Fillable TRAVIS COUNTY DOMESTIC RELATIONS OFFICE APPLICATION FOR ENFORCEMENT form

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TRAVIS COUNTY DOMESTIC RELATIONS OFFICE APPLICATION FOR ENFORCEMENT form

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TRAVIS COUNTY DOMESTIC RELATIONS OFFICE
1010 Lavaca Street
P.O. BOX 1495
AUSTIN, TEXAS 78767
(512) 854-9696
FAX (512) 854-9819
www.traviscountydro.com
APPLICATION FOR ENFORCEMENT
Your name:________________________________________ Date of Birth_______________ or SSN______________________________________
Address:___________________________________________City________________________________State_____ Zip Code_______________
Phone: ________________________________________ e-mail_________________________________________________________________
The person responsible for paying child support is:
Name :________________________________________ Date of Birth_______________ or SSN______XXX-XX-________________________
Address:___________________________________________City________________________________State_____ Zip Code_______________
Unknown
Relationship to Child: Father Mother Other
Which type of Court Order do you have? CAUSE NUMBER ________________Date of Order____________
Paternity Decree
Divorce Decree
Modification Order
Protective Order
What Enforcement Action are you requesting?
Child Support Enforcement
Medical Insurance Reimbursement Enforcement * Provide detailed documentation from provider
Reimbursement for Medical Expenses not paid by Insurance * please attach Spreadsheet
Arrears What Type? Medical Child Support * if children are emancipated please provide copy of High School
Diploma
Have the children subject to this Court Order lived with the NCP in excess of the visitation period defined by the court order?
Yes…..Please provide dates__________________________________________________________________________________________________
No
Who is providing Health Insurance Coverage for the children You NCP Other (specify)______________________
Is the NCP ordered to provide Health Insurance coverage for the children? Yes No
1
_____________________________________________
XXX-XX-
______________________
___
Information about you (The Custodial Parent or Person with Custody)
What is your Relationship to the Children?
Father Mother Other
Your full name
Date of birth/ City & State of Birth
Driver’s License and/or ID Number/State
Your Employer’s Name
Your Employer Address
Employer Phone Number
Your Mailing address
Your Physical address
Phone/Fax Number and/or E-mail
Gender
Race
Height/ Weight
Primary Language
Alternate contact name/number
Alternate contact’s relationship to you?
INFORMATION ABOUT THE CHILD/REN
NAME
Date of Birth
HS Graduation Date:
Name
Date of Birth
HS Graduation Date:
Name
Date of Birth
HS Graduation Date:
Name
Date of Birth
HS Graduation Date:
Name
Date of Birth
HS Graduation Date:
2
Information about the Non-Custodial Parent (parent without Custody)
Relationship to children?
Father Mother Other
Full Legal Name
Alias-Nickname’s
Date of birth
City & State or Country of Birth
Driver’s License and/or ID Number/State
Mailing address
UNKNOWN
Physical address
SAME AS ABOVE
UNKNOWN
Phone/Fax Number and /or E-mail
Gender
Race
Height/ Weight
Primary Language
List any distinctive tattoos, marks or scars
on the NCP
NCP Alternate Contact Name
Address/Phone number
Alternate contact’s relationship to NCP
PLEASE PROVIDE A PICTURE OF THE PERSON ORDERED BY THE COURT TO PAY CHILD SUPPORT
3
Information about the Non-Custodial Parent (parent without Custody) Continued
Does NCP own a Vehicle? Yes No Unknown
Car Truck Van Motorcycle Boat Plane
Year Make Model Color
License Plate Number and State
# Unknown
Does NCP own property/assets
No Yes - Please describe
Unknown
Vehicles (other than the one listed above)
Financial, IRA’s etc
No Unknown Yes - Please list
Real Estate
No Unknown Yes - Please provide location, description etc.
Home, Rental Property
No Unknown Yes - Please provide location, description etc.
Current Employer Name
Unemployed Unknown
Unemployed
Unknown
Employer Address
Unemployed Unknown
Corporate Office Address
Phone/Fax Number and or E-mail
Unknown
What kind of work does NCP do?
Unknown
What hours does NCP work?
Unknown
Does NCP have specialized License i.e. Plumbers,
Electrician, CDL etc
Yes No Unknown
If Yes
License ID/Number?_________________________________
Type of License?____________________________________
Does NCP receive any other income?
Yes No Unknown
Retirement Social Security
Disability Unemployment Benefits
Other Don’t Know
Has NCP been in Jail and or Prison
Yes No Unknown
If Yes Date_______________________________
Location______________________________
Offense_____________________________
Length of Sentence ____________________Release Date_______________
Was or is NCP currently on Probation and or Parole?
Yes No Unknown
If Yes
Parole/Probation Officer Name________________________________________
Location__________________ Phone Number
_________________________
Does NCP own a Weapon?
Yes No Unknown
If Yes Type of weapon
Does NCP have any documented Mental Health Issues?
Yes No Unknown If yes please explain
Does NCP have any documented substance abuse
issues?
Yes No Unknown If yes please explain
I affirm that the information I provided in this application is true and correct to the best of my knowledge and ability.
______________________________________________ ________________________________
Your Signature Date Signed
4
TRAVIS COUNTY DOMESTIC RELATIONS OFFICE
1010 Lavaca Street
P.O. BOX 1495
AUSTIN, TEXAS 78767
(512) 854-9696
FAX (512) 854-9819
www.traviscountydro.com
CUSTODIAL PARENT’S AFFIDAVIT OF DIRECT PAYMENTS
CAUSE NUMBER______________________ OR DRO ACCOUNT NUMBER_______________________
I____________________________________, the custodial parent: certify that either:
I have not received any support payments (in any form) directly from __________________________________, the
Non-custodial parent, including payments from a Trust Fund Escrow Account or Military Allotment, and any payments I received were send to
me from either the Domestic Relations Office or the State Disbursement Unit (SDU) or
the list of support payments provided below (including all dates and amounts) is a correct list of payments I received directly
from_________________________________, the non-custodial parent, and that these payments were not sent to me from
either the Domestic Relations Office or the State Disbursement Unit SDU).
I authorize and request the Domestic Relations Office to disclose this document in its entirety, to _______________________________,(the person from
Whom the support payments were received) and file it with the court.
I certify that there is no court order in effect that prohibits the release of this information, and that this information will be used only for Child Support
purposes.
TOTAL OF ALL DIRECT PAYEMNTS: $ ______________________
Date Amount Date Amount Date Amount Date Amount Date Amount
_______________________________ ____________________________
Custodial Parent Date
STATE OF TEXAS
SUBCRIBED AND SWORN TO BEFORE ME on this ______________day of _________________________
___________________________________
Notary Public in and for the State of Texas
5
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TRAVIS COUNTY DOMESTIC RELATIONS OFFICE APPLICATION FOR ENFORCEMENT form

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Completed 18 January 2020

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