Enrollment to Receive Child Support Services

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Your enrollment will NOT submit using Internet Explorer. 

Welcome! We're glad you're here.   ¡Bienvenido! Nos da gusto que esté aquí.

Enrolling with child support services used to be a long, complicated process, but those days are behind us.

This NEW SIMPLIFIED Enrollment Process (SEP) was designed to allow you to provide as much, or as little information as you choose.

 

El proceso de solicitar servicios de child support antes era bastante largo y complicado; pero eso ha cambiado.

La NUEVA solicitud SIMPLIFICADA de Child Support fue diseñada para permitirle proporcionar tanta o poca información como desea.

Which language do you prefer? / ¿Qué idioma prefieres?
Ready to Begin?
Clear

Depending on how much information you can provide, it could take between 5 and 15 minutes to complete your enrollment.

NO - You are not required to have or provide a SSN or ITIN to complete this enrollment or receive services from any child support office in the state of California.

This online enrollment asks for your Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN), but you may leave that question blank if:

  • you do not have an SSN or ITIN
    or
  • you do not have that information available
    or
  • you do not feel comfortable providing that information on an online platform
    Note: you may provide only the last 4 digits if you are uncomfortable entering your complete SSN or ITIN. 

You will be asked to provide basic information about yourself, your child(ren), and the person you wish to open this child support case with.

  • Name/age/location/contact details
  • Information about relationships between the adults & child(ren)
  • Details regarding custody/visitation & prior court orders (if any exist)
Would you like to receive more information about child support services?
Clear

Are you sure? Checking the box above means you must wait to receive important child support enrollment forms via mail instead of receiving instantly via email.

If you don't have an address where you live or receive mail (or both), enter the county or city and state that you spend the most time.
This is where I:
Clear
How do you prefer that we contact you?
Clear

Standard text message data rates may apply.
Check with your wireless carrier for more information.

Standard text message data rates may apply.
Check with your wireless carrier for more information.

Phone Number Type
Dividing Line on ABOUT YOU screen between Phone# and best days/times for a call
Preferred days for a phone call Select all that apply
Best time to call Pacific Standard Time (PST)

Child Support Services will not use the information you provide for any purpose other than communicating directly with you about a pending or complete enrollment for child support services.

Hey 

Before you click "Next", did you mean to leave the address field empty?

It's very important that you tell us where you live or spend the most time because that is how we know which child support office to send your enrollment for processing. 

Nice to meet you, .

Congratulations! You finished the first step!

See how easy that was?

Over the next few screens, you will be asked for information about your child(ren) and the parent or person you wish to open this case with.

Whenever you are able, provide as much detail as possible.

What if I am unable to answer a question?  
Why should I provide information NOW instead of waiting to provide information during my intake interview? 

This screen is simple - just check the box next to each of the statements below that apply to your enrollment.

I would like to establish legal parentage

Check this box if:

  • The parents of the child were not married when the child was conceived or born
    AND
  • The parents did not complete a Voluntary Declaration of Parentage after the child was born
    AND
  • There is no court order to establish the parents of the child(ren)

Parentage is the recognition of a parent's legal relationship to a child.

I would like to get an order for me to RECEIVE child support for the child(ren)

Check this box if:

  • There are NO existing court orders for child support
    AND
  • You would like to establish an order for YOU to RECEIVE child support

I would like to get an order for me to PAY child support for my child(ren)

Check this box if:

  • There are NO existing court orders for child support
    AND
  • You would like to establish an order for YOU to PAY child support

I would like to get an order for medical insurance or expenses

Check this box if:

  • There are NO existing court orders for either parent to provide medical insurance or pay for medical expenses for the child(ren)

Do you already have an OPEN child support case?


YES: Great news! You DON'T need to submit a new enrollment. Just contact your case worker (or call (866) 901-3212) to request a modification.
NO:

That's ok! Complete this enrollment and we'll take it from there.


