Free CHILD SUPPORT OBLIGATION WORKSHEET REQUIRED LOCATION INFORMATION - Utah


File Size: 10.4 kB
Pages: 2
Date: December 26, 2008
File Format: PDF
State: Utah
Category: Court Forms - State
Author: Unknown
Word Count: 401 Words, 4,559 Characters
Page Size: Letter (8 1/2" x 11")
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http://www.utcourts.gov/resources/forms/ch_support/support_obl_location.pdf

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CHILD SUPPORT OBLIGATION WORKSHEET REQUIRED LOCATION INFORMATION
Court: ________________________________ Case No: ______________________ Petitioner: ____________________________ Respondent: ______________________
As required by 62A-11-304.4, U.C.A., "Upon the entry of an order in a proceeding to establish paternity or to establish, modify, or enforce a support order, each party shall file identifying information and shall update that information as changes occur: (i) with the court or administrative agency that conducted the proceeding, and (ii) after October 1, 1998, with the state case registry." THE FOLLOWING INFORMATION MUST BE SUBMITTED AT THE TIME THE CHILD SUPPORT OBLIGATION WORKSHEET IS SUBMITTED. Whether you are the Petitioner or the Respondent, please fill out the information for yourself and the other party to the best of your ability. If any information is unknown, please so indicate. Do not leave any space blank.

PETITIONER: I am the (check one) _____ custodial parent _____ non-custodial parent Social Security Number _______________________________ Driver License Number ___________________________ State __________________ Residential Address ______________________________________________________________ Mailing Address (if different than residential address:) ______________________________________________________________________________ Telephone Number: _______________________ Date of Birth: _______________ Employer: _____________________________________________________ Employer's Address: _______________________________________________________________ Employer's Phone Number: _______________________________________ THIS INFORMATION IS CURRENT AS OF ___________________ (date) RESPONDENT: Social Security Number __________________________________________________ Driver License Number ___________________________ State __________________ Residential Address ________________________________________________________________ Mailing Address (if different than residential address:) _________________________________________________________________________________ Telephone Number: __________________________Date of Birth: _____________________ Employer: _____________________________________________________ Employer's Address: _____________________________________________________________ Employer's Phone Number: _____________________________________ THIS INFORMATION IS CURRENT AS OF ___________________ (date) Federal Law contains a prohibition against disclosing federal case registry information (name, social security number, date of birth, state) if the State has notified the registry there is reasonable evidence of domestic violence or child abuse or that disclosure of the information could be harmful to the parent or the child. If you wish to request the information be "safeguarded" (that is, not disclosed), check in the appropriate place below. _____________________________________ (Petitioner or Attorney for Petitioner) I request that this information be safeguarded (not disclosed) ______ _____________________________________ (Respondent or Attorney for Respondent) I request that this information be safeguarded (not disclosed) ______

CHILD SUPPORT OBLIGATION WORKSHEET REQUIRED LOCATION INFORMATION
AS REQUIRED BY TECHNICAL AMENDMENTS TO WELFARE REFORM SECTION 653(h)(2) (federal law) and U.C.A. 62A-11-103(14), THE FOLLOWING INFORMATION MUST BE SUBMITTED FOR EACH CHILD AT THE TIME THE CHILD SUPPORT OBLIGATION WORKSHEET IS SUBMITTED.

Name: ___________________________________________________ Date of Birth: ________________________________ Social Security Number: _____________________________________

Name: ___________________________________________________ Date of Birth: ________________________________ Social Security Number: _____________________________________

Name: ___________________________________________________ Date of Birth: ________________________________ Social Security Number: _____________________________________

Name: ___________________________________________________ Date of Birth: ________________________________ Social Security Number: _____________________________________

Name: ___________________________________________________ Date of Birth: ________________________________ Social Security Number: _____________________________________

Name: ___________________________________________________ Date of Birth: ________________________________ Social Security Number: _____________________________________

(Attach additional sheets if necessary)