Child Enforcement Forms Part I
Your Last Name
M.I.
Your First Name
D.O.B.
Social Security Number
City/State/Zip Code
Address
Work Phone
Home Phone
Message Phone
Cell Phone
Have you in the past?
Are you currently receiving TANIF?
Case Number
In what state were you awarded child support
Are you currently Employed
If so where?
How many children do you have by the
non custodial parent
Please give the names, Date of Birth,
Male/Female, SSN, and grades of
children currently in school
Are you currently receiving child support
If yes, are the payments the result of
wage withholding order
Has the NCP ever paid Child Support
Do you have an open child support
case with a state agency
If yes, list the county of the state agency
Part II Non Custodial Parent Information
SSN
NCP Last Name
NCP First Name
Date of Birth
Is the NCP currently employed
Where?
What city/state
NCP current address
NCP previous address
Is the NCP currently married or living
with a roommate?
Part III Additional Information
Are there other non custodial parents that owe you child support?
Do you have a court order awarding you child support?