Edit, Download, and Sign the Florida Child Support Services Application Form

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How do I fill this out?

To fill out this form, follow the instructions provided carefully and ensure all required information is accurate. You will need to provide details about yourself, the other parent, and the child(ren) involved. Be sure to complete and sign the form where indicated.

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How to fill out the Florida Child Support Services Application Form?

  1. 1

    Complete your personal information including name, address, and contact details.

  2. 2

    Provide details about the other parent, including their contact and employment information.

  3. 3

    Fill out information about the child(ren) involved, including names and social security numbers.

  4. 4

    Sign and date the form where indicated to confirm the accuracy of the information provided.

  5. 5

    Submit the completed form to the Florida Department of Revenue Child Support Program.

Who needs the Florida Child Support Services Application Form?

  1. 1

    Parents who need assistance with obtaining child support payments.

  2. 2

    Caregivers who are responsible for children and seeking support.

  3. 3

    Individuals looking to establish paternity for their child(ren).

  4. 4

    Parents who need to modify existing child support orders due to changes in circumstances.

  5. 5

    People who want to ensure their child(ren) receive health insurance coverage as part of child support.

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What are the instructions for submitting this form?

Submit the completed form to the Florida Department of Revenue Child Support Program by mail or through their online submission portal. You can mail the form to: Florida Department of Revenue, Child Support Program, P.O. Box 8030, Tallahassee, FL 32314-8030. Alternatively, you can submit the form using their online application system on the Department of Revenue's website. For further assistance, you may contact their customer service at 1-800-622-5437.

What are the important dates for this form in 2024 and 2025?

Important dates for this form include the yearly review of child support orders and the deadlines for submitting updated information if changes occur.

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What is the purpose of this form?

The purpose of this form is to facilitate the application process for child support services provided by the Florida Department of Revenue. The form requires detailed and accurate information about the applicant, the other parent, and the child(ren) involved. By submitting the completed form, applicants seek assistance in obtaining support payments, establishing paternity, and ensuring the child(ren) receive necessary health insurance coverage.

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Tell me about this form and its components and fields line-by-line.

This form contains several fields that require specific information about the applicant, the other parent, and the child(ren) involved.
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  • 1. Your Full Name: The complete name of the applicant including first, middle, last, and suffix.
  • 2. Fear of Harm: Indicate whether the applicant has a fear of physical or emotional harm from the other parent.
  • 3. Child’s Caregiver: Specify whether the child(ren) primarily lives with the mother, father, or a caregiver.
  • 4. Social Security Number: Provide the social security number of the applicant.
  • 5. Date of Birth: Enter the applicant’s date of birth.
  • 6. Sex: Select the applicant’s sex (female or male).
  • 7. Mailing Address: Provide the mailing address of the applicant.
  • 8. Driver’s License: Enter the applicant’s driver’s license number and issuing state.
  • 9. Home Phone: Provide the home phone number of the applicant including area code.
  • 10. Work Phone: Provide the work phone number of the applicant including area code.
  • 11. Race: Select the applicant’s race from the options provided.
  • 12. Email Address: Provide the email address of the applicant.
  • 13. Other Names: List any other names the applicant is known by (maiden, former married, nickname).
  • 14. Employment Information: Provide employment details if the applicant is the mother or father of the child(ren).
  • 15. Health Insurance: Provide health insurance details including company name, phone number, policy number, and group number.

What happens if I fail to submit this form?

Failure to submit this form may result in delays or denial of child support services.

  • Delayed Support Payments: Timely support payments may be delayed.
  • No Paternity Establishment: Paternity may not be established for the child(ren).
  • No Health Insurance: The child(ren) may not receive needed health insurance coverage.

How do I know when to use this form?

Use this form when seeking child support services from the Florida Department of Revenue.
fields
  • 1. Request Support Payments: Apply for assistance in obtaining child support payments.
  • 2. Establish Paternity: Use the form to establish paternity for the child(ren).
  • 3. Modify Support Order: Request a modification of existing child support orders.
  • 4. Provide Updated Information: Submit updated information about the child(ren) or parents.
  • 5. Seek Health Insurance Coverage: Ensure the child(ren) receive necessary health insurance coverage.

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What should I do after completing the form?

Submit the completed form to the appropriate authorities following the provided submission instructions.

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