Child Support Data Sheet
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Child Support Data Sheet Form. This is a Illinois form and can be use in Dekalb Local County.
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Tags: Child Support Data Sheet, Illinois Local County, Dekalb
CASE NO._____________
____________________________
PLAINTIFF/PETITIONER
COUNTY______________
Vs.
__________________________
DEFENDANT/RESPONDENT
CHILD SUPPORT DATA SHEET
OBLIGOR INFORMATION
Last Name:
First Name:
Complete Residential Address:
DATE_________________
OBLIGEE INFORMATION
Last Name:
Middle In.:
First Name:
Complete Residential Address:
Middle In.:
Complete Mailing Address (If other than above):
Complete Mailing Address (If other than above):
Date of Birth:
Date of Birth:
Driver’s License No.:
Driver’s License No.:
*Social Security No.:
Social Security No.:
Home Phone Number: ( )
Employer(s) Name/Company:
Home Phone Number: ( )
Employer(s) Name/Company:
Employer(s) Address:
Employer(s) Address:
Employer(s) ID Number:
Employer(s) ID Number:
Work Phone Number: (
)
Work Phone Number: (
)
CHILD/CHILDREN INFORMATION
LAST
FIRST
MIDDLE
INITIAL
DATE OF
BIRTH
SOCIAL SECURITY
NUMBER
1.
2.
3.
4.
5.
(If more space is needed, attach an additional sheet.)
*If obligor is not a U.S. citizen, so indicate and provide the obligor’s alien registration number, passport number and home country’s social security or national health
number.
Form approved by Conference of Chief Circuit Judges
Exhibit 1
Revised 1/20/06
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