WAUKESHA COUNTY CHANGE OF INFORMATION FORM Case#: _______________________ Date: ____________________ ADDRESS CHANGE Your Name: ___________________________ Old Address: ___________________________ New Address: __________________________ ___________________________ ___________________________ __________________________ ___________________________ Phone#: __________________________ __________________________ ___________________________ Effective Date:___________________________ Signature: ___________________________ Previous Name: NAME CHANGE ________________________________(Please Print) Present Name: ________________________________(Please Print) Effective Date: ________________________________ Signature: ________________________________ EMPLOYER INFORMATION CHANGE Payer Name: _____________________________ Payer Phone#: _______________________ Payer D.O.B.: _______________________ Last Date of Employment: ____________________ Previous Employer Name: ____________________________________ New Employer Name: ____________________________________ Employer Address: ____________________________________ ____________________________________ ____________________________________ ____________________________________ Payroll Phone #: ____________________________________ Payroll Contact Person: ____________________________________ Effective Date of New Employment: ____________________________________ Complete the form and make two (2) copies: Mail one (1) copy to the other party and the original and one (1) copy to: Family Court Division, Rm. C-112, PO Box 1627, Waukesha, WI 53188 Original = Clerk of Courts Family Division Copy 1 = Child Support Division Copy 2= The Other Party American LegalNet, Inc. www.FormsWorkflow.com