The family responsibility office contact form is the central point where child support payments and back child support or child support arrears in separation agreements or divorce or family court orders are filed. The office is authorized to collect money directly. Below is a sample family responsibility office contact form.
Sample Family Responsibility Office Contact
Client’s full name ________________________Date of birth_________________
Full address _______________Phone_________________
Other parties full name ________________Date of birth _________________
Date of marriage ________________Date of separation or divorce ______________
Date of cohabitation ___________________Previous divorce_______________ date______
Name of child_____________ DOB ________________School _____________Grade _
Resides With _______________
Do you receive/pay child support? _________________
Do you have any arrears related to Family Responsibility Office? __________
Have you been convicted for defaulting in payment? ___________________
Do you have legal representation with regard to child support obligations? ____________
I agree to follow guidelines of child support obligations.
Signature and Date_________________ Lawyers name and Signature___________