NOT
SURE:

Click ..Save but do not Submit.. 

Then call (866) 901-3212 to ask whether you have an open case. If you do, they will connect you with your caseworker, so you can request a modification. If you don't, click the link in your email to return to your saved enrollment and pickup where you left off. 


I already have a court order for child support that I would like to change

Check this box if: 

  • There is an existing court order for either parent to pay child support 
    AND
  • You would like to request a modification (change) to that court order

I already have a court order for child support that I would like to enforce

Check this box if:

  • There is an existing court order for either parent to provide child support
    AND 
  • You would like to enforce that order

I already have a court order for medical insurance that I would like to enforce

Check this box if:

  • Either parent is already ordered to provide medical insurance
    AND
  • You would like to enforce that order

What happens next?
The child support office managing your case will contact you for an intake interview within 30 calendar days of receiving your enrollment.

During this interview, they will verify the information you have already provided, and ask a few more questions to gather the information you don't provide here.

If they are unable to reach you via phone or email, your enrollment may not move forward and your child support case could be closed. 

Why should I provide information NOW instead of waiting to provide information during my intake interview?
Whenever possible, please provide as much detail as you can NOW instead of waiting to provide details during your intake interview. This prevents delays in processing information once your child support case is open. 

Avoiding these delays ensures that the case opening and order establishment processes move as swiftly as possible. 

What if I am unable to answer a question?  
If you don't have the answer to a question, or need more time to look for the answer, you have 2 options: 

  1. SAVE your application where you are, and pickup where you left off when you are ready 

  2. SKIP the question for now, and submit your enrollment with the information you have handy

Don't worry if you're unable to answer any questions throughout the enrollment. Child Support Services is able to locate many individuals with as little as a name and date of birth!

Does it cost anything to complete this enrollment or open a case with Child Support Servies?
No
- Completing the enrollment to open a child support case is completely free. 

The only time you could pay anything at all, is $35 for an entire year of services, and only if:

  • we collect more than $550 in child support for your case that year.
    AND
  • you have never received CalWORKS/TANF/any cash assistance. 

You must select at least one of the boxes above so we know what service(s) you are completing this enrollment for.

HIDDEN: Is there RO?

Hey  - Did you know that most child support orders include a requirement for one of the parties to provide health insurance for the child(ren)?

Check the box below if you do NOT want the child support office to provide health insurance enforcement.  

If you DECLINE health insurance enforcement, you must tell the child support office who is providing health insurance for your child(ren). 

All information you provide is kept confidential

But we understand that you or your family may have additional safety concerns. For your protection, we can mark your case with a "Family Violence Indicator". 

If you want your case marked with a Family Violence Indicator, please complete this safety screening. 

Select all that apply


In the next section, we are going to ask questions about the person or parent you are requesting a child support case be opened with.

It is always best to try to provide as much detail as you are able because that helps move things along faster than when we don't have this information. 
You may skip questions you're unable to answer, as long as they don't have a red asterisk *

You may name only one person in this section.

If you need to open a case with another person, you can do that after you submit this application. 

Just the basics - Tell us about the other person or parent

DO NOT ENTER YOUR OWN INFORMATION IN THIS SECTION

Previous Submissions

Hidden Response Mapped Fields & Calculations

Dividing Line on OP screen between name & DOB
Dividing Line on OP screen before address/after SSN
If you don't know the current address for this person or parent, provide the last state and county you saw this person or the last place you were aware of them staying.
Select the type of address you provided for this person/parent
Clear
Dividing Line on OP screen before Phone#/after type of address
Phone Number Type
Clear
Dividing Line on OP screen before incarceration questions.
Have they ever been incarcerated?
Are they currently on probation or parole?

Do you know any relatives or close contacts that know how to reach ?

Does App know any relatives/contacts?

Relationships

Please tell us about the marriage history between you and  , if applicable

This information helps the child support office managing your case to determine what (if any) legal relationships exist between you, your child(ren), and  .

