Illinois > Local County > Champaign > Civil
Child Support Data Sheet - Illinois
| Child Support Data Sheet Form. This is a Illinois form and can be used in Civil Champaign Local County . |
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CIRCUIT COURT OF ILLINOIS Sixth Judicial Circuit Champaign County ________________________________ Petitioner vs. Case No: ___________________ ______________________________ Respondent CHILD SUPPORT DATA SHEET OBLIGOR INFORMATION Last Name: First Name: Complete Residential Address: Middle Init.: Last Name: First Name: OBLIGEE INFORMATION Middle Init.: Complete Residential Address: Complete Mailing Address (If other than above) Complete Mailing Address (If other than above) Date of Birth: Driver's License No.: *Social Security No.: Home Phone Number: ( Employer(s) Name/Company: Employer(s) Address: ) Date of Birth: Driver's License No.: *Social Security No.: Home Phone Number: ( Employer(s) Name/Company: Employer(s) Address: ) Employer(s) ID Number: Work Phone Number: ( ) Employer(s) ID Number: Work Phone Number: ( ) CHILD/CHILDREN INFORMATION LAST 1. 2. 3. 4. 5. *If obligor is not a US citizen, so indicate and provide the obligor's alien registration number, passport number and home country's social security or national health number. FIRST MIDDLE INITIAL DATE OF BIRTH SOCIAL SECURITY NUMBER (If more space is needed, attach an additional sheet.) Revised: 12/12 Katie M. Blakeman Clerk of the Sixth Judicial Circuit Court 101 E. Main Street Urbana, Illinois 61801 American LegalNet, Inc. www.FormsWorkFlow.com
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