Michigan Attorney Child Support Complaint Form


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CHILD SUPPORT COMPLAINT FORM


(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.
Custodial Parent Information

Last Name:	* *	First Name:	* * MI: *
Street Address:	* *	City:	* *
Your State:	*	Zip Code:	* *
Your County:		Cell Phone:	* (5175551212)
Home Phone:	* (5175551212)	Work Phone:	* (5175551212) Ext: *
Fax Number:	* (5175551212)	E-mail Address:	* *
Date of Birth:	* * (mm/dd/yyyy)	Re-type your E-mail:	*
Social Security No.:	* (333224444)

Non-Custodial Parent Information

Last Name:	* *	First Name:	* * MI: *
Street Address:	*	City:	*
State:		Zip Code:	*
County:
Phone:	* (5175551212)	Cell Phone:	* (5175551212)
Fax Number:	* (5175551212)	E-mail Address:	*
Vehicle Make/Model:	*	Scars, marks, tattoos:	*
Date of Birth:	* * (mm/dd/yyyy)	Social Security No.:	* (333224444)
Gender:		Race:
Eye Color:		Hair Color:
Height:	*	Weight:	*
Alias/Nickname:
Does this individual have a history of domestic violence? YesNo *

Children Affected

Child 1 First and Last Name:	* (ex. John Smith)	Child 1 Date of Birth:	* * (mm/dd/yyyy)
Child 2 First and Last Name:	*	Child 2 Date of Birth:	* * (mm/dd/yyyy)
Child 3 First and Last Name:	*	Child 3 Date of Birth:	* * (mm/dd/yyyy)
Child 4 First and Last Name:	*	Child 4 Date of Birth:	* * (mm/dd/yyyy)
Child 5 First and Last Name:	*	Child 5 Date of Birth:	* * (mm/dd/yyyy)
Child 6 First and Last Name:	*	Child 6 Date of Birth:	* * (mm/dd/yyyy)

Case Information

County of Support Order:
Docket Number of Support Order:		* (D-123, D. 1-234, ...)
Amount of Arrearage Owed?		* * ($1.50, 150, $1,500)
What is the Support Order Amount?		* ($1.50, 150, $1,500)
What is the original Support Order Date?		* * (mm/dd/yyyy)
Has Support Order ever been modified? YesNo

Non-Custodial Parent Immediate Family (including current spouse):
Last Name:		First Name:
Street Address:		City:
State:		Zip Code:	*
Home Phone:	* (5175551212)	Work Phone:	* (5175551212)
Fax Number:	* (5175551212)	E-mail Address:	*

Non-Custodial Parent Additional Immediate Family:
Last Name:		First Name:
Street Address:		City:
State:		Zip Code:	*
Home Phone:	* (5175551212)	Work Phone:	* (5175551212)
Fax Number:	* (5175551212)	E-mail Address:	*

Non-Custodial Parent Work History:
Present Employer:		Location:
Dates Employed:		Approximate Income:
Past Employer:		Location:
Dates Employed:		Approximate Income:

Other Information:
1) Is the Non-Custodial Parent the biological parent of each child? * Limited to 400 characters
2) Where did the Non-Custodial Parent live when the court order was entered for child support? * Limited to 400 characters
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) * Limited to 400 characters
4) What is the Non-Custodial Parent's education background and specialized job skills? * Limited to 400 characters
5) State what you know, and the source(s) of this information, about i) Ability to work ii) Income iii) Assets * Limited to 400 characters
6) Have the children lived with you continuously since the child support order was issued? If not, explain. * Limited to 400 characters
7) Have the children ever been adopted, and if so, when? * Limited to 400 characters
8) What contact does the Non-Custodial Parent have with the Children? What contact has occurred in the past? * Limited to 400 characters
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? * Limited to 400 characters
10) Have you ever agreed to a support arrangement that is different from the court order? If so, explain. * Limited to 400 characters
11) Did you offer or agree not to request child support for any reason? If so, explain. * Limited to 400 characters
12) Please describe the enforcement proceedings that have taken place and the agency that took action, including the number of bench warrants issued. * Limited to 400 characters
13) Has the Non-Custodial Parent been investigated or prosecuted for criminal non-support? * Limited to 400 characters
14) To your knowledge, has the Non-Custodial Parent ever been disabled, or received Social Security benefits for a disability? * Limited to 400 characters
15) How long were you in a relationship with the Non-Custodial Parent? * Limited to 400 characters
16) How were you referred to the Attorney General’s office?

Child Support Complaint Detail * Limited to 24000 characters
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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I certify that the information on this form is true and accurate to the best of my knowledge. *
I consent to releasing to the Michigan Attorney General any information or document relative to the investigation of this complaint. By checking this box, I also certify that I have had the opportunity to review the Michigan Attorney General Privacy Policy before submitting this complaint. * Read the Privacy Policy
Once a criminal charge has been brought, you cannot have it dropped or reduced. Any charge reduction is in the discretion of the Attorney General's office. As a result of prosecution, the Non-Custodial Parent may go to jail or prison and would not be paying child support while incarcerated. The proceedings may put a strain on any relationship he/she has with the children, and/or possibly between the children and you. There is no assurance that you will receive any money due to criminal prosecution and you may be required to testify in court. With these things in mind, I certify by checking this box that I want to request criminal prosecution. *


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