
Child Support Information (Illinois)
This form is a supplement to the Divorce with Minor Children packet in Illinois. The form provided here is simply a sample of what the actual form looks like.
STATE OF ILLINOIS
IN THE CIRCUIT COURT OF THE ___________ JUDICIAL CIRCUIT
__________________ COUNTY
) No. ______________
______________________, Plaintiff, )
v. )
______________________, Defendant. )
CHILD SUPPORT INFORMATION
Plaintiff Information
Last Name _____________________________
First _____________________________
MI _____________________________
Residential Address: ________________________________
City: __________________________________
State: ________________
Zip: ______________
Date of Birth: ___________________________
Soc. Sec. No.: ______________________________
Driver's License No.: _____________________
Home Phone ( ) _____________________
Employer Name and Address:
_______________________________________
_______________________________________
_______________________________________
Employer(s) ID Number: _______________________
Work Phone (_____) _______________________
Defendant Information
Last Name _____________________________
First _____________________________
MI _____________________________
Residential Address: ________________________________
City: __________________________________
State: ________________
Zip: ______________
Date of Birth: ___________________________
Soc. Sec. No.: ______________________________
Driver's License No.: _____________________
Home Phone (____) _____________________
Employer Name and Address:
_______________________________________
_______________________________________
_______________________________________
Employer(s) ID Number: _______________________
Work Phone (_____) _______________________
Child/Children Information:
Last Name _______________________
First Name _______________________
MI _______________________
Date of Birth _______________________
Social Security Number _______________________