Noncustodial Parent Child Support Enforcement Application

To submit this form, send the completed application to the Washington State Department of Social and Health Services, Division of Child Support by mail, fax, or online submission. Check the DSHS website for the latest submission addresses and fax numbers. Ensure that all sections are completed and required documents are attached. Mail the completed form to: Washington State Department of Social and Health Services, Division of Child Support. Alternatively, email or fax the application to the provided addresses on the DSHS website. For online submissions, follow the instructions provided on the DSHS portal.

There are no specific dates related to this form for 2024 and 2025.

The Noncustodial Parent Child Support Enforcement Application is designed to assist noncustodial parents in providing essential information for child support enforcement. By completing this form, applicants supply personal, employment, financial, health insurance, and marital details to the Washington State Department of Social and Health Services, Division of Child Support. This information is used to establish or modify child support orders and ensure that children receive the financial support they need.

• 1. FULL NAME: Your full name, including last, first, and middle names.
• 2. BIRTHDATE: Your date of birth.
• 3. SEX: Your gender.
• 4. SOCIAL SECURITY NUMBER: Your Social Security Number.
• 5. OTHER NAMES YOU USE: Any other names you use or have used in the past.
• 6. ETHNIC ORIGIN: Your ethnic background.
• 7. HEIGHT: Your height.
• 8. WEIGHT: Your weight.
• 9. COLOR OF HAIR: The color of your hair.
• 10. COLOR OF EYES: The color of your eyes.
• 11. LANGUAGE: The language you prefer for correspondence if not English.
• 12. PLACE OF BIRTH: City, state, and country where you were born.
• 13. INDIAN TRIBE: Whether you are a member of an Indian tribe and the name of the tribe.
• 14. RESERVATION: Whether you live on a reservation and the name of the reservation.
• 15. MAILING ADDRESS: Your P.O. Box or street number, city, state, and ZIP code.
• 16. RESIDENCE ADDRESS: Your residence address if different from the mailing address.
• 17. HOME TELEPHONE NUMBER: Your home telephone number.
• 18. MESSAGE / CELL TELEPHONE NUMBER: Your cell phone number.
• 19. WORK TELEPHONE NUMBER: Your work telephone number.
• 20. MOTHER'S FULL NAME: Your mother's full name, including last and first (list even if deceased).
• 21. MOTHER'S MAIDEN NAME: Your mother's maiden name.
• 22. MOTHER'S ADDRESS: Your mother's address (list even if deceased).
• 23. FATHER'S FULL NAME: Your father's full name, including last and first (list even if deceased).
• 24. FATHER'S ADDRESS: Your father's address (list even if deceased).
• 25. MILITARY STATUS: Whether you are a member of the military reserve forces, the service branch, reserve/national guard, and duty station.
• 26. CONTACT INFORMATION: Information for relatives, friends, or places where DCS can contact you, such as name, address, telephone number, and relation to you.
• 27. EMPLOYMENT: Information about your employment including company name, address, and telephone number.
• 28. UNION: Information about your labor union, including the union's name, local number, and address.
• 29. HEALTH INSURANCE: Information about health insurance available through your employer, union, or Indian Health Services, including insurance company name, policy number, group number, address, type of coverage, and effective dates.
• 30. FINANCIAL: Information about your financial status including gross and net monthly earnings, pay period, bank name, branch, and address.
• 31. RETIREMENT BENEFITS: Information on whether you receive retirement benefits and details of military retirement benefits if applicable.
• 32. WORKERS COMPENSATION: Information on whether you receive workers compensation benefits and the claim number.
• 33. OTHER INCOME: Information on any other income sources.
• 34. PROPERTY: Information on whether you own property, its location, and type.
• 35. MARRIAGE DETAILS: Information about your marriage, paternity, and child support order, including dates and places of marriage, divorce, separation, and child support orders.
• 36. SPOUSAL MAINTENANCE: Information about spousal maintenance, including dates paid and names of persons paid.

Failure to submit this form may result in delays in processing your child support case. It could also impact the enforcement of child support orders.

• Processing Delays: Your child support case may not be processed in a timely manner.
• Impact on Child Support Orders: The enforcement of child support orders may be affected, potentially impacting the financial support your children receive.

• 1. Applying for Child Support: Noncustodial parents needing to apply for child support should use this form.
• 2. Updating Child Support Orders: Use this form to update your existing child support orders.
• 3. Providing Health Insurance Information: Use this form to provide details about health insurance coverage for your children.
• 4. Reporting Financial Information: Use this form to report your financial and employment details for child support calculations.
• 5. Legal Recognition of Responsibilities: Separated or divorced parents can use this form to ensure legal recognition of their financial responsibilities.