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Memorandum To The Clerk Form - Circuit Court For The Twelfth Judicial Circuit In And For Manatee County

IN THE CIRCUIT COURT FOR THE TWELFTH JUDICIAL CIRCUIT

IN AND FOR MANATEE COUNTY, FLORIDA

FAMILY DIVISION

IN RE:

CASE NO. ________________

________________________________,

Petitioner,

and

________________________________,

Respondent.

___________________________________/

MEMORANDUM TO CLERK

TO:

CLERK, CIRCUIT COURT, DOMESTIC RELATIONS DIVISION

The Court has ordered the payment of child support and/or alimony to your office in the amounts and

at the times indicated below. Please make disbursement of this money to the proper payee.

PAYOR INFORMATION

Name: ___________________________________ Home Telephone: __________________

Address:

__________________________________________________________________________

Date of Birth: __________________ Social Security Number: _________________________

Driver’s License Number: ______________________________ State: __________________

Height: _________________ Sex: ___________

Employer:

_________________________________________________________________________

Address:

_________________________________________________________________________

Telephone: ____________________________ Wages: ____________________________

Attorney for

Payor:__________________________________________________________________

Memorandum To The Clerk Form - Circuit Court For The Twelfth Judicial Circuit In And For Manatee County