Alaska Department of Revenue Please Reply To: CSSD, MS 550 W. 7TH Ave., Suite 310 Anchorage, AK 99501-6699 www.csed.state.ak.us Child Support Services Division Case No.: INFORMATION LOCATE SHEET We are trying to locate the non-custodial parent for your child support case. We need additional information from you concerning the possible location of this person. Please provide as much information as you can. Places to look for this information include: tax returns, bank statements, credit accounts, legal documents, and friends or relatives. INFORMATION ABOUT THE NON-CUSTODIAL PARENT 1. 2. 3. 4. 5. Full legal name (no nicknames): ____________________________________________ Any other name(s) used: __________________________________________________ Social Security Number: ___________________________________________________ Date of Birth: _________________ Place of birth: ______________________________ Physical description: ______________________________________________________ Did the absent parent ever live or work in Alaska? Yes _____ No _____ When ________ Is the absent parent a citizen of the United States? Yes _____No _____ If not, what country 7. 8. is he or she a citizen of? ____________________________________________________ Mailing address: __________________________________________________________ City/State/Zip: ___________________________________________________________ Residence address: ________________________________________________________ City/State/Zip: ____________________________________________________________ Work telephone number: ______________ Home telephone number: _______________ 9. Most Recent Employers: ______________________ ______________________ 10. Addresses of Employers: __________________________ __________________________ Phone #: _______________ _______________ 6. Unions (name & local number): ______________________________________________ His/her usual occupation: ___________________________________________________ Military Status: (__) Active (__) Reserved (__) Guard (__) Retired Branch/Unit: _____________________________________________________________ PLEASE COMPLETE AND SIGN THE SECOND PAGE 11. 12. CSSD 04-1423 (Rev 05/20/04) MAT-SU: (907) 357-3550 TOLL FREE (In-state, outside Anchorage): (800) 478-3300 SOUTHEAST: (907) 465-5887 ANCHORAGE: (907) 269-6900 FAX: (907) 269-6813 or 6914 FAIRBANKS: (907) 451-2830 TDD machine only: (907) 269-6894 / TDD machine only, toll free (In-state, outside Anchorage): (800) 370-6894 American LegalNet, Inc. www.USCourtForms.com OTHER INFORMATION: Please provide any further information that you think may be helpful in obtaining support money for your children, such as bank account numbers, assets, stocks, property, retirement programs, Native corporation memberships, etc. ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ NAMES AND ADDRESSES OF FRIENDS OR RELATIVES WHO MAY KNOW THE ADDRESS OF THE NON-CUSTODIAL PARENT: ___________________________________________________________________________________ ___________________________________________________________________________________ INFORMATION ABOUT THE CHILDREN: Name Date of Birth Social Security No. _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Please list any payments made directly to you: Month Amount Month Amount ____________________________________ ____________________________________ ____________________________________ ______________________________________ ______________________________________ ______________________________________ ____________________________ Your Name (PLEASE PRINT) ______________________________________ Signature Date Work Telephone No: __________________ Home Telephone No: ____________________ Your address: _________________________________________________________________________ Your Social Security No. _______________________ Date of Birth: ____________________________ THANK YOU FOR THIS INFORMATION. MAT-SU: (907) 357-3550 TOLL FREE (In-state, outside Anchorage): (800) 478-3300 SOUTHEAST: (907) 465-5887 ANCHORAGE: (907) 269-6900 FAX: (907) 269-6813 or 6914 FAIRBANKS: (907) 451-2830 TDD machine only: (907) 269-6894 / TDD machine only, toll free (In-state, outside Anchorage): (800) 370-6894 American LegalNet, Inc. www.USCourtForms.com