Appearance Of Child Support Creditor Or Representative
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Appearance Of Child Support Creditor Or Representative Form. This is a Oregon form and can be use in Bankruptcy Court Federal.
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Tags: Appearance Of Child Support Creditor Or Representative, 119, Oregon Federal, Bankruptcy Court
B281 (8/06)
UNITED STATES BANKRUPTCY COURT
DISTRICT OF OREGON
In re
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Debtor(s)
Case No. ________________
APPEARANCE OF CHILD
SUPPORT CREDITOR*
OR REPRESENTATIVE
I certify under penalty of perjury that I am a child support creditor* of the debtor, _______________________,
or the authorized representative of such child support creditor, with respect to the child support obligation which
is set out below.
Name:
Organization:
Address:
Telephone number:
__________
Date
_____________________________________________________
Signature of Child Support Creditor* or Authorized Representative
Summary of Child Support Obligation
Amount in arrears:
If Child Support has been assigned:
$_____________________
Amount of Support which is owed under
assignments:
Amount currently due per week or per
month on a continuing basis:
$_____________________
Amount owed primary child support creditor (balance
not assigned):
$______________________
(per week)
(per month)
$_____________________
Attach an itemized statement of account. Do not disclose the name of a minor child. See 11 USC ยง112. If
a social security number or a taxpayer identification number is included, set out only the last four digits of
the number. Judicial Conference Privacy Policy (09/01).
*Child support creditor includes both creditor to whom the debtor has a primary obligation to pay child support as
well as any entity to whom such support has been assigned, if pursuant to Section 402(a)(26) of the Social Security
Act or if such debt has been assigned to the Federal Government or to any State or political subdivision of a State.
119 (8/06)
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