Child Support Information Sheet | Pdf Fpdf Doc Docx | Nevada

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Child Support Information Sheet | Pdf Fpdf Doc Docx | Nevada

Child Support Information Sheet

This is a Nevada form that can be used for Family within County, Washoe, District Court.

Alternate TextLast updated: 5/16/2006

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1 CODE 2 3 4 5 6 IN THE FAMILY DIVISION 7 OF THE SECOND JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA 8 IN AND FOR THE COUNTY OF WASHOE 9 ________________________________, 10 Plaintiff/Petitioner, 11 vs. Case No.12 ________________________________, Dept. No. 13 Defendant/Respondent. __________________________________/ 14 15 CHILD SUPPORT INFORMATION SHEET 16 Pursuant to NRS 425.400, each party in a family law case involving children are17 required to complete the following information: 18 Name: ___________________________________________________________________19 Residential Address: ____________________________________________ Apt. # ______20 Mailing Address: _______________________________________________ Apt. # ______21 City: ____________________ State: ____ Zip: __________ Telephone # ______________22 Social Security Number: ______-______-______ Date of Birth: _______________________23 Drivers License # ___________________________________________ State: _________24 Are you employed? ( ) Yes ( ) No 25 Name of Employer: _________________________________________________________26 Business Address: __________________________________________________________27 City: ____________________ State: ____ Zip: __________ Telephone # ______________28 // <<<<<<<<<********>>>>>>>>>>>>> 2 1 Ethnicity: ( ) White (Not Hispanic) ( ) Hispanic (Hispanic Surname) 2 ( ) Black (Not Hispanic) ( ) American Indian/Alaskan Native 3 ( ) Asian or Pacific Islander ( ) Other 4 CHILD(REN) INVOLVED IN THIS CASE: 5 Name: _____________________________ SSN _____/ _____/_____ DOB ____/____/____ 6 Name: _____________________________ SSN _____/ _____/_____ DOB ____/____/____ 7 Name: _____________________________ SSN _____/ _____/_____ DOB ____/____/____ 8 Name: _____________________________ SSN _____/ _____/_____ DOB ____/____/____ 9 Name: _____________________________ SSN _____/ _____/_____ DOB ____/____/____10 If more than 5 children qualify, list there names on a separate sheet of paper and attach.11 Does this case involve family violence? ( ) Yes ( ) No 12 Are you requesting Child Support Enforcement Services from the District Attorneys Office 13 (IV-D Services)? ( ) Yes ( ) No 14 TO BE FILLED OUT BY COURT PERSONNEL ONLY 15 16 ( ) CUSTODIAL PARENT ( ) NON-CUSTODIAL PARENT17 18 19 20 21 22 23 24 25 26 27 28 - 2 -

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