Oklahoma Child Support Services Central Case Registry Request for Address of Record I am requesting the address of record for this person: First name Date of birth Social Security number Middle initial Last name District court case number List child(ren) in this case: First name Oklahoma child support case number FGN: County State Middle initial Last name Date of birth Last name of custodial person (CP) Last name of noncustodial person (NCP) First First Middle Middle Social Security number Social Security number Under 43 O.S. § 112A, the last known address of record will be released to the person requesting address disclosure. Home addresses are not disclosed if prohibited by a court order granted for the protection of a parent or custodian, or if the Oklahoma Child Support Services (OCSS) case has been assigned a family violence indicator. I am an authorized person to request this information under Oklahoma law (43 O.S. § 112A) because I am the: (Check one) custodian of the child(ren). noncustodial parent. attorney for the custodian. OBA no.: attorney for the noncustodial parent. OBA no.: other party or authorized representative: Form 03EN009E (CSED-9) revised 7-8-2010 may continue on next page, page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com I am requesting this address of record for service of process for the following purpose: support visitation custody I state under penalty of perjury under the laws of the State of Oklahoma that the forgoing is true and correct. Type or print name of requestor Signature of requestor Date Notice: The person whose address of record you are requesting may be notified of your request. A copy of page one of this request ma y be sent with the notice. OCSS allows a 15-day time period for a response. Within 45 days after OCSS receives your request, OCSS will notify you if your request can be processed. Complete the following information about yourself. This information is for identification and communication with you. This page will not be sent with the notice to the non-requesting party. Information about the person requesting address disclosure. First name of requestor Social Security number if CP or NCP District court case number Street address Area code Middle initial Last name Oklahoma child support case number FGN: County State Date of birth, If CP or NCP City Area code State Zip Home telephone number Work telephone number E-mail address, optional Form 03EN009E (CSED-9) revised 7-8-2010 may continue on next page, page 2 of 3 American LegalNet, Inc. www.FormsWorkFlow.com Purpose of form Form 03EN009E may be used by a custodial person (CP), noncustodial parent (NCP), the attorney for either, or an authorized person to request disclosure of the custodial person's or the noncustodial parent's address of record. Instructions · · · · · · Enter name, date of birth, and Social Security number of the person whose address of record you are requesting. Enter the OCSS case number. This is also called the FGN number. Enter the district court case num ber along with the county and state where it was entered. Enter the names and dates of birth of up to four children in this case. Enter the names and Social Security numbers of the CP and the NCP. Check the appropriate box to indicate you are the CP, NCP , attorney fo r the CP or NCP, or an authori zed representative. If you are the attorney, enter your Oklahoma Bar Association number. If you are a party or authorized representative not listed, check the other box and explain your status and authority for making this request. Check the box c orresponding with the pur pose for your request. Under Oklahoma law, addresses of record are for service of process in support, visitation, and custody actions. [43 O.S. § 112A] Type or print your name, and sign and date the form. If you are the CP or a NCP, enter your Social Security number. Enter your mailing address. Include a street address or a post office box number with city, state, and zip code. If you are the CP or a NCP, enter your date of birth. Enter your home and work telephone numbers. Include area code(s). Enter your e-mail address (not required). Routing Make a copy of the form to keep for yourself, and return the original completed form to: OCSS, Central Case Registry Attn: Address Disclosures P. O. Box 248843 Oklahoma City, OK 73124-8843 Questions? Telephone 918-295-3500 in the Tulsa area; 405-522-2273 in the Oklahoma City area; or 1- 800-522-2922 toll free. TTY 405- 522-3792 in the Oklahoma City area or 1-866-264-4767 toll free. · · · · · · · Form 03EN009E (CSED-9) revised 7-8-2010 may continue on next page, page 3 of 3 American LegalNet, Inc. www.FormsWorkFlow.com