Pro Se (Self-Representation) Divorce Packet - State Of Kansas 6th Judicial District Page 49
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50As per Supreme Court Administrative Order No. 168 (amended), all new or
modified non-IVD support orders filed in the Kansas district courts must be
accompanied by this child support order information sheet.
P.O. Box 758599
Topeka, KS 66675-8599
Purpose: Federal law requires Kansas to process child support through a single location in the
state. To insure
that processing of child support payments is not delayed, the Kansas Payment Center must
have all
information listed on the form below.
Who submits this information sheet: The payee's attorney shall submit a child support order
information
sheet with any new or modified non-IVD support orders filed with the Clerk of the District
Court.
Case Number: You must give the full, accurate case number, or payments may be delayed. The
case number
may be copied from the child support order.
Date: _________________________
Case Number: ___________________________________________
Payer’s Name: __________________________________ Date of Birth: ____________
Gender: Male/Female
SSN: __________________________________ *If SSN not known, give reason for
unavailability of SSN:
______________________________________________________________________________
_______
Address, City, State, Zip:
_____________________________________________________________________
Payee’s Name: __________________________________ Date of Birth: ____________
Gender: Male/Female
SSN: __________________________________ *If SSN not known, give reason for
unavailability of SSN:
______________________________________________________________________________
____________
Address, City, State, Zip:
_____________________________________________________________________
Debt Type: CS Obligation Frequency: Weekly
(Circle one) MN (circle one) Bi-weekly
OT Semi-Monthly
Monthly
Obligation Amount: $______________ Start Date: _______________
Child #1: Name: ________________________________ Date of Birth: ____________ Gender:
Male/Female
SSN: ____________________________ (If SSN known, please provide)
Child #2: Name: ________________________________ Date of Birth: ____________ Gender:
Male/Female
Pro Se Divorce Packet
Page 49
Last Updated: 01//26/09
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