Illinois > Local County > Lake > Family Law
Child Support Data Sheet 171-192 - Illinois
| Child Support Data Sheet Form. This is a Illinois form and can be used in Family Law Lake Local County . |
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IN THE CIRCUIT COURT OF THE NINETEENTH JUDICIAL CIRCUIT LAKE COUNTY, ILLINOIS ) ________________________________________) PLAINTIFF/PETITIONER) vs. ) ) ________________________________________) DEFENDANT/RESPONDENT) CASE NO. _____________________ COUNTY: _____________________ DATE: _______________________ CHILD SUPPORT DATA SHEET OBLIGOR INFORMATION Last name: First name: Complete Residential Address: Middle In.: Last name: First name: Complete Residential Address: Middle In.: OBLIGEE INFORMATION 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: ( ) Date of Birth: Driver's License No.: Social Security No.: Home Phone Number: ( ) Employer(s) Name/Company: Employer(s) Name/Company: Employer(s) Address: Employer(s) Address: Employer(s) ID Number: Work Phone Number: ( ) Employer(s) ID Number: Work Phone Number: ( ) CHILD/CHILDREN INFORMATION LAST FIRST MIDDLE INITIAL DATE OF BIRTH SOCIAL SECURITY NUMBER 1. 2. 3. 4. 5. (If more space is needed, attach an additional sheet.) * 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. Form approved by Conference of Chief Circuit Judges 171-192 Rev 04/06 Exhibit 1 American LegalNet, Inc. www.FormsWorkflow.com
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