STATE OF ILLINOIS IN THE CIRCUIT COURT OF THE ____________________ JUDICIAL CIRCUIT ______________________ COUNTY __________________________________, Plaintiff ) ) ) ) ) ) v. ________________________________, Defendant No. ___________________ CHILD SUPPORT INFORMATION Plaintiff Information Defendant Information _____________________________________ Last Name First MI __________________________________________ Last Name First MI Residental Address: Residential Address: _______________________________________ __________________________________________ City: __________________________________ City: ______________________________________ State: ________________Zip: ______________ State: ___________________ Zip: _____________ Date of Birth: ___________________________ Date of Birth: ______________________________ Soc. Sec. No.: __________________________ Soc. Sec. No.: ______________________________ Driver’s License No.: _____________________ Driver’s License No.: _________________________ Home Phone ( Home Phone ( ) _____________________ ) _________________________ Employer Name and Address: Employer Name and Address: _______________________________________ __________________________________________ _______________________________________ __________________________________________ Employer(s) ID Number: ___________________ Employer(s) ID Number: _______________________ Work Phone ( Work Phone ( ) _______________________ ) __________________________ Child/Children Information: Last Name First Name MI Date of Birth Social Security Number 1. ___________________________________________________________________________________ 2. ___________________________________________________________________________________ 3. ___________________________________________________________________________________ 4. ___________________________________________________________________________________ 5. ___________________________________________________________________________________ American LegalNet, Inc. www.FormsWorkflow.com