 

Are you currently married to  ?

Are you currently married to OP?

Were you ever married to  ?

Were you ever married to OP?

Are you currently married to someone other than  ?

Are you currently married to anyone else?

Is   currently married to anyone else (that you are aware of)?

Is OP currently married to anyone else?
Clear

Hey 

Before you click "Next", did you mean to leave 's address field empty?

It's very important that you tell us where you think  lives or spends the most time because that is how we know which child support office to send your enrollment for processing.

If you aren't sure of 's exact address, please provide the county and state you believe they spend the most time.

Thanks ! Now, let's go over a few questions your child support case worker will need answered in order to take the next important step once your child support case is open.
You can skip anything you don't know the answer to, as long as you don't see a red asterisk * next to the question. 

This screen should only take a minute or two and the information you provide will make a BIG difference!

Does  have any source of income? 

Does the other parent have any source of income?
Clear

How much income do you believe  receives?
Enter 's TOTAL combined income from all sources BEFORE taxes or deductions  

Dividing Line before OP Types of Income
Select the types of regular or recurring EARNINGS/INCOME the other person/parent receives Select all that apply
Select the types of regular or recurring BENEFITS the other person/parent receives Select all that apply

Do you know where  works?

Do you know where the other parent works?
Clear
OP Emp2 Full Time or Part Time
Clear
OP Emp2 Full Time or Part Time
Clear
OP Emp2 Full Time or Part Time
Clear

Has  ever served in the military?

Has the other parent ever served military?
Clear

In this section, please tell us about the child(ren) you share with  .

Please do not include any child(ren) that you do not share with  

You can apply to open a case for additional child(ren) after you submit this application to open a case with  .

Who do these children live with?
Clear

¿How is   related to the child(ren)? *

Child 1

How is   related to ?

You have selected that you and   are BOTH the NON-Parent Caretaker or Guardian for .

If you are a NON-Parent Caretaker or Guardian of , the other person named MUST be a parent to complete your enrollment.

Please review the answers you selected and choose a different relationship for either yourself or  .

You already selected "Parent who gave birth" as your relationship to

A parent who gave birth is someone who was pregnant with and gave birth to a child. 

Each child can have only one Birth Parent.

 Please make a different selection to one of the relationships for

Child 2

How is   related to ?

You have selected that you and   are BOTH the NON-Parent Caretaker or Guardian for .

If you are a NON-Parent Caretaker or Guardian of , the other person named MUST be a parent to complete your enrollment.

Please review the answers you selected and choose a different relationship for either yourself or  .

You already selected "Parent who gave birth" as your relationship to

A parent who gave birth is someone who was pregnant with and gave birth to a child. 

Each child can have only one Birth Parent.

Please make a different selection to one of the relationships for

Child 3

How is   related to ?

You have selected that you and   are BOTH the NON-Parent Caretaker or Guardian for .

If you are a NON-Parent Caretaker or Guardian of , the other person named MUST be a parent to complete your enrollment.

Please review the answers you selected and choose a different relationship for either yourself or  .

You already selected "Parent who gave birth" as your relationship to

A parent who gave birth is someone who was pregnant with and gave birth to a child. 

Each child can have only one Birth Parent.

Please make a different selection to one of the relationships for

Child 4

How is   related to ?

You have selected that you and   are BOTH the NON-Parent Caretaker or Guardian for .

If you are a NON-Parent Caretaker or Guardian of , the other person named MUST be a parent to complete your enrollment.

Please review the answers you selected and choose a different relationship for either yourself or  .

You already selected "Parent who gave birth" as your relationship to

A parent who gave birth is someone who was pregnant with and gave birth to a child. 

Each child can have only one Birth Parent.

Please make a different selection to one of the relationships for

Child 5

How is   related to ?

You have selected that you and   are BOTH the NON-Parent Caretaker or Guardian for .

