MC: 0040S Bar Code Area FS#: Central File Maintenance P.O. BOX 12048 AUSTIN, TX 78711-2048 Date: APPLICATION FOR STATE PARENT LOCATOR SERVICE The Office of the Attorney General provides this service to locate the missing parent (non-custodial parent or alleged father) of a child who is not currently receiving Temporary Aid to Needy Families (TANF). This service may be requested only for the purpose of · establishing a court order for paternity, child support, or medical support, or · collecting court-ordered support The State Parent Locator Service provides only information about the missing parent's possible location(s). The State Parent Locator Service attempts to obtain the most recent address and employment information about the missing parent from state and federal records, and forwards that information to the applicant. The State Parent Locator Service does not verify or investigate the information obtained, and cannot guarantee that the missing parent will be found. WHO MAY USE THIS SERVICE You may apply for State Parent Locator Service if you are: the custodial parent with physical possession a person (other than a parent) who, for at least the past six months, has had physical possession the legal guardian or managing conservator with legal custody a judge or agent of a court with jurisdiction over the paternity and/or support case or · the attorney of the child for whom paternity and/or support is sought. If you are a parent (or other person) with qualifying custody of a child, you may obtain the full services of the Office of the Attorney General to establish paternity, child support and medical support, or to modify or enforce an existing support order. Contact the nearest office of our Child Support Division for an application or go to www.texasattorneygeneral.gov for more information. · · · · INSTRUCTIONS FOR COMPLETING THE APPLICATION FOR STATE PARENT LOCATOR SERVICE GENERAL: Please type or print all information requested except "Signature." Provide all information requested (if known) and answer all questions asked. A clear and complete application will help us to provide you our best service. Submit a separate application for each missing parent. A. INFORMATION ABOUT THE APPLICANT Enter all the information requested C. INFORMATION ABOUT THE CHILDREN Enter the information rquested about the child(ren) of the custodial parent with this missing parent only. D. INFORMATION ABOUT THE MISSING PARENT Enter all known information requested. To effectively locate the missing parent, we must have either a social security number of the missing parent's date of birth, place of birth, and parents' names. B. INFORMATION ABOUT THE CUSTODIAL PARENT If the custodial parent is not the applicant, enter the name and social security number of the custodial parent. SUBMITTING THE APPLICATION - Sign and date the application, and mail to: Office of the Attorney General - MC 0040S State Parent Locator Service P.O. Box 12017 Austin, Texas 78711-2017 (512) 460-6000 November 2014 American LegalNet, Inc. www.FormsWorkFlow.com 1A010e APPLICATION FOR STATE PARENT LOCATOR SERVICE Application Sequence #: (Please read the information and instructions on the reverse before completing this form.) A. INFORMATION ABOUT THE APPLICANT (Please Print All Information) NAME (LAST, FIRST, MI) SSN OR STATE BAR NUMBER DAYTIME TELEPHONE NUMBER STREET ADDRESS CITY STATE ZIP CODE APPLICANTS RELATIONSHIP TO THE CHILD(REN) FOR WHOM PATERNITY OR SUPPORT IS SOUGHT (check one): Custodial Parent with physical possession of the child(ren) Person (other than a parent) with physical possession of the child (ren) for at least the past six months Relationship to the child(ren) (specify): __________________________ Guardian or managing conservator with legal custody of the child(ren) (Attach a copy of court order granting custody.) Attorney representing either the child(ren) or parent of the child(ren) I declare that my service does not meet the definition of a Private Child Support Enforcement agency as defined by Texas Finance Code 396.001(7). Judge or Agent of a Court with jurisdiction to establish paternity and/or establish/modify/enforce child/medical support for the child(ren) B. INFORMATION ABOUT THE CUSTODIAL PARENT (Complete if the applicant is not the custodial parent) NAME (Last, First, MI) SOCIAL SECURITY NUMBER C. INFORMATION ABOUT THE CHILDREN NAME (Last, First, MI) DATE OF BIRTH SEX SOCIAL SECURITY NUMBER D. INFORMATION ABOUT THE MISSING PARENT NAME (Last, First, MI) ALIAS (Last Name Only ) SOCIAL SECURITY NUMBER* LAST KNOWN STREET ADDRESS CITY STATE ZIP CODE DATE OF BIRTH Was the missing parent ever married to the custodial parent? YES NO YES NO Did the missing parent ever serve in any of the U.S. military services? DON'T KNOW * COMPLETE ITEMS BELOW IF THE MISSING PARENT'S SOCIAL SECURITY NUMBER IS NOT KNOWN NAME OF MISSING PARENT'S FATHER (Last, First, MI) MAIDEN NAME OF MISSING PARENT'S MOTHER (Last, First, MI) MISSING PARENT'S PLACE OF BIRTH (City , State, or Foreign Country ) In applying to the Office of the Attorney General for State Parent Locator Service, I certify that: · information provided in this application is true, correct and complete to the best of my knowledge · the request is being made to obtain information for the purpose of establishing parentage or establishing, setting the amount of, modifying or enforcing child/medical support · any information obtained through the SPLS shall be used solely for these purposes and shall otherwise be treated as confidential. I further certify that Temporary Aid to Needy Families (TANF) is not being received for the child(ren) listed. ___________________________________________________________________ (Signature) _______________________________ (Date) Texas Government Chapter 559 gives you the right to review and request correction of information on this form. Privacy Act of 1974 Notice. Disclosure of your social security number, and the social security numbers of your child(ren), is required by federal law (42 USC 666). The Child Support Division will use these social security numbers only for the purpose of establishing and enforcing support for you and your family. November 2014 American LegalNet, Inc. www.FormsWorkFlow.com Form 1A010e