NOTICE-ADMINISTRATIVE SUPPORT DECISION APPEAL Va. Code 63.2-1943 Case No. DCSE ID No. Juvenile and Domestic Relations District Court Virginia Department of Social Services, Division of Child Support Enforcement ex rel. V. ADDRESS LOCATION ADDRESS LOCATION Social Security No. Social Security No. Telephone No. (H) (W) Telephone No. (H) (W) Date of Birth Date of Birth Names of Dependents Date of Birth Relationship to Defendant I appeal the decision of the hearing officer in the above-styled case an d ask that this court try the case without considering the decision of the hearing officer as an appeal de novo pursuant to Va. Cod e 63.2-1943 as applicable. The order appealed involved: Administrative support order Notice and finding Mandatory withholding of earnings Order to withhold and deliver The city or county in which this court is located is a proper location f or this hearing because it is where: I reside the appellee resides and I do not reside in Virginia either the obligors property or the place of business of the obligors employer is located and neither the appellee nor I reside in Virginia I understand that the decision of the hearing officer remains valid and enforcible during the appeal. DATE SIGNATURE OF APPELLANT COURT USE ONLY Notice of Hearing is the date and time of the hearing of this appeal. The Division of Child Support Enforcement is directed to forward a copy of the hearing o fficers decision by DATE DATE CLERK DEPUTY CLERK Case No. NOTICE-ADMINISTRATIVE SUPPORT DECISION APPEAL American LegalNet, Inc. www.USCourtForms.comFORM DC-601 (PAGE ONE OF ONE) 10/02 PDF