Application For Child Support Calculation Page 3
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3ADDRESS:_______________________________
DATE OF BIRTH:_______________PLACE__________________
_________________________________________
SEX:__________GRADUATION DATE:_____________________
NAME:__________________________________
SOCIAL SECURITY NO.:_________________________________
ADDRESS:_______________________________
DATE OF BIRTH:_______________PLACE__________________
_________________________________________
SEX:__________GRADUATION DATE:_____________________
NAME:__________________________________
SOCIAL SECURITY NO.:_________________________________
ADDRESS:_______________________________
DATE OF BIRTH:_______________PLACE__________________
_________________________________________
SEX:__________GRADUATION DATE:_____________________
NAME:__________________________________
SOCIAL SECURITY NO.:_________________________________
ADDRESS:_______________________________
DATE OF BIRTH:________________PLACE___________________
_________________________________________
SEX:__________GRADUATION DATE:_____________________
THE EL PASO COUNTY DOMESTIC RELATIONS OFFICE ENFORCEMENT DIVISION REPRESENTS ONLY THE COURT THAT HAS
RENDERED THE ORDER AS “FRIEND OF THE COURT”. THE OFFICE REPRESENTS NEITHER THE APPLICANT NOR THE PAYOR.
I SWEAR OR AFFIRM THAT I HAVE READ THE ENTIRE APPLICATION, I UNDERSTAND THE INFORMATION CONTAINED THEREIN
AND THE INFORMATION I HAVE WRITTEN ON THIS APPLICATION IS TRUE AND CORRECT TO THE BEST OF MY BELIEF AND
KNOWLEDGE, AND I AGREE WITH THE TERMS SET FORTH ABOVE.
________________________________________________
APPLICANT SIGNATURE
________________________________________________
APPLICANT ‘S PRINTED NAME
________________________________________________
DATE SIGNED
F:\Common\Application forms\application for child support calculation - english.doc
REVISED 4/12
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