1 2 3 SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF --------------------------------------------------------------------x Plaintiff, -againstIndex No. SUPPORT COLLECTION UNIT INFORMATION SHEET 4 Defendant. -------------------------------------------------------------------x The following information is required pursuant to Section 240(1) of the Domestic Relations Law: 5 PLAINTIFF: Address: Date of Birth 6 DEFENDANT: Address: Date of Birth 7 8 Date and Place of Marriage: Plaintiff OR Defendant is the custodial parent and is OR is not receiving public assistance. 9 UNEMANCIPATED CHILDREN: Name Date of Birth SS #: SS #: SUPPORT: Maintenance $ Child Support $ Total Support $ per week OR bi-weekly OR Semi-monthly OR per month per week OR bi-weekly OR Semi-monthly OR per month per week OR bi-weekly OR Semi-monthly OR per month 10 Support payments are to be made to the Support Collection Unit for the benefit of Plaintiff OR Defendant OR Third Party. 11 12 If third party, list name and address: Non-custodial parent's employer: Address: 13 Dated: (Form UD-8a, Rev. 1/25/16) American LegalNet, Inc. www.FormsWorkFlow.com