2010 Child Support packet by 6y7epU

VIEWS: 17 PAGES: 12

									OFFICE OF THE                   APPLICATION FOR CHILD SUPPORT ENFORCEMENT SERVICES
PROSECUTING               You have asked that the Johnson County Child Support Division enforce your case.
 ATTORNEY                 Please note that we only enforce Johnson County Child Support Orders. If your child
                          support order is in another county, you may initially apply for child support services in
                          Johnson County, but our office will forward your application to the county of your order
                          for enforcement. If you receive TANF or Medicaid in another county, the county in
                          which you receive TANF or Medicaid will be responsible for establishing paternity
                          and/or your child support order.

                          Please provide all of the required documentation on the following checklist:

                          1. ______ A completed “Application for Title IV-D Child Support Services”
BRADLEY D. COOPER            (attached).
   Johnson County
 Prosecuting Attorney
                          2. ______ A signed “Child Support Enforcement Services Waiver” (attached).
1 Caisson Drive, Ste. A
Franklin, Indiana 46131
                          3. ______ A signed “Termination of Child Support Services Notice” (attached).
  Tel: 317-346-4584
  Fax: 317-736-5709
                          4. ______ A completed “Affidavit of Direct Payments Received” (attached).
    Lori M. Lampert
                          5. ______ A completed “Pro Se Appearance” Form (attached).
  Supervising Deputy
 Child Support Division
                          6. ______ One (1) copy of your driver’s license or picture I.D. card for identification
     Lisa Lancaster          purposes.
     Child Support
      Coordinator         7. ______ One (1) copy of the Paternity Affidavit signed by the father, if it is
                             applicable to your case. (This document can be obtained at the Health Department in
     Maryjo Lykins           the county of the child’s birth. NOTE: a Paternity Affidavit is not a Birth
     Investigator            Certificate).

                          8. ______ Three (3) certified copies of your Divorce Decree or Child Support Order.
     Child Support
                             (Certified copy means the Clerk of the Court has placed a seal on the document
  Enforcement Agents:
                             stating that it is an accurate copy and has not been tampered with. Use the “Request
     Cindy Myers             for Certified Child Support Documentation” form provided in your application
        Felony               packet to obtain these certified copies free of charge).

   Heather Woodlee        9. ______ Three (3) certified copies of any changes in the court order for current child
     Payor A-Col             support and the most recent court order showing an established arrearage amount.

     Linda Bowers         10. ______ One (1) certified copy of all child support payments made on your case (this
     Payor Com-E              document can be obtained at the County Clerk of the Court).
     Marcy Klem           11. ______ If you DO NOT currently receive TANF or Medicaid, a one-time
      Payor F-J
                              application fee of twenty-five dollars ($25.00) must be included with your
   Christina Graham
                              application. The fee must be made by money order or cashier’s check made payable
      Payor K-Pq              to the Indiana Department of Child Services. We cannot accept cash or personal
                              checks.
     Larra Young
     Payor Pr-Spq         12. ______ If you DO currently receive TANF or Medicaid, the application fee will be
                              waived if you provide proof of assistance received (For example: one copy of your
    Hannah Griffin            Medicaid cards).
     Payor Spr-Z
                          After you have obtained all of the required documentation listed above, please contact the
                          Johnson County Child Support Division at (317)346-4584 on Tuesday or Thursday to
                          schedule an appointment with an enforcement agent to initiate the child support
                          enforcement process.

                          We look forward to hearing from you.
APPLICATION FOR TITLE IV-D CHILD SUPPORT SERVICES (page 1)
State Form 34882 (R6/12-92) DFC Form 425A
Complete one application for each absent parent for whom application is made.

                                                                                               PRIVACY STATEMENT

Indiana Department of Child Services                                             The records in this series are confidential according to 45 CFR 303.21.
CHILD SUPPORT BUREAU                                                             This agency is requesting disclosure of personal information that is
402 W. Washington St. Rm. W360                                                   necessary to accomplish the statutory purpose of the agency according to
                                                                                 45 CFR 303.70. Disclosure of this information is mandatory. Failure to
Indianapolis, IN 46204                                                           provide any information may prevent this form from being processed.


                                                             INSTRUCTIONS (please read)

The Indiana Child Support Bureau offers child support services to persons desiring to obtain child support from a responsible parent outside the home.
These services are: Complete Service or Parent Locator Only Service. ALL FEES FOR SERVICES ARE NONREFUNDABLE.