If you are a NON-Parent Caretaker or Guardian of , the other person named MUST be a parent to complete your enrollment.

Please review the answers you selected and choose a different relationship for either yourself or  .

You already selected "Parent who gave birth" as your relationship to

A parent who gave birth is someone who was pregnant with and gave birth to a child. 

Each child can have only one Birth Parent.

Please make a different selection to one of the relationships for

Child 6

How is   related to ?

You have selected that you and   are BOTH the NON-Parent Caretaker or Guardian for .

If you are a NON-Parent Caretaker or Guardian of , the other person named MUST be a parent to complete your enrollment.

Please review the answers you selected and choose a different relationship for either yourself or  .

You already selected "Parent who gave birth" as your relationship to

A parent who gave birth is someone who was pregnant with and gave birth to a child. 

Each child can have only one Birth Parent.

Please make a different selection to one of the relationships for

Child 7

How is   related to ?

You have selected that you and   are BOTH the NON-Parent Caretaker or Guardian for .

If you are a NON-Parent Caretaker or Guardian of , the other person named MUST be a parent to complete your enrollment.

Please review the answers you selected and choose a different relationship for either yourself or  .

You already selected "Parent who gave birth" as your relationship to

A parent who gave birth is someone who was pregnant with and gave birth to a child. 

Each child can have only one Birth Parent.

Please make a different selection to one of the relationships for

Child 8

How is   related to ?

You have selected that you and   are BOTH the NON-Parent Caretaker or Guardian for .

If you are a NON-Parent Caretaker or Guardian of , the other person named MUST be a parent to complete your enrollment.

Please review the answers you selected and choose a different relationship for either yourself or  .

You already selected "Parent who gave birth" as your relationship to

A parent who gave birth is someone who was pregnant with and gave birth to a child. 

Each child can have only one Birth Parent.

Please make a different selection to one of the relationships for

Child 9

How is   related to ?

You have selected that you and   are BOTH the NON-Parent Caretaker or Guardian for .

If you are a NON-Parent Caretaker or Guardian of , the other person named MUST be a parent to complete your enrollment.

Please review the answers you selected and choose a different relationship for either yourself or  .

You already selected "Parent who gave birth" as your relationship to

A parent who gave birth is someone who was pregnant with and gave birth to a child. 

Each child can have only one Birth Parent.

Please make a different selection to one of the relationships for

Child 10

How is   related to ?

You have selected that you and   are BOTH the NON-Parent Caretaker or Guardian for .

If you are a NON-Parent Caretaker or Guardian of , the other person named MUST be a parent to complete your enrollment.

Please review the answers you selected and choose a different relationship for either yourself or  .

You already selected "Parent who gave birth" as your relationship to

A parent who gave birth is someone who was pregnant with and gave birth to a child. 

Each child can have only one Birth Parent.

Please make a different selection to one of the relationships for

For the child(ren) above that you are a NON-Parent Caretaker or Guardian: Do you have a court order (or other documentation) granting legal custody or guardianship?

Hey 

Before you click "Next", you forgot to answer one of the relationship questions above.

This information is needed for us to process your enrollment. 

The definitions below can help answer questions with relationship options on this screen.  
Please select the one that most closely matches the relationship for each child.

Parent who gave birth: A parent who was pregnant and gave birth to a child

Parent who did not give birth: A (non-adoptive) parent who did NOT give birth to their child

Adoptive Parent: A parent who has completed a legal process to have permanent parental rights and responsibilities to a child

Non-Parent Caregiver or Guardian: A person who is not the parent to a child but has rights and responsibilities to care for that child (without terminating the rights of the child's parents).  


Hey  - we thought you'd be excited to know that you're more than halfway finished!

In this section please tell us about any court orders that include the child(ren) in this application. 
Even court orders for $0.00 or "Reserved" child support are important!
And if you don't have any court order at all, that's ok too - in fact, helping get orders for child support is our specialty!

