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Forms
Inquire about
the availability of documents in alternate
formats
Please print the appropriate form and
submit to our office at your earliest convenience. Do
not attempt to complete these forms online
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- Child
Care Verification
- This document must be filled out by the child
care provider indicating the child for which care
is provided and the cost of their service. The
custodial parent may fill this out but will need
to attach any receipts or copies of cancelled
checks for child care they have.
- Claim
of Exemption Updated
7/27/04
- New regulation (AB 1752) change. To apply for
a Claim of Exemption on the seizure of funds
over $3,500 or up to the total amount of funds
levied by Franchise Tax Board, the non-custodial
parent needs to file this form with the Local
Child Support Agency on whose behalf FTB is collecting.
- Complaint
Resolution
- This form is used to initiate the formal complaint
process with either Sacramento County DCSS or
another county DCSS.
- Compromise
of Arrearages Updated
6/24/04
- This form needs to be filled out by the non-custodial
parent if he/she meets all the requirements to
qualify to have the amount of child support debt
lowered.
- Custody
Letter
- This document must be filled out if custody
of the child has changed from one party to another.
- Direct
Pay Record
- This document needs to be filled out by the
custodial parent if she/he has accepted any child
support payments from the non-custodial parent
without the knowledge of the local child support
agency responsible for collecting support payments.
- Domestic
Violence Questionnaire
- This document must be filled out by both parties
on a case to report any instances of domestic
violence by either participant.
- Emancipation
Letter
- This form must be completed by the custodial
parent if the age of emancipation (18 years) of
the child is approaching and the child is still
eligible to receive support by meeting specific
criteria.
- Health
Insurance Information
- This form should be filled out by the non-custodial
parent when providing health insurance information
such as policy number and medical insurance provider.
- Long
income & expense form
- This document must be filled out by both the
custodial and non-custodial parent prior to establishment
of a court order for child support as well as
before a modification of child support can be
entertained.
- Modification
Packet
- The custodial or non-custodial parent must complete
this packet prior to a review for modification.Please
include a completed long income and expense form
as the income and expense documents in this packet
are not sufficient for modification consideration
- Paternity
Questionnaire | Supplemental
Paternity Questionnaire
- The custodial parent must fill this out naming
the father of the child on the case and answering
simple questions pertaining to their relationship.
- Visitation
Verification
- This document must be filled out by the custodial
or non-custodial parent to document the time the
non-custodial parent spent with the child.
- Voluntary
closure request
- This form is completed by a custodial parent
who wishes to close his/her case.
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