COMPLETE SERVICE: The applicant will be entitled to all services offered by the IV-D program as long as the case remains active. This service shall
include the Parent Locator Service and the legal services of the local IV-D agency. These services include Establishing Paternity,/Establishing and/or
Enforcing a support obligation (including health insurance coverage). The complete service does NOT include handling a divorce case, enforcement of
custody or visitation provisions, nor matters other than those associated with the support of dependent children. All support payments may be directed to the
State for monitoring and disbursement. ANY COSTS INCURRED IN EXCESS OF THE APPLICATION FEE, SUCH AS COURT COSTS,
WITNESS FEES, BLOOD TEST COSTS, IRS INTERCEPT FEES AND ADMINISTRATIVE COSTS ASSOCIATED WITH THIS CASE MAY
BE CHARGED AGAINST THE APPLICANT.

In addition the Tax Refund Intercept Project may be used to collect child support arrearages. Application for complete service does not guarantee, however,
that your case will be submitted for tax refund intercept nor that tax refund monies will be collected. In order to certify a case for intercept, there must be a
valid child support order, the absent parent must be at least $500 in arrears, and the applicant must have the absent parent's Social Security number. If any
children of the absent parent have received TANF/AFDC in the past, any collection made from an intercept will first be applied by the State to any
unreimbursed public assistance on any former TANF/AFDC case. If the IRS, for any reason, reclaims all or any portion of an intercepted refund that has
already been paid to you, you are obligated to repay the State of Indiana the amount reclaimed by the IRS. You authorize that any such repayment may be
deducted from support collected on your behalf if other arrangements have not been made and fulfilled.

PARENT LOCATOR SERVICE: The applicant will be entitled to all resources offered by the State and Federal Parent Locator Service until a verified
address is provided or all sources for location are exhausted. The payment of the application fee does not guarantee a successful location. The success will
greatly depend on the applicant's own knowledge about the absent parent. If all sources of information are exhausted without a successful location, the
applicant will be notified. Upon notification,the applicant will have six months to provide additional information. If no additional information is provided
within the six month period, the case will be closed and the applicant notified.

TERMINATION OF SERVICES: The applicant may terminate services only if any charges due or overpayments owing are paid, by notifying the Child
Support Bureau in writing that services are no longer desired. The State may terminate services only in accordance with 45 C.F.R. 303.11. Services in
respect to this application will also terminate if the applicant receives TANF/AFDC.

APPLICANT'S OBLIGATIONS: The applicant is expected to fully cooperate with the local IV-D agency in the legal and non-legal preparation of the
case, including, but not limited to notifying the local IV-D agency of change of address, supplemental information regarding the absent parent, reuniting
with the absent parent, and other information pertinent to the case. THE APPLICANT MUST ALSO NOTIFY THE CHILD SUPPORT BUREAU AT
THE ABOVE ADDRESS OF ANY CHANGE OF ADDRESS.

                             APPLICANT'S STATEMENT

I affirm that the information in this application is true and correct and that false information could result in perjury charges against me. I understand that I
am to cooperate with the local IV-D agency in order for my case to be processed, and non-cooperation can result in termination of my case. I further
understand that payment of the application fee does not guarantee successful action on the case but rather all reasonable attempts, will be made in my behalf
to obtain successful results for the service requested. I have read and understand the above NOTICE.

I hereby request the following service under the terms outlined above.      __Complete Service         __Parent Locator Service Only

Signature of applicant                                                                                                       Date signed (mo., day, yr.)

____________________________________                                                                                          _______________

Application taken by                                                   Case Number                                    Fee Paid

____________________________________                                   ________________                              $_________________
APPLICATION FOR TITLE IV-D CHILD SUPPORT SERVICES (page 2)
State Form 34882 (R6/12-92) DFC Form 425A

                                                      PART II: APPLICANT DATA

1. Full name of applicant (last, first and middle initial) ________________________________________________________
    Maiden Name (if applicable) __________________

2. Date of birth (mo., day, yr.) ___________________        Sex _____     Race _____ Social Security number ___________________

3. Address of applicant (street and number or rural route number) ____________________________________________________
Apt. or room number ___________ City _______________State _______             ZIP code _______________

4. My mailing address is: ______ Same as above         Different (if different, print below)




5. Contact Information:
Telephone number (home) ( ) ____________ Telephone number (work) (                ) ______________ Cell Phone (     ) ______________
Email address: ____________________________________________

6. Name and address of other person who will always know my whereabouts:


     Name                                                                                      Telephone number (   )


Address (street, city, state, ZIP code)                                                        Relationship to me



7. Have you ever received an AFDC/Welfare check in Indiana? Yes: _____________ No: ______________

If "Yes" give the month and year of last check. _________________________________________________


                                            PART III: DEPENDENT DATA/CHILD DATA

I wish to secure support payments on behalf of the following children.

