Kansas > Local District Court > 4th Judicial District > Domestic
Kansas Payment Center Child Support Order Information Sheet - Kansas
| Kansas Payment Center Child Support Order Information Sheet Form. This is a Kansas form and can be used in Domestic 4th Judicial District Local District Court . |
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CHILD SUPPORT ORDER INFORMATION SHEET As per Supreme Court Administrative Order No. 168 (amended), all new or modified nonIVD support orders filed in the Kansas district courts must be accompanied by this child support order information sheet. Purpose: Federal law requires Kansas to process child support through a single location in the state. To insure that processing of child support payments is not delayed, the Kansas Payment Center must have all information listed on the form below. Who submits this information sheet: The payee's attorney shall submit a child support order information sheet with any new or modified non-IVD support orders filed with the Clerk of the District Court. Case Number: You must give the full, accurate case number, or payments may be delayed. The case number may be copied from the child support order. Date: Case Number: Payer's Name: Gender: Male Female SSN: Date of Birth: *If SSN or Trustee Fee: Active or Inactive (please check one) DOB not known, give reason for unavailability: Address, City, State, Zip E-mail Address: Phone Numbers (mark primary): Home ( Work ( Cell ( ) ) ) Date of Birth: Payee's Name: Revised date: 11/2010 American LegalNet, Inc. www.FormsWorkFlow.com Gender: Male Female SSN: DOB not known, give reason for unavailability: *If SSN or Address, City, State, Zip E-mail Address: Phone Numbers (mark primary): Home ( Work ( Cell Debt Type: CS MN OT Amount ( ) ) ) Obligation Frequency: Weekly Bi-weekly Semi-Monthly Monthly Child #1: Name: Gender: Male SSN: Child #2: Name: Gender: Male SSN: Child #3: Name: Gender: Male SSN: Child #4: Name: Gender: Male SSN: Child #5: Name: Gender: Male SSN: Child #6: Name: Gender: Male SSN: Date of Birth: Female Start Date Date of Birth: Female Date of Birth: Female Date of Birth: Female Date of Birth: Female Date of Birth: Female List additional children on a separate sheet. Revised date: 11/2010 American LegalNet, Inc. www.FormsWorkFlow.com Third Party Payee: Provide the following if payee is an individual: Gender: Male Female Date of Birth: (*If SSN or DOB not known, give SSN: reason for unavailability) Address, City, State, Zip: *Absent extenuating circumstances as determined by the Kansas Payment Center, Payers' and Payees' Social Security Numbers and Dates of Birth must be provided on this form. Form Completed By: Revised date: 11/2010 American LegalNet, Inc. www.FormsWorkFlow.com
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