Fill and Sign the Custodial Parent Information Child Support New York State

SUPREME COURT OF THE STATE OF NEW YORK 11 COUNTY OF --------------------------------------------------------------------x 22 33 Plaintiff,Index No. -against-SUPPORT COLLECTION UNIT 44 INFORMATION SHEET Defendant.-------------------------------------------------------------------x The following information is required pursuant to Section 240(1) of the Domestic RelationsLaw: 5 5PLAINTIFF: Address: Date of Birth SS #: 6 6DEFENDANT: Address: Date of Birth SS #: 77Date and Place of Marriage: 88 Plaintiff OR  Defendant is the custodial parent and  is OR  is not receiving public assistance. 9 9UNEMANCIPATED CHILDREN: NameDate of Birth SUPPORT:Maintenance $  per week OR  bi-weekly OR  Semi-monthly OR  per monthChild Support $  per week OR  bi-weekly OR  Semi-monthly OR  per monthTotal Support $  per week OR  bi-weekly OR  Semi-monthly OR  per month1010Support payments are to be made to the Support Collection Unit for the benefit of  Plaintiff OR  Defendant OR  Third Party.1111If third party, list name and address: 1212Non-custodial parent’s employer: Address: 1313Dated: (Form UD-8a, Rev. 1/25/16)