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Affidavit For Change Of Name Address CCSD-0001 - Illinois

Affidavit For Change Of Name Address Form. This is a Illinois form and can be used in Child Support Cook Local County .
 Fillable pdf Last Modified 6/30/2011

COURT COUNTY OFAffidavit for Change of Name/Address(12/08/03) CCSD 0001. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.OFFICE OF THE CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOISAFFIDAVIT FOR CHANGE OF NAME/ADDRESSCalendar No.JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)Please fill out this form completely, HAVE IT NOTARIZED, then return to our office located at 28 N. Clark Street; Chicago, IL 60602. This information is needed to update our records and properly distribute your child support payments. Our office can be reached at (312) 603-2000; FAX (312) 345-4146. If you would like your payments to be directly deposited, please call (312) 345-4040. If you need TO CHANGE YOUR NAME AS IT CURRENTLY APPEARS on your child support check because: 1) you have remarried, please attach a copy of the marriage license certificate from your local city/village hall/county clerk. 2) you have resumed the use of your maiden name, please attach a copy of the court-order divorce decree authorizing this name change. We only need the first and last 2 pages. Be sure to include the page that states that you can use your maiden name.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Your direct deposit will not be affected by your address being updated. THIS FORM WILL BE RETURNED IF IT IS NOT COMPLETED IN FULL AND NOTARIZEDTHE PEOPLE OF THE STATE OF NEW YORK TO= = = = = = = = = = = = = = = = = = = = = = = = = I, on oath state that I am the party whose name appears on: (please print your name) A. Court docket number(s): B. Please provide the name and social security number of the parent paying for support of child(ren):GREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in room C. Name(s) of child(ren): Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. D. I would like to have my child support payments mailed to the following address:(address)(apt #)(zip code)(state)(city), one of the Justices of theI will be moving to this address, or this address takes effect on: , Court in Witness, Honorableday of, 20 County,Home phone no. () Work phone no. () Your social security no. Date of birth (Attorney must sign above and type name below)Attorney(s) forYourchild(ren)'s social security No(s). // SignatureDate signedNOTARY: Please put your seal in this spaceOffice and P.O. AddressSubscribed and sworn to before me this: day of , Telephone No.: Facsimile No.: E-Mail Address:My commission expires //Check if seal is embossed Notary Public SignatureMobile Tel. No.:DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOISAmerican LegalNet, Inc. www.USCourtForms.com
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