Court Order Information

Select all the statements below that apply

On an earlier screen, you told us you already have a court order that you want to enforce or modify.
On this screen, you told us there are NO court orders involving the child(ren) named in this enrollment.

Please review and correct your responses to tell us about ANY court orders for child support, healthcare expenses, or regarding custody and visitation.

To change your response(s) to an earlier question in this enrollment: Scroll to the bottom of this page and click the blue ""Back"" button until you reach the responses you want to change.

Click the "Add Court Order Details" button below to provide details about court-orders involving the child(ren) in this application

Do you already have an OPEN child support case?

YES:  Great news! You DON'T need to submit a new enrollment. Just contact your case worker (or call (866) 901-3212) to request a modification.
NO:  That's ok! Complete this enrollment and we'll take it from there.
NOT SURE:  Call (866) 901-3212 to ask whether you have an open case. If you do, they will connect you with your caseworker, so you can request a modification.

Custody & Visitation Information

Do you want to tell us how much time you spend with the child(ren)?

Do you want to tell us about how much time  spends with the child(ren)?

Does the parent without primary custody spend any time with the children?

Hey  - Did you know you can learn more about the Guideline Calculator by watching a brief video AND you can even access the calculator yourself?!?


Congratulations, ! You completed your enrollment. 

Please review the information you provided below.

If anything is incorrect or any questions were missed that you would like to answer, use the ..Back.. button at the bottom of this screen to make necessary corrections. 

Fields may be left blank, as long as they do not have a red asterisk * indicating a required field.


About You


 

First Name:
Middle Name:
Last Name:
Suffix:
Other name(s) used:
Date of Birth:
Age:
Last 4 of SSN or ITIN:
Phone Number:
Phone Number Type:
Prefered Contact Method:
Email Address:
 

Please confirm your address below - this information is important for determining where your child support enrollment will be processed. If you do not have an address where you live and/or receive mail, please provide the county and state that you spend the most time.

To help with communication, I require support with:

About    


 

First Name:
 
Middle Name:
Last Name:
Suffix:
Email Address:
Date of Birth:
Age:
SSN or ITIN:
Phone Number:
Phone Number Type:
 

Please confirm 's address below. If you do not know the address where  lives and/or receives mail, please provide the county and state they are known or believed to spend the most time.

Dividing Line on CONFIRM screen between Appl & OP info

When contacting , they may require support with:

They may require support with:

What is 's preferred language?


Relationship between you and    

Please confirm your relationship with the other parent

About your child(ren)
 

Child's Name Date of Birth State of Birth Last 4 of SSN Gender  Relationship to Child  Relationship to Child

The child(ren) named above (mostly) live with  .*

Do you agree with the statement above? (Required)

Do you agree with the statement above?

Document Upload and Additional Comments

Before you click next, use this section to upload any documents that apply to your situation.
Click here for examples of documents to include 

You can also enter comments or any additional information not already provided in your enrollment. 

These comments will only be seen by the office processing your enrollment and CA Child Support Services. 


DO NOT INCLUDE ANY COURT ORDER OR OTHER DOCUMENT THAT YOU HAVE ALREADY ATTACHED ON A PREVIOUS PAGE

Examples of documents you may want to attach to your enrollment: 

  • Court Orders involving the child(ren) named in this application.
    • Example: child support, custody and visitation, or divorce/dissolution orders from ANY court
    • NOTE: PLEASE DO NOT INCLUDE ANY COURT ORDER OR OTHER DOCUMENT THAT YOU HAVE ALREADY UPLOADED ON A PREVIOUS PAGE

  • Birth Certificate for the child(ren)
  • Marriage certificate
  • Restraining Orders between you and the other parent or naming the child(ren) in this application
  • Photo of the other parent
  • Proof of income for yourself or the other parent
  • Visitation schedule
  • Child support payment history information (if there is already an order for the other parent to pay child support)
  • Any other document or image that you would like to provide the child support agency managing your case

DUPLICATE UPLOADS OF THE SAME ITEM MAY PREVENT YOUR ENROLLMENT FROM SUBMITTING SUCCESSFULLY.


