Form 281 - Appearance Of Child Support Creditor* Or Representative printable pdf download

Form 281 - Appearance Of Child Support Creditor* Or Representative

Form 281 (08/06)

United States Bankruptcy Court

_______________ District Of _______________

In re ______________________________,

Case No. ________________

Debtor(s)

APPEARANCE OF CHILD SUPPORT CREDITOR*

OR REPRESENTATIVE

I certify under penalty of perjury that I am a child support creditor* of the above-named

debtor, or the authorized representative of such child support creditor, with respect to the

child support obligation which is set out below.

Name:

Organization:

Address:

Telephone Number:

________________

X_________________________________________________

Date

Child Support Creditor* or Authorized Representative

Summary of Child Support Obligation

Amount in arrears:

If Child Support has been assigned:

$ ___________________________

Amount of Support which is owed

under assignments:

Amount currently due per week or per month:

on a continuing basis:

$ _______________________

$ ___________________________

Amount owed primary child support

(per week) (per month)

creditor (balance not assigned):

$ _______________________

Attach an itemized statement of account. Do not disclose the name of a minor child. See 11 U.S.C.

§ 112. If a social security number or a taxpayer identification number is included, set out only the

last four digits of the number. Judicial Conference Privacy Policy (09/01).

* Child support creditor includes both creditor to whom the debtor has a primary obligation to pay child support

as well as any entity to whom such support has been assigned, if pursuant to Section 402(a)(26) of the Social

Security Act or if such debt has been assigned to the Federal Government or to any State or political subdivision

of a State.

Form 281 - Appearance Of Child Support Creditor* Or Representative