Florida > Local County > Palm Beach > Child Support
Support Information Sheet - Florida
| Support Information Sheet Form. This is a Florida form and can be used in Child Support Palm Beach Local County . |
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SUPPORT INFORMATION SHEET PURSUANT TO S.61.13(10), F.S., THE SECOND PAGE OF THIS DOCUMENT, CONTAINING SOCIAL SECURITY NUMBERS OF THE PARTIES, SHALL BE KEPT CONFIDENTIAL FROM PUBLIC DISCLOSURE. THIS DOCUMENT IS NOT AN ORDER, AND IS FOR ADMINISTRATIVE USE BY THE CLERK. THIS DOCUMENT DOES NOT ESTABLISH OR MODIFY THE RIGHTS OFANY PARTY. THE FORMAT OF THIS DOCUMENT IS APPROVED BY ADMINISTRATIVE ORDER NUMBER 5.012/12-99, AND SHALL NOT BE AMENDED WITHOUT A NEW ADMINISTRATIVE ORDER. and CASE # 9 1. 9 2. 9 3. DIRECT PAYMENT: All child support, alimony, or other support, included in any order requiring the payment of same shall be paid directly to:____________________________ address:___________________________________City/State/Zip:___________________ PAYMENTS THROUGH STATE DISBURSEMENT UNIT: All child support and/or alimony and/or arrearage shall be made payable to and mailed to the State of Florida Disbursement Unit, Post Office Box 8500, Tallahassee, FL 32314-8500. CHILD SUPPORT: The following provisions for payment shall apply: $______Total (Child Support Payment) 9 Temporary 9 Permanent 9 Modified Child support payments shall start on ________________ (Date) and shall stop: 9 upon the child reaching the age of 18. 9 4. 9 upon the child's graduation from high school or at age 19. 9 upon the child's graduation from college or at age ________. 9 by further order of Court or in accordance with the law. ALIMONY: The following provisions for payment shall apply: $______Total (Alimony Payment) 9 TEMPORARY $_________________9 REHABILITATIVE $_______________ 9 PERMANENT PERIODIC $_______9 LUMP SUM $____________________ Payments shall start on ________________ and shall stop on ________________ or upon full payment. 9 5. 9 6. 9 7. 9 8. ARREARAGE $_______________DUE AS OF ___________________. $_________Total (Arrearage Payment) Arrearage payments shall start on _______________ in the amount of $__________ and shall stop upon full payment. OTHER PAYMENTS: DUE FOR ___________________________________ Payments shall start on _______________ in the amount of $__________ and shall stop upon full payment. (Date) SERVICE CHARGE: 4% of each payment, not to exceed $5.25: PAYMENT SCHEDULE : Payment shall be made: $________Total $________ GRAND TOTAL (Arrearage or other payment) $______Total (equitable distribution, attorney's fees, etc) 9 WEEKLY 9 MONTHLY 9 EVERY OTHER WEEK 9 TWICE MONTHLY 9 (1ST & 15TH) 9 (15TH & 30TH) ______________________ The preparer of this form shall insert a specific commencement date which coincides with the first payroll cycle date of the Obligor following entry of the implementing judgment (order), but no earlier than 30 days from entry of the judgment (order). This is because the Court acknowledges that it will take some time to have the Clerk establish the C.S.E. Ledger and to effectuate income deduction order. Accordingly, in the interim, for the next 30 days, those post-judgment support obligations shall be paid directly between the parties, with the Court reserving jurisdiction to enforce non-payment upon the filing of the appropriate motion. The first post-judgment support payment made through F.L.S.D.U. shall occur on the first payment date after expiration of the 30 days hereinabove referenced. American LegalNet, Inc. www.FormsWorkFlow.com ******CLERK: PLEASE KEEP THIS PAGE SEPARATE FROM FILE AND KEEP CONFIDENTIAL****** 9. PERSONAL INFORMATION: Person Paying Support (Obligor) Name:___________________________________ Address:_________________________________ City/State/Zip:____________________________ Phone Number:(____)______________________ Driver's License No.:_____-_____-_____-______ Car Tag Number:__________________________ Date of Birth:__________/__________/________ Social Security Number:_______-______-______ Employer:___________________________________ Employer Address:____________________________ ___________________________________________ Employer's Phone Number (____)______________ Children: Name:__________________________________DOB:__________/__________/__________SS No.:_____-______-__ Name:__________________________________DOB:__________/__________/__________SS No.:_____-______-___ Name:__________________________________DOB:__________/__________/__________SS No.:_____-______-___ Name:__________________________________DOB:__________/__________/__________SS No.:_____-______-___ PREPARED BY: ____________________________________ _____________________________ Name Date REVIEWED BY: ____________________________________ _____________________________ Name Date sis2/12-16-99/lrs Person Receiving Support (Obligee) Name:______________________________________ Address:____________________________________ City/State/Zip:_______________________________ Phone Number:(_____)________________________ Driver's License No.:_____-_____-_____-_________ Car Tag Number:_____________________________ Date of Birth:__________/__________/___________ Social Security Number:________-______-________ Employer:___________________________________ Employer Address:____________________________ ___________________________________________ Employer's Phone Number (____)______________ American LegalNet, Inc. www.FormsWorkFlow.com
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