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(Only New Complaints May Be Filed On-Line)
Please be aware of the following:
- When your complaint has been submitted, you will be informed of your
Web Complaint Number in your confirmation. Please make an accurate record of
this number or print the confirmation page.
- A copy of the complaint may be sent to other governmental agencies.
- Do not use punctuation when providing names and addresses.
- Your Social Security Number is encrypted for your privacy and will
not be shared with any non-governmental, third party.
NOTE: Fields labelled in
RED are required values.
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Custodial Parent Information
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Last Name:
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First Name:
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MI:
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Street Address:
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City:
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Your State:
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Zip Code:
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Your County:
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Cell Phone:
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Home Phone:
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Work Phone:
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Ext:
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Fax Number:
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E-mail Address:
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Date of Birth:
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Re-type your E-mail:
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Non-Custodial Parent Information
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Last Name:
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First Name:
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MI:
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Street Address:
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City:
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State:
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Zip Code:
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County:
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Phone:
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Cell Phone:
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Fax Number:
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E-mail Address:
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Vehicle Make/Model:
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Scars, marks, tattoos:
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Date of Birth:
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Social Security No.:
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Gender:
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Race:
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Eye Color:
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Hair Color:
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Height:
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Weight:
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Alias/Nickname:
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Does this individual have a history of domestic violence?
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Children Affected
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Child 1 First and Last Name:
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(ex. John Smith)
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Child 1 Date of Birth:
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Child 2 First and Last Name:
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Child 2 Date of Birth:
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Child 3 First and Last Name:
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Child 3 Date of Birth:
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Child 4 First and Last Name:
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Child 4 Date of Birth:
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Child 5 First and Last Name:
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Child 5 Date of Birth:
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Child 6 First and Last Name:
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Child 6 Date of Birth:
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Case Information
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County of Support Order:
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Docket Number of Support Order:
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Amount of Arrearage Owed?
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What is the Support Order Amount?
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What is the original Support Order Date?
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Has Support Order ever been modified?
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Non-Custodial Parent Immediate Family (including current spouse):
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Last Name:
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First Name:
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Street Address:
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City:
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State:
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Zip Code:
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Home Phone:
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Work Phone:
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Fax Number:
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E-mail Address:
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Non-Custodial Parent Additional Immediate Family:
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Last Name:
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First Name:
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Street Address:
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City:
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State:
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Zip Code:
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Home Phone:
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Work Phone:
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Fax Number:
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E-mail Address:
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Non-Custodial Parent Work History:
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Present Employer:
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Location:
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Dates Employed:
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Approximate Income:
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Past Employer:
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Location:
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Dates Employed:
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Approximate Income:
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Other Information:
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1) Is the Non-Custodial Parent the biological
parent of each child?
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2) Where did the Non-Custodial Parent live when
the court order was entered for child support?
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3) What evidence is there the Non-Custodial
Parent had actual knowledge of the court order to pay? (e.g. personal service, voluntary
payments, appearances in court, arrest, motions filed)
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4) What is the Non-Custodial Parent's
education background and specialized job skills?
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5) State what you know, and the source(s)
of this information, about
i) Ability to work ii) Income iii) Assets
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6) Have the children lived with you continuously
since the child support order was issued? If not, explain.
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7) Have the children ever been adopted,
and if so, when?
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8) What contact does the Non-Custodial
Parent have with the Children? What contact has occurred in the past?
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9) Have you received direct payment from
the Non-Custodial Parent or his/her family, which did not go through the Friend
of the Court?
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10) Have you ever agreed to a support
arrangement that is different from the court order? If so, explain.
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11) Did you offer or agree not to request
child support for any reason? If so, explain.
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12) Please describe the enforcement proceedings
that have taken place and the agency that took action, including the number of bench
warrants issued.
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13) Has the Non-Custodial Parent been investigated
or prosecuted for criminal non-support?
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14) To your knowledge, has the Non-Custodial Parent
ever been disabled, or received Social Security benefits for a disability?
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15) How long were you in a relationship with the Non-Custodial Parent?
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16) How were you referred to the Attorney General’s office?
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Child Support Complaint Detail
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Please provide any additional relevant information in chronological order, including
dates where possible. You have approximately 8-10 typed pages and you
may paste text from word processing documents.
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Read the Privacy Policy
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