Demographic Data - Why does it matter?

In the section below we ask just a few questions about you and   to help gather demographic data that allows us to take a data-driven approach to child support services and policy-making.

This helps to ensure that every individual receives fair treatment and has equitable access to all services offered by the child support program. 

You are not required to provide this information - these details are incredibly helpful, but not mandatory to submit your enrollment. 

You may skip the questions below by clicking the blue ..Next.. button at the bottom of this page. 
 

Demographic Details About You

Please indicate YOUR race-ethnicity(ies) Check all that apply

Asian: Origins of any original peoples of the Far East, Southeast Asia, or the Indian subcontinent (Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam), including those identifying as Asian Indian, Chinese, Filipino, Korean, Japanese, Vietnamese, and Other Asian or provide other detailed Asian responses.  

Black or African American: Origins of any Black racial groups of Africa. It includes people who indicate their race as Black, African American; or identify as African American, Kenyan, Nigerian, or Haitian.

Indigenous American Indian or Alaska Native: Origins of any original peoples of North and South America (including Central America) and who maintains tribal affiliation or community attachment. This includes those identifying as American Indian or Alaska Native, Navajo, Blackfeet, Inupiat, Yup'ik, Central American Indian groups, and South American Indian groups.

Hispanic, Latinx or Spanish Origin: Hispanic origin can be viewed as the heritage, nationality, lineage, or country of birth of the person or the person’s parents or ancestors before arriving in the United States. People who identify as Hispanic, Latino, or Spanish may be any race.

Middle Eastern or North African: Origins of Algeria, Bahrain, Djibouti, Egypt, Iran, Iraq, Israel, Jordan, Kuwait, Lebanon, Libya, Malta, Morocco, Oman, Qatar, Saudi Arabia, Syria, Tunisia, United Arab Emirates, Palestine, and Yemen.

Native Hawaiian and Other Pacific Islander: Origins of any original peoples of Hawaii, Guam, Samoa, or other Pacific Islands, including those who identify their race as Native Hawaiian, Guamanian or Chamorro, Samoan, and Other Pacific Islander.

White: Origins of any of the original peoples of Europe, the Middle East, or North Africa. It includes people who indicate their race as White or report entries such as Irish, German, Italian, Lebanese, Arab, Moroccan, or Caucasian.

How did you learn about this enrollment for child support services? Check all that apply

Demographic Details About  

Please indicate THEIR race-ethnicity(ies) Check all that apply


One last thing,   

All information you provide is kept confidential but we understand that you or your family may have additional safety concerns. For your protection, we can mark your case with a Family Violence Indicator.  

Family Violence Questionnaire

DCSS 0048 (02/02/2009)

Section I: Select your response for each of the questions.

Have you or the child(ren) in this case ever been a victim of family violence or child abuse committed by the other parent in this child support case?
If you or the child(ren) in this case receive public assistance, do you want the welfare department to determine eligibility to close your support case because of the increased risk of physical, sexual, or emotional harm to you or the child(ren) in this case, by the other party? This is called having “good cause” to close the support case.

Section II: Please complete this section if you answered "Yes" to any question on this form.

This information helps the child support office understand the history and ensure appropriate safety precautions are taken.

Section III: Please read the statement below and if appropriate, check the box next to the statement.

I understand that IF approved:

  • This request will stay in effect until I let the local child support agency know in writing that they may now give out my information, and the local child support agency tells me that they have received my request.
  • Under federal law, an authorized person may make a written request to the court that has jurisdiction to make or enforce child support or visitation determinations, for release of my information.
  • The local child support agency will let me know in writing if the court orders the release of any information on my case.

