JODY PHILLIPS
DUVAL COUNTY CLERK OF THE CIRCUIT COURT
DOMESTIC RELATIONS DEPOSITORY
STOP IDO REQUEST FORM
501 West Adams Street
Jacksonville, FL 32202
Fax: 904-255-2392
Please complete this form and mail or fax it back. Please print.
Your Case #:
Your Name:
Your SSN:
Daytime Telephone Number:
Your Current Address:
City, State:
Zip Code:
Employer Payroll Information
This section must be completed in full in order to process your request.
Name of Employer:
Address:
City, State:
Phone #:
Fax #:
Contact Person:
Email Address:
Signed:
Date