California > Local County > Merced > Family Court
Department Of Child Support Services Court Information Sheet MCDSS-123 - California
| Department Of Child Support Services Court Information Sheet Form. This is a California form and can be used in Family Court Merced Local County . |
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THIS FORM MUST BE COMPLETED AND SIGNED BEFORE YOUR ORDER CAN BE HEARD IN COURT OR FILED WITH THE SUPERIOR COURT CLERK'S OFFICE. MERCED COUNTY DEPARTMENT OF CHILD SUPPORT SERVICES NON-CUSTODIAL PARENT Full Name: Last First Middle Date of Birth: Month Phone: Day Year Sex: Last Known Address: Description: Number & Street City State Zip Home Message/Cell Race: Weight White Black Native American Hispanic Asian Other Hair Eyes Height Present or Last Known Employer: Name of Company Social Security Number: Address Drivers License #: City & State Phone Name & Address of Friend or Relative: CUSTODIAL PARENT Full Name: Last First Middle Date of Birth: Month Phone: Day Year Sex: Last Number & Street City Known Address: Social Security Number: Marriage Date: State Zip Dissolution Date & County Home Message/Cell Welfare #: (If Aided) CHILDREN Name of Child(ren) Date of Birth Social Security # State of Conception Birth Place THIS FORM CONSTITUTES AN APPLICATION FOR SERVICES. I UNDERSTAND THAT THE DEPARTMENT OF CHILD SUPPORT SERVICES WILL ASSIST ME IN MY EFFORTS TO ENFORCE AND/OR MAINTAIN CHILD AND/OR MEDICAL SUPPORT FOR THE ABOVE CHILD(REN). SIGNATURE OF: CUSTODIAL PARENT NON-CUSTODIAL PARENT (Check One) DATE Revised 3/1/2005 MCDSS 123 DEPARTMENT OF CHILD SUPPORT SERVICES COURT INFORMATION SHEET American LegalNet, Inc. www.FormsWorkFlow.com
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