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Child Support Enforcement Agency Information Worksheet Form. This is a Ohio form and can be use in Shelby County (Court Of Common Pleas).
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Tags: Child Support Enforcement Agency Information Worksheet, DR-3, Ohio County (Court Of Common Pleas), Shelby
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
Index No.
:
Plaintiff(s)
-against-
Calendar No.
:
JUDICIAL SUBPOENA
:
:
:
Defendant(s)
:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .DR-3 . .
....
SHELBY COUNTY
CHILD SUPPORT ENFORCEMENT AGENCY INFORMATION WORKSHEET
THE PEOPLE OF THE STATE OF NEW YORK
TO
PLAINTIFF/FIRST PETITI ONER:
DEFENDANT/SECOND PETITIONER:
____________________________________
______________________________________
Name
Name
GREETINGS:
___________________________________
_____________________________________
Address
Address
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable
Court
___________________________________ at the
_____________________________________
located at
County of
City, State and Zip Code
City, State and Zip Code
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
___________________________________
or adjourned date, to testify and give evidence as a witness in this _____________________________________
action on the part of the
SSN
Birthdate
SSN
Birthdate
___________________________________
_____________________________________
Employer
Your failure to comply with this subpoena is punishable Employer
as a contempt of court and will make you liable to
the party___________________________________ for a maximum penalty of $50 and all damages sustained as a
on whose behalf this subpoena was issued
_____________________________________
result of Employer’s Address
your failure to comply.
Employer’s Address
___________________________________
Witness, Honorable
City, State and Zip Code
Court in
County,
day of
_____________________________________
, one of the Justices of the
City, State and Zip Code
, 20
AMOUNT COURT ORDERED SUPPORT: $ ___________________
PAY PERIOD:
_____________________________________ must sign above and type name below)
(Attorney
(Weekly, bi-weekly, semi-monthly, monthly)
AMOUNT COURT ORDERED TOWARDS ARREARAGE: $ _________________________
Attorney(s) for
PLEASE CHECK WITH THE CHILD SUPPORT ENFORCEMENT AGENCY TO DETERMINE WHETHER
AN ARREARAGE EXISTS BEFORE FINAL HEARING.
Is Obligee a recipient of ADC? _____
In what county? ________________________
Office and P.O. Address
**** This form should be attached to any support order relating to temporary child support orders, final
child support orders and modified child support orders ****
**** BE SURE TO PUT A COPY OF THE “OBLIGEE’STelephone No.:REMEDIES FOR ENFORCEMENT
RIGHTS AND
Facsimile No.:
OF SUPPORT” WITH THIS DR-3 FORM ****
E-Mail Address:
Mobile Tel. No.:
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