Application

With decades of experience and a record of success that no one else can match, Child Support 2 Collect is ready to help.

Help starts when your short application is completed.

What Is Your Name?

(required)

What Is Your Email Address?

(required)

What is your address?




State:

Please List Your Phone Number With Area Codes:

Primary Phone Number: (required)

Phone (Work):

Phone (Other):

What is the best time and location to reach you by telephone?

Do you have a court order for child support?

yesno

If your answer to this question was no, we are unable to help you with your case. You would need to consult an attorney.

Where did you get your court order?


State:

What year did you get your court order?

How much was the monthly amount of child support in this order?

Was the amount of child support ever changed?

yesno

If yes, what was the changed amount?

What is the approximate amount of past due support?

Please list the dates of birth of all children involved in this child support case. (MM/DD/YY)?

child 1:
child 2:
child 3:
child 4:
child 5:
child 6:

What is the obligor's name?

What is the most recent address you have for the obligor?


State:

What is the obligor's date of birth?

What is the obligor's social security number?

What was the obligor's last known occupation or employer?

Did you ever request assistance collecting child support from one of the following? (Select all that apply.)

Did you ever receive cash benefits from the state government?

(AFDC/TANF/Welfare)
yesno

Were any of your children on Medicaid?

yesno

If you answered yes to either of the two previous questions, has any state debt been repaid?

yesno

How did you first hear of ChildSupport2Collect?

Are there any questions you would like to ask us?

Published by Steven Sinkin on 2013-08-13