CHILD'S FULL NAME                 SEX     BIRTHDATE         PLACE OF BIRTH         SOCIAL SECURITY # RELATIONSHIP TO ME
(Last, first, M.I.)                       (mo., day, yr.)


1.


2.


3.


4.


5.


6.
APPLICATION FOR TITLE IV-D CHILD SUPPORT SERVICES (page 3-a)
State Form 34882 (R6/12-92) DFC Form 425A

_______________________________________________________________________________________________________________
                                           PART IV: ABSENT PARENT DATA
Applicant (Custodial Parent Name)



A. Full name of absent parent (last, first and middle)                                 Alias or maiden name (last, first, middle)


Social Security number                      Date of birth      Age                            Place of birth (city and state)


 Race                     Height                            Weight                                         Hair                     Eyes



B. Absent parent's address                  Street name and number or rural route number             Apt. or room number
     Current
     Last known         (years)


City                               State                                                                ZIP code

Additional Contact Information: Home Phone Number: ____________________ Work Phone Number: _________________________
                                 Cell Phone Number: ___________________ Email address: ________________________________

C. Name of employer: ________________________________________ Current _____ Last known ________ (years)

       Street name and number or rural route number ________________________________________________

       City ________________________ State ________ Zip Code __________ Usual type of work _________________________

D. Marital status of children's parents Date married ________________ Location married ______________________
   Married               Deserted
   Divorced              Never married      Date separated or divorced ___________ Location separated or divorced _________________
   Separated             Unknown

E. Complete if parent:    Is currently          Or has been in the military service                        F. Names of the absent parent's
  Branch of service       Army         Navy Marines Air Force                     Coast Guard              children. (check blank in front of
  Rank       Officer            Enlisted Service number                                                    name if there is "No" support
                                                                                                           order for this child.)
G. Prior arrest record    Yes          No    Date: ____________ Location:______________
The absent parent         is currently       as been in the past in a jail, prison or institution
Name of institution                                                                                          1.          Date sentenced

Address (city, state or county)                          Date released                                       2.

H. Absent parent's father's name                                                                             3.

Address (city, state or county)                                                                              4.

H. Absent parent's mother's maiden name                                                                      5.

Address (city, state or county)                                                                              6.

I. Other contact person for absent parent                                                                  Verification and comments

Address (city, state or county)
APPLICATION FOR TITLE IV-D CHILD SUPPORT SERVICES (page 3-b)
State Form 34882 (R6/12-92) DFC Form 425A


    PART IV: (continued) COURT ORDER INFORMATION:
 J. COMPLETE THIS SECTION IF CHILD IS BORN OUT OF WEDLOCK
      (Place all other paternity information in comment section)

Has paternity suit been filed?         Yes         No Date filed:_______________ Location filed:_________________________

Has paternity been established by court order? _____ Yes ____ No

Has parent ever paid support or medical or bought things for the children?     Yes ____ No

Amount $________                             Frequency _______________

     K. COURT DATA (all applicants must complete this section)

Has parent ever been ordered by a court to pay support for these children? _____ Yes _____No

Name of court_______________________________________

If No, has a petition been filed and a hearing pending? _____ Yes ______ No

Address of court


Cause number of court order ______________________________

Amount $__________                     Frequency _________________

Absent parent paying support           Yes            No


To whom does parent pay support? ________________________________

Date last paid _______________

Is parent paying military allotment?         Yes      No      Amount $ ______________
APPLICATION FOR TITLE IV-D CHILD SUPPORT SERVICES (page 4)

             ASSIGNMENT FOR COLLECTION FOR PERSONS NOT RECEIVING PUBLIC ASSISTANCE


Name of absent parent

                                                          CHILDREN'S NAMES

1.                                                                      5.

2.                                                                      6.

3.                                                                      7.

4.                                                                      8.



