Form 127 (Rev. 03/10) The Family Court of the State of Delaware In and For New Castle Kent Sussex County INTER-STATE REGISTRATION OF SUPPORT ORDER Petitioner Name v. Respondent Name File Number Street Address Street Address Apt. or P.O. Box Number Apt. or P.O. Box Number Petition Number State Zip Code City/State/Zip Code City Attorney Name and Phone Number Attorney Name and Phone Number Entry Date of Defaulted Support Order: Arrearage: $ AND NOW, IT APPREAING THAT THE RESPONDENT IS IN DEFAULT ON AN ORDER OF SUPPORT entered on the above mentioned date, and in light of the Respondent's current location of residence, the Court of the below named County and State may obtain jurisdiction over this person. County: State: IN ACCORDANCE WITH THE DELAWARE UINIFORM RECIPROCAL ENFORCEMENT OF SUPPORT ACT (13 Del. Code, § 639), the forgoing findings should be certified and registered with the above mentioned Court. Furthermore, one (1) copy of this Certification, as well as one (1) copy of the Order of Support as aforesaid, and one (1) copy of 13 Del. Code, Chapter 6 should be sent to the above mentioned Court by the Clerk of the Family Court of the State of Delaware. TO THE BEST OF THE PETITIONER'S KNOWLEDGE, THE RESPONDENT HAS THE FOLLOWING property located in the State (s) of: Real Estate Description Location Personal Property THE ABOVE MENTIONED ORDER HAS BEEN REGISTERED IN THE FOLLOWING STATE (S): Petitioner Date Sworn to subscribed before me: Mediator/Notary Public Date American LegalNet, Inc. www.FormsWorkFlow.com