Written Agreement for Past-Due SupportJuly 15th, 2019
FiledJuly 15th, 2019CHILD SUPPORT ENFORCEMENT TRANSMITTAL #1 - INITIAL REQUEST The information on this form may be disclosed as authorized by law. If you are not the intended recipient, you are hereby notified that any use, disclosure, distribution, or copying of this form or its contents is strictly prohibited. Child Support Agency Confidential Information Form must be attached. CS-IS23 N. 01/18 File Stamp IV-D Case: [ ] TANFPetitioner: [ ] IV-E Foster CareTribal Affiliation (if applicable) [ ] Medicaid OnlyRespondent: [ X ] Former Assistance