Fill and Sign the Request for Virginia Registration of a Childcase No Form

REQUEST FOR VIRGINIA REGISTRATION Case No. ........................................................................\ .................................................................. OF NON-VIRGINIA SUPPORT ORDER Commonwealth of Virginia VA. CODE §§ 20- 88.67, 20 -88.72 DCSE ID NO. ........................................................................\ .................................................... ........................................................................\ ................................................................................................\ ............................................................... Juvenile and Domestic Relations District Court CITY/COUNTY ........................................................................\ ................................................................................................\ ................................................................................................\ ................................................................................................\ COURT ADDRESS Name and Address of Obligee: ........................................................................\ ................................................................................................\ ................................................................................................\ ........... ........................................................................................................\ ........................ ........................................................................\ ........................ ........................................................................\ ................................................................ Nam e and Address of Obligor: ........................................................................\ ................................................................................................\ ................................................................................................\ ........... ........................................................................\ ................................................................................................\ ........................ Obligor DOB: ........................................................................\ ...................................................... Obligor SSN: ........................................................................\ ................................................... Other Sources of Income: ........................................................................\ ....................................................... Name/Address of Obligor’s Employer: ........................................................................\ ................................................................................................\ ...................................................................................... ........................................................................\ ................................................................................................\ ................................................................................................\ ................................................................................................\ Des cription /Location of Obligor’s property w ithin Virginia: ........................................................................\ ................................................................................................\ ............................ Support enforcement agency to whom support payment s are to be remitted, if applicable : ........................................................................\ ................................................ I r equest that the clerk of the above -named court register the o rder described below for [ ] enforcement and/or [ ] modification . Two copies (in cluding at least one certified copy) of the order are attached. [ ] As two or more orders are in effect, I am alleging the order below to be the controlling order . ........................................................................\ ........................................................................\ ........................ ........................................................................\ .................................... ................................................ TYPE OF ORDER SUPPORT AMOUNT AND FREQUENCY NAME OF COURT DATE OF ENTRY [ ] I am asserting the following orders to be in effect, in addition to the order described above that I allege to be the controlling order, as two or more orders are in effect. A copy of each order asserted to be in effect is attached. TYPE OF ORDER (Support, Divorce, Income -Withholding, etc.) SUPPORT AMOUNT AND FREQUENCY NAME OF COURT AND DATE OF ENTRY 1. ........................................................................\ ............................................ 1. ........................................................................\ ........................ . 1. ........................................................................\ ............................ 2. ................................ ................................ ................................ .................... 2. ................................ ................................ ................................ . 2. ................................ ................................ ................................ .... 3. ........................................................................\ ............................................ 3. ........................................................................\ ........................ . 3. ........................................................................\ ............................ The amount of consolidated arrears is ........................................................................\ .......................................... [ ] I request a determination of which order is the controlling order. ........................................................................\ ................................................... ________________________________________________________________________\ ___________ DATE S IGNATURE OF REQUESTING PARTY [ ] OBLIGEE [ ] OBLIGOR [ ] SUPPORT ENFORCEMENT AGENCY CERTIFICATION OF ARREARAGE [ ] I swear or affirm that the total amount of the arrearage through ........................................................................\ .......................... is $ ....................................................................... ___________________________________________ SIGNATURE OF REGISTERING PARTY [ ] I CERTIFY THAT I AM THE CUSTODIAN OF THE PAYMENT RECORD AND THAT THE TOTAL AMOUNT OF ARREARAGE THROUGH ........................................................................\ ................................................................................. IS ........................................................................\ ............................................................................................. ........................................................................\ ............................................. ______________________________________________________________________ DATE SIGNATURE/TITLE State of ........................................................................\ ................................................. County of ........................................................................\ ........................................... ; Sub scribed and sworn to before me this ..................... day of ........................................................................\ ...................................................... , ...................................... . ........................................................................\ ........................................................................ ________________________________________________________________________\ NOTARY REGISTRATION NUMBER NOTARY P UBLIC (My commission expires: ..................................................................) FORM DC -685 (MASTER, PAGE ONE OF TWO) 04/15 Case No. ........................................................................\ ..................................................................... CONFIRMATION ORDER Pursuant to Va. Code §§ 20-88.71 through 20-88.73, the request for registration of the abo ve-mentioned n on-Virginia s upport order is: [ ] Confirmed on c ourt motion following the failure of the non-registering party to contest the validity or enforcement of such registered order within twenty (20) days of mailing or personal service of notice of registration . [ ] Confirmed following a hearing for the purposes of [ ] enforcement [ ] modification. [ ] Not confirmed because: [ ] the issuing tribunal lacked personal jurisdiction over the contesting party ; [ ] the order was obtained by fraud; [ ] the order has been vacated, suspended, or modified by a later order; [ ] the issuing tribunal has stayed the order pending appeal; [ ] there is a defense under the law of this Commonwealth to the remedy sought; [ ] full or partial paym ent has been made; [ ] the statute of limitations under § 20- 88.69 precludes enforcement of some or all of the arrearages; or [ ] the alleged controlling order is not the controlling order. It appears to the court that the contesting party has prese nted evidence establishing a full or partial defense; therefore, enforcement of the registered support order is stayed, and the proceeding is continued to permit production of additional relevant evidence . It is further ordered as follows: ........................................................................\ ................................................................................................\ ................................................................................................\ .................................................................................... ........................................................................\ ................................................................................................\ ................................................................................................\ .................................................................................... ........................................................................\ ................................................................................................\ ................................................................................................\ .................................................................................... ........................................................................\ ................................................................................................\ ................................................................................................\ .................................................................................... Any uncontested portion of the registered order may be enforced by all remedies available under the law of this Commonwealth, to -wit: ........................................................................\ ................................................................................................\ ................................................................................................\ .................................................................................... ........................................................................\ ................................................................................................\ ................................................................................................\ .................................................................................... ........................................................................\ ................................................................................................\ ................................................................................................\ .................................................................................... ........................................................................\ ................................................. ___________________________________________ DATE JUDGE FORM DC-685 (MASTER, PAGE TWO OF TWO) 04/15