                                                             AGREEMENT


I understand and agree that support payments collected hereafter from the absent parent names above on behalf of myself and/or the above
named children will be paid to the Division of Family and Children, Family and Social Services Administration, and that said support
payments will be paid to me by the agency after deduction of any charges due and owing to that agency. Such charges are explained in page
one of the "Application for Title IV-D Child Support Services" executed by the applicant. This authorization shall continue in effect until
terminated in the manner set forth on page one of the "Application for Child Support Services".

Printed name of applicant


Signature of applicant                                                                             Date signed (mo., day, yr.)


Cause number or support order                                                                      Court name
OFFICE OF THE                  TITLE IV-D CHILD SUPPORT ENFORCEMENT SERVICES WAIVER
PROSECUTING
 ATTORNEY                 The undersigned custodial parent acknowledges that the Johnson County Prosecutor’s
                          Office is an agent of the State of Indiana and the Department of Child Services and
                          cannot serve as a private attorney to custodial parents. The function of the Prosecuting
                          Attorney’s Office is to protect and promote the interests of the State of Indiana and the
                          best interests of the children, and these interests may conflict at times with the interests of
                          the custodial parent.

                          Pursuant to Title IV-D of the Social Security Act, the Child Support Office of the
                          Johnson County Prosecuting Attorney provides four (4) basic services:
BRADLEY D. COOPER             1.      The location of obligated parents.
   Johnson County
                              2.      The establishment of paternity and child support orders
 Prosecuting Attorney
                              3.      The enforcement of child support orders.
1 Caisson Drive, Ste. A
                              4.      The modification of child support orders.
Franklin, Indiana 46131
  Tel: 317-346-4584
                          Pursuant to the mandate of Title IV-D, the Prosecutor’s Office is not allowed to provide
  Fax: 317-736-5709
                          representation, or be involved in, matters that deal with visitation, custody and property
                          settlement. You should consult with a private attorney, legal aid or access
    Lori M. Lampert
  Supervising Deputy      http://www.in.gov/judiciary/selfservice/ concerning those issues.
 Child Support Division
                          The undersigned acknowledges that they are not entering into an attorney-client
     Lisa Lancaster       relationship with any attorney in the Johnson County Prosecutor’s Office. Accordingly,
     Child Support        any confidential information provided to this office is not information protected by an
      Coordinator         attorney-client relationship. Therefore, information provided to the Office of the
                          Prosecuting Attorney may be used by the Office in the prosecution of criminal offenses
     Maryjo Lykins        or civil violations without regard to the source of the information. The undersigned
     Investigator         acknowledges that his/her involvement in the Title IV-D Child Support Enforcement
                          Service does not protect him/her from prosecution for any criminal offense or civil
     Child Support
                          infraction.
  Enforcement Agents:

     Cindy Myers
        Felony
                          NOTE: THIS FORM IS A WAIVER OF LEGAL RIGHTS AND SHOULD BE
   Heather Woodlee        SIGNED ONLY AFTER BEING READ CAREFULLY YOUR SIGNATURE
     Payor A-Cla          VERIFIES THAT YOU HAVE READ AND UNDERSTOOD THE CONTENTS OF
                          THIS FORM.
     Linda Bowers
     Payor Clb-Ge

      Marcy Klem
      Payor Gf-La         I have read the above information in full and understand the contents of this waiver
                          and consent to its terms.
   Christina Graham
     Payor Lb-Ra

     Larra Young
     Payor Rb-Sta
                          ________________________________                            ________________________
    Hannah Griffin
     Payor Stb-Z          Custodial Parent Signature                                  Date
OFFICE OF THE         TERMINATION OF CHILD SUPPORT SERVICES NOTICE
PROSECUTING
              This is to notify you, as a person who is utilizing government services, that the
 ATTORNEY
                          Johnson County Prosecutor’s Office will terminate IV-D Child Support
                          Enforcement Services1 on your case(s) for any of the following reasons:

                              1.       Hiring private counsel regarding child support;

                              2.       Filing motions with the court on your own behalf regarding child
                                       support;

                              3.       Providing false information to any member of the Johnson County
BRADLEY D. COOPER
   Johnson County
                                       Prosecutor’s office, including but not limited to, an enforcement agent,
 Prosecuting Attorney                  the deputy prosecutor or the child support intake line;
1 Caisson Drive, Ste. A
Franklin, Indiana 46131       4.       Providing false information to any member of the Johnson County
  Tel: 317-346-4584                    Court System, including but not limited to, a Judge, bailiff,
  Fax: 317-736-5709                    receptionist or hearing facilitator;

    Lori M. Lampert           5.       Failure to keep the Johnson County Prosecutor’s Office or court
  Supervising Deputy                   notified of your current telephone number and address;
 Child Support Division

     Lisa Lancaster
                              6.       Failure to appear for appointments or required court hearings;
     Child Support
      Coordinator             7.       Failure to discuss private agreements impacting child support in
                                       advance with a Johnson County Prosecutor’s Office child support
     Maryjo Lykins                     enforcement agent, including but not limited to custody changes,
     Investigator
                                       agreed entries, modifications, etc.;

                              8.       Failure to provide documents necessary to litigate your case, including
     Child Support                     but not limited to, court orders, agreed entries and paternity affidavits;
  Enforcement Agents:
                              9.       Continued acceptance of direct child support payments in violation of
     Cindy Myers                       the Johnson County Prosecutor’s Office policy;
        Felony

   Heather Woodlee
                              10.      A demand or request that the Johnson County Prosecutor's Office act
     Payor A-Cla                       unethically, illegally or outside the bounds of the law after having been
                                       informed of the illegality or infeasibility of demand or request;
     Linda Bowers
     Payor Clb-Ge             11.      Signing on with any other child support collection agency, including
                                       but not limited to, www.supportkids.com;
      Marcy Klem
      Payor Gf-La
                              12.      Objecting to incarceration of the non-custodial parent in reference to
   Christina Graham                    civil or criminal child support hearings;
     Payor Lb-Ra
                              13.      Contacting the non-custodial parent’s place of employment regarding
     Larra Young                       any issues related to child support;
     Payor Rb-Sta

    Hannah Griffin
     Payor Stb-Z

                          1 Termination of a child support case includes termination of the following services: enforcement
                          of a child support order, establishment of a child support order, parent locator services, paternity
                          establishment, income withholding orders and tax refund offsets. If a party using our services is a
                          TANF and/or Medicaid recipient, those benefits may also be sanctioned as a result.
OFFICE OF THE
PROSECUTING
 ATTORNEY
                             TERMINATION OF CHILD SUPPORT SERVICES NOTICE (cont.)


                             14.     Failure to provide documentation to the Johnson County Prosecutor’s
                                     Office Child Support Division regarding Social Security Benefits that
                                     the minor child is receiving as a derivative of the non-custodial
                                     parent’s Social Security Disability.

BRADLEY D. COOPER            15.     Any instance of abusive, condescending, demeaning, obscene or vulgar language in
   Johnson County                    the Johnson County Prosecutor’s Office, in the courtroom or court lobby, via
 Prosecuting Attorney                telephone or email to any member of the Johnson County Prosecutor’s staff by the
1 Caisson Drive, Ste. A              custodial parent or any third party acting on behalf of the custodial parent;
Franklin, Indiana 46131
  Tel: 317-346-4584          16.     Any instance of rude, disruptive, abusive or disorderly conduct in the Johnson
  Fax: 317-736-5709                  County Prosecutor’s Office, in the courtroom or court lobby, via telephone or email
                                     to any member of the Johnson County Prosecutor’s staff including, but not limited
                                     to, shouting at staff, interrupting staff, or hanging up the telephone during a call, by
    Lori M. Lampert                  the custodial parent or any third party acting on behalf of the custodial parent;
  Supervising Deputy
 Child Support Division      17.     Threats made to Johnson County Prosecutor’s Office staff by the custodial parent or
                                     any third party acting on the behalf of the custodial parent;
     Lisa Lancaster
     Child Support           18.     A criminal act committed against any member of Johnson County Prosecutor’s
      Coordinator                    Office staff by the custodial parent or any third party acting on the behalf of the
                                     custodial parent;
     Maryjo Lykins
     Investigator

                          I hereby acknowledge that I have received and read the above referenced
                          Termination of Services. I further acknowledge that my signature on said
     Child Support        document shall serve as my request for immediate termination of all IV-D Child
  Enforcement Agents:     Support Enforcement Services for non-cooperation, including being sanctioned
     Cindy Myers
                          from any TANF and/or Medicaid Benefits that I receive if the offense is subject to
        Felony            being sanctioned, with no further action or notification necessary.

