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Appearance Of Child Support Creditor Or Representative 119 - Oregon
| Appearance Of Child Support Creditor Or Representative Form. This is a Oregon form and can be used in Bankruptcy Court Federal . |
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UNITED STATES BANKRUPTCY COURT DISTRI CT OF OREGON In re ) ) Case No.__________________ ) ) APPEARA NCE OF CHILD ) SUPPORT CREDITOR* ) OR REPRES ENTA TIVEDebtor(s) ) I certify under penalty of perjury that I am a child support creditor* of the debtor,________________________________________, or the authorized representative of such childsupport creditor, with respect to the child support obligation which is set out below. Name: Organization: Address: Telephone number: _________________________ X_____________________________________________Date Child Support Creditor* or Authorized Representative Summary of Child Support Obligation Amount in arrears: If Child Support has been assigned: $_____________________ Amount of Support which is owed under assignments: Amount currently due per week or per $_____________________ month on a continuing basis: Amount owed primary child support creditor (balance not assigned): $______________________ (per week) (per month) $_____________________ Attach an itemized statement of account*C hild support creditor includes both creditor to whom the debtor has a primary obligation to pay childsupport as well as any entity to whom such support has been assigned, if pursuant to Section 402(a)(26)of the Social Security Act or if such debt has been assigned to the Federal Government or to any State orpolitical subdivision of a State. 119 (12/7/95)
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