duty to pay court costs, I designate an amount equal to five (5) percent of the support payment I
make to be applied and distributed in payment of court costs, not support.
I acknowledge the Clerk of Court or, if payments are withheld from my income, the centralized wage
withholding system to deduct the fee from every payment made by me or on my behalf.
I acknowledge that should I not pay the full amount due, that an arrearage will accrue and that the Clerk of Court
may take enforcement action against me for failure to pay all amounts ordered by the Court.
If an amendment to the law changes the amount of court costs, this designation authorizes deduction of court
collection costs in the amount established by law.
Date: ___________________, 20_____
Signature of Person paying Support**
** NOTE TO CLERK: FILE AND PROCESS THIS FORM EVEN IF SIGNATURE OF PERSON PAYING
SUPPORT IS NOT PROVIDED.**
SCCA 446 (4/2010)
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