Oklahoma > Statewide > District Court > Child Support
Family Violence Address Of Record Statement - Oklahoma
| Family Violence Address Of Record Statement Form. This is a Oklahoma form and can be used in Child Support District Court Statewide . |
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OKLAHOMA DEPARTMENT OF HUMAN SERVICES Oklahoma Child Support Services Address of Record Statement or Family Violence Name of custodian (Person receiving support) Last Middle First Social Security number Name of noncustodial parent (Person ordered to pay support) Last Middle First Social Security number Oklahoma child support case number FGN: I, District court case number County State , state that: Type or print your name family violence IS a risk to me or my child(ren) from Name of potentially dangerous person family violence IS NOT a risk in my case. Address of record Use the address below as my public address where I will accept legal and other official papers by regular mail. This address will be printed in legal/court documents and therefore, will be provided to the other parent or party. If family violence is a risk, this address of record should be different from a home address. Street or P.O. Box City State Zip Area code Phone number Area code Fax number I am claiming famil y violence is a risk in m y case. Use the address below as m y confidential location address that will not be released or appear in court documents: Street or P.O. Box City State Zip Area code Phone number Area code Fax number I state under penalty of perjury under the laws of Oklahoma that the foregoing is true and correct. _________________________________________ Signature ________________________ Date and place Form 03EN008E (CSED-8) revised 6-16-2011 may continue on next page, page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Address of Record Statement or Family Violence Purpose of form 03EN008E (CSED-8) A custodial person or a noncustodial parent may use Form 03EN008E to request that his or her home address (location information) not be released to another parent or party in a child support case because release could result in family violence to the requesting person or the person's children. The person may also use Form 03EN008E to designate an address of record for service of legal and other official papers. The address of record may be released to the other parent or party, and it may be shown in court papers. Giving an address of record to Oklahoma Child Support Services (OCSS) is required by law (43 O.S. § 112A). Instructions · · · · · · · · · Enter names and Social Security numbers of the custodian and noncustodial parent. Social security numbers will only be used for child support purposes. Enter the OCSS case number. This is also called the Family Group number (FGN). Enter district court case number and the county and state where it was entered. Type or print the name of person submitting the form. Check one of the boxes to indicate whether family violence is a risk in your case. If family violence is a risk in your case, enter name of potentially dangerous person. Enter address of record information, which is not the home and/or physical address (location). Include a street address or a post office box number with city, state, and zip code that can be released to authorized persons. Enter confidential address information if family violence is an issue in your case. Sign and date the form. Routing This form must be returned either with your application for service or separately. If you complete this form at your local child support office, please leave it at the office. Whether you complete this form at your local child support office, return it with your application, or mail it to the designated address, you must include a copy of an identification card that contains a photograph of you. Make a copy of this form to keep for your records. If you complete this form away from your local child support office, please return it to: OCSS, Central Case Registry, Attn: Address Disclosures P. O. Box 248843 Oklahoma City, OK 73124-8843 Questions? Telephone (918) 295-3500 in the Tulsa area; (405) 522-2273 in the Oklahoma City area; or 1-800-522-2922 toll free. TTY (405) 522-3792 in the Oklahoma City area or 1-866-264-4767 toll free. Form 03EN008E (CSED-8) revised 6-16-2011 may continue on next page, page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com
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