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Fill and Sign the Justia Stop Payment Form Texas Harris Local County Free

Fill and Sign the Justia Stop Payment Form Texas Harris Local County Free

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CHARLES BACARISSE, HARRIS COUNTY DISTRICT CLERKCHILD SUPPORT DEPARTMENT1115 CONGRESS, ROOM 10HOUSTON, TEXAS 77002Phone No. (713) 755-6077 Fax No. (713) 755-4359 LOCATION VERIFICATION FORM FOR FUNDS HELD AWAITING ADDRESSES (PLEASE PRINT) DATE: ______________________ CAUSE #_______________________________________ PAYOR NAME: ___________________________________ _ SSN: __________________________________ PAYEE NAME: __________________________________ _ SSN: __________________________________ ________________________________________________________________________________________ PREVIOUS ADDRESS CITYSTATEZIP ________________________________________________________________________________________ CURRENT ADDRESS CITYSTATEZIP HOME PHONE: (_____)___________________ BUSINESS PHONE: (____)______________ NUMBER OF CHILDREN: ____________ NAME: _____________________________________________________ DOB:________________ NAME: _____________________________________________________ DOB:________________ NAME: _____________________________________________________ DOB:________________ NAME: _____________________________________________________ DOB:________________ NAME: _____________________________________________________ DOB:________________ PAYEE SIGNATURE: _____________________________________________________________**Please attach a copy of your state issued picture ID along with the above informationFINCS11 REV 03/29/00

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