Child Support Order Summary Form {CSS 809}

CHILD SUPPORT ORDER SUMMARY FORM CSS 809 (I.C. 32 - 710A) Child Support Order Summary Form This form mus t be completed and given to the Clerk of the Court, with a copy of the final order attached. SUPPORT PAYMENTS UNDER T HIS ORDER MUST BE SENT TO THE STATE OF IDAHO, CHII.D SUPPORT RECEIPTING, P.O. BOX 70008, BOISE, ID 83707 Case # County Date of Order Who is ordered to pay child support? (full name) How much? $ How often: weekly monthly Beginning date: Special child su pport terms in this order (check all that apply): Cost of living increases Modification of a previous order Decrease for visitation Other Is there an order for Wage Assignment? Yes No (If yes, please attach a copy of the Wage Assignment Order) Male Female Social S ecurity # Date of Birth Phone Number Mailing address Residence address (if different than mai ling) Employer name and address Plaintiff's attorney: Phone City/State Defendant's full name Male Female Social Security # Date of birth Phone number Mailing address Residence address (if different than mailing) Employer name and address Defendant's attorney: Phone City/State Children for whom support is ordered in this order: Child's Full Name Social Security # Date of Birth Sex If support is ordered for more than four children, please attach a separate sheet of paper wi th the information. Print name of person who completed this form: Date: American LegalNet, Inc. www.FormsWorkFlow.com