   Heather Woodlee
     Payor A-Cla          ______________________________                                 ________________________
     Linda Bowers
                          Custodial Parent Signature                                     Date
     Payor Clb-Ge

      Marcy Klem
      Payor Gf-La

   Christina Graham
     Payor Lb-Ra

     Larra Young
     Payor Rb-Sta

    Hannah Griffin
     Payor Stb-Z
STATE OF INDIANA                            )      IN THE JOHNSON CIRCUIT COURT
                                            )SS:   JUVENILE & FAMILY DIVISION
COUNTY OF JOHNSON                           )      CAUSE NO. ________________________________

_______________________                            )
Petitioner,                                        )
                                                   )
vs.                                                )
                                                   )
_______________________                            )
Respondent.                                        )

AFFIDAVIT OF DIRECT PAYMENTS

Comes now the Affiant, _____________________________________________, and states as follows:
      1. The Respondent has paid to me a total of $ ___________________ in direct payments, from the
          date of _______________________ to _______________________.
      2. I will not accept any further direct payments of child support from the Respondent from this point
          forward or I will be terminated from the Johnson County Title IV-D Child Support Enforcement
          Program without further notice.
      3. I understand that the State of Indiana will request an arrearage determination hearing from the
          court to present evidence on the amount of direct payments that will be deducted from the
          Respondent’s child support arrearage owed to me.
      4. I hereby AFFIRM under the penalties for perjury that the foregoing representations are true.

FURTHER AFFIANT SAITH NOT.


_________________________________                          _________________________________
Signature                                                  Printed Name



Subscribed and sworn to before me, a Notary Public, in and for the said County and State, on __________
day of ____________________, ___________.


____________________                                       ____________________________________
COMMISSON EXPIRES                                          NOTARY PUBLIC
STATE OF INDIANA                        )        IN THE JOHNSON CIRCUIT COURT
                                        )SS:     JUVENILE & FAMILY DIVISION
COUNTY OF JOHNSON                       )        CAUSE NO. ________________________________

_______________________                          )
Petitioner,                                      )
                                                 )
vs.                                              )
                                                 )
_______________________                          )
Respondent.                                      )

NOTICE OF PRO SE APPEARANCE

I am the _____ Petitioner _____ Respondent in this matter.

I enter my pro se appearance; I will represent myself. Unless I, or an attorney, notify the Court
otherwise, no attorney will represent me in this matter.

In representing myself, I understand that it is my responsibility to:

               Notify the Court, in writing, of any changes in my address, employment or telephone
                numbers;
               Always include my cause number, name, address and telephone number on all
                correspondence I file with the Court; and
               Send copies of all papers I file with the Court to the other party involved in this
                matter.

All Court papers may be mailed to me by First Class Mail at the address listed below.

Service Address:          ___________________________________
                          ___________________________________
                          ___________________________________
                          ___________________________________

________________________________                         ____________________________________
Date                                                     Signature of Party Appearing

                                                         ____________________________________
                                                         Printed Name of Party Appearing
Distribution:
Johnson County Prosecutor’s Office
Petitioner/Respondent
OFFICE OF THE
PROSECUTING
 ATTORNEY
                            CLERK OF THE COURT:



                            RE: ___________________________________________________

                            Cause Number: __________________________________________


BRADLEY D. COOPER
    Johnson County
  Prosecuting Attorney
 1 Caisson Drive, Ste. A
 Franklin, Indiana 46131       REQUEST FOR CERTIFIED CHILD SUPPORT DOCUMENTATION
   Tel: 317-346-4584        Please provide The Johnson County Child Support Division with three (3) certified
   Fax: 317-736-5709
                            copies of the following information:
    Lori M. Lampert             1.      Divorce Decree and/or Paternity Order;
  Supervising Deputy
 Child Support Division         2.      Certified payment history of all payments made, including all Pre-
                                        ISETS payments; and
       Lisa Lancaster
Child Support Coordinator       3.      Any modification Order that would affect the calculation of the child

      Maryjo Lykins                     support Order for the above referenced individuals.
      Investigator



      Child Support
   Enforcement Agents:
                            The person wishing to collect child support has been authorized to pick up these
      Cindy Myers           copies for the Johnson County Child Support Division and should not be charged
         Felony
                            any fee for certification and copies of the documents.
    Heather Woodlee
      Payor A-Cla

      Linda Bowers
      Payor Clb-Ge          Deputy Prosecuting Attorney

      Marcy Klem            Johnson County Child Support Enforcement
      Payor Gf-La

    Christina Graham
      Payor Lb-Ra

      Larra Young
      Payor Rb-Sta

     Hannah Griffin
      Payor Stb-Z


                            ATTENTION: You must give the clerk and/or the court staff sufficient notice
                            to obtain these copies.

								
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