Information requested on this form is used by the Department of Child Support Services and local child support agencies for the purpose of safeguarding information from disclosure in domestic and/or child abuse situations.
Failure to provide this information will limit DCSS’ ability to safeguard your information.
The information you provide may be given to the federal government, and other public agencies to the extent required by law.
The agency official responsible for maintenance of the form is:

DCSS: Records Officer
PO Box 419064, MS-110

Rancho Cordova, CA 95741
Fax Number: (916) 464-5069

Copies of this form are maintained in confidential files of the Department of Child Support Services or local child support agencies for 4 years and 4 months after the closure of your child support case.
You have the right of access to this form upon request by faxing (916) 464-5069.

Legal references authorizing solicitation and maintenance of this personal information include: Title 22 California Code of Regulations §§112110(h), 112300, 112301, and 112302; Family Code §17212.
The Information Practices Act of 1997 (Civil Code §1798.17) and the Federal Privacy Act of 1974 (Title 5, United States Code §552a (e)(3), §7 Note) require that this notice be provided when collecting personal information from individuals.

If you have any questions or concerns regarding this notice, please call us at 1-866-901-3212.

The folks in Legal make us say this...


Child Support Services will not use the information you provide for any purpose other than communicating directly with you about a pending or complete enrollment submission.

Your information will never be shared or sold. 


Information and Notices Regarding Your Rights and Responsibilities: 

Participant Responsibility to Protect Confidential Information (DCSS 0749)

Notice of Child Support Services Program (DCSS 0064)

Request for Support Services (DCSS 0055)

Family Violence Questionnaire Cover (DCSS 0049)

Complaint Resolution - State Hearing Information (DCSS 0642)

Servicemember Civil Relief Act (DCSS 0386) 

Declaration of Support Payment History (DCSS 0569)

Visitation Verification (DCSS 0053)

Health Insurance Information (DCSS 0054)

Child Care Verification (DCSS 0069)

Income & Expense Declaration (FL-150)

Confidential Parentage Questionnaire (DCSS 0095)

Repaying Overpayments (DCSS 0161)

These notices will be included in the confirmation email you receive after submitting your enrollment. 

  Beginning October 1, 2020, the Department of Child Support services may assess a $35 Annual Service Fee for each case that has never received public assistance.  
This fee will be assessed one time each year on October 1st for each case with over $550 collected the prior (Federal Fiscal) year.  The fee will be automatically deducted from payment(s) issued to the custodial party after October 1st until $35 has been recovered in full. 
If less than $550 is collected on your case, there is no fee charged for the services provided that year. 
 
  I want the local child support agency to help me get a court order to establish paternity and/or child support, or to enforce a court order I already have.  
 

I will let the child support agency know right away:

  • When each child marries
  • When each child reaches age 18 years and is no longer attending high school, or 19 years, whichever  happens first
  • If my home address, mailing address, or telephone number changes
  • If my employer, including name, address, and telephone number changes
  • If my income changes
  • If my status, cost, or availability of health insurance coverage changes
  • If any information regarding the whereabouts of the other parent(s) changes
  • If the other parent moves back in the same home as the children
  • If there is any change in custody, childcare or visitation
 
 

I understand: 

  • The local child support agency does not represent me, the other parent, or the children in this case.  
  • No attorney-client relationship currently exists between the local child support agency and me, the other parent, or the children.  
  • No attorney-client relationship will be created if the local child support agency provides the support services I have requested. 
  • I am requesting these services from Child Support Services Program under Title IV-D of the Social Security Act.
 
  I declare under penalty of perjury that I have read, understand, and agree to all of the terms specified above.  

I declare under penalty of perjury under the laws of the State of California that the answers I provided on this form are true and correct. 

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Applicant Role

Indicators

HIDDEN: Spanish
HIDDEN: SEP Language (mapped from text set options)

LCSA Routing & Assignment

Roles

HIDDEN: Who is Custodial Party?

PAR details

HIDDEN: Does a court order exist? (Radio)
HIDDEN: Does Applicant provide OP Visitation Info
Clear