Fill and Sign the Ny Collection Unit Form

SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF       ---------------------------------------------------------------------x            Plaintiff, Index No.       -against- SUPPORT COLLECTION UNIT INFORMATION SHEET            Defendant. ---------------------------------------------------------------------x The following information is required pursuant to Section 240(1) of the Domestic Relations Law: PLAINTIFF:       Address:       Date of Birth       SS #:       DEFENDANT:       Address:       Date of Birth       SS #:       Date and Place of Marriage:       Plaintiff OR Defendant is the custodial parent and is OR is not receiving public assistance. UNEMANCIPATED CHILDREN: Name Date of Birth SUPPORT: Maintenance $       per week OR bi-weekly OR per month Child Support $       per week OR bi-weekly OR per month Total Support $       per week OR bi-weekly OR per month Support payments are to be made to Plaintiff OR Defendant OR Third Party. If third party, list name and address:       Non-custodial parent’s employer:       Address:       Dated: