Fill and Sign the New York Case Form

Supreme Court New York State Case Registry Filing Form * For Use With Child Support Orders and Combined Child and Spousal Support Orders Payable To Other Than A Child Support Collection Unit *Social Services Law §111-b(4)(a) and Domestic Relations Law §240(5) direct that such orders must be filed with the State Case Registry Name of Court:       County Name:       Index Number:       Child Support Payor:                   Social Security #:       Date of Birth:       (first) (last) (middle initial) (Payor) (Payor) Child Support Payee:                   Social Security #:       Date of Birth:       (first) (last) (middle initial) (Payee) (Payee) Child #1 Name:                   Social Security #:       Date of Birth:       (first) (last) (middle initial) (Child #1) (Child #1) Child #2 Name:                   Social Security #:       Date of Birth:       (first) (last) (middle initial) (Child #2) (Child #2) Child #3 Name:                   Social Security #:       Date of Birth:       (first) (last) (middle initial) (Child #3) (Child #3) (If more children, please use additional form.) FAMILY VIOLENCE INQUIRY Has a Temporary or Final Order of Protection been granted on behalf of either party? yes no do not know If yes, which party - Payor Payee Has a request for confidentiality of address been granted on behalf of either party? yes no If yes, which party - Payor Payee