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    Forms

     

    The Montgomery County Child Support Enforcement Agency  (CSEA) has provided the forms listed below for your easy access. All forms have been created in Adobe Acrobat PDF format for easy viewing and printing. We have also made each form enterable from your computer. Once you have downloaded the form, simply click on the first enterable field and start filling in your information. Once you have filled out all your information on the form you can print the form to be mailed.  

     

     
    When the form has been completed and signed, please mail all forms to:  

    Montgomery County - CSEA
    14 W. Fourth Street
    PO Box 8744
    Dayton, Ohio 45401-8744
     

     
    Address Change pdf_icon
    Any change in address shall be reported to Montgomery County CSEA. This form must be signed and sent to the Montgomery County CSEA, 14 W Fourth Street, P.O. Box 8744 Dayton, OH 45401
     
    Administrative Adjustment Review Form pdf_icon
    Your child support order will qualify for a review every three years to determine if a modification is applicable based upon your income and circumstances as well as the income and circumstances of the other party. Adjustment reviews may be conducted upon completion of a JFS 01849 and providing the required documentation. To initiate a review of your child support order, you may send this form to Montgomery County CSEA, 14 W Fourth Street, PO Box 8744 Dayton, OH 45401.  Following a review, the support order may increase, decrease, or remain the same.  If your order was completed before October, 2008, any modification will now include an obligation for cash medical support in addition to child support.
     

    General Application for Child Support Services pdf_icon

    Caretaker Application for Child Support Servicespdf_icon

    The Application for Child Support Services (IV-D Application) is your first step in acquiring assistance from the Montgomery County CSEA with your child support case. Application to the program provides for establishment of a support order, enforcement of a support order, location, modification, income tax offset, and other related services. The questionaire provides more detailed information that will be used to determine what type of action we can take on your case to assist with establishing paternity and or/child support order.  Information may be mailed to Montgomery County CSEA, 14 W Fourth Street, P.O. Box 8744 Dayton, OH 45401.
     
    BMV Locations and Offices pdf_icon
    This form provides you with addresses, phone numbers and directions to state BMV offices.  If child support has reinstated your license, you must visit a state BMV office to pay the reinstatement fee for the final reinstatement to occur

     

    Direct Credit Affidavits pdf_icon
    Credit may be granted by the Domestic Relations Court on a case by case basis for payments of support direct to the Obligee. A notarized affidavit may be prepared and submitted to the court for approval. This form must be filled out in its entirety, and is subject to review by the legal staff
     
    Direct Deposit pdf_icon
    Direct Deposit is a convenient method to automatically deposit your child support/spousal support payments to the Financial Institution of your choice.

    To enroll for this direct deposit service:

    1. Download the Direct Deposit form.
    2. Include voided check or deposit slip from your checking or savings account 
      from your bank, savings and loan, or credit union to the form.
    3. Returning the form and voided check or deposit slip to Ohio CSPC at the 
      address provided on the form.
    CSPC must receive your signed, original form and a voided check or deposit slip, before direct deposit can be implemented. Enrollment may take up to three weeks for processing.
     
    Important Payment Information pdf_icon
    This form provides you with the available options of making a child support payment.
     
    Informed Consent pdf_icon
    Informed and Express Consent to Release/Receive Information in behalf of an obligor/obligee.  This forms authorizes a representative to have access to case and Federal Tax Information
     
    Obligor Notification pdf_icon
    The Obligor Notification Form is to serve as notification to the Montgomery County CSEA of any change in circumstances that will impact your support order. Change in financial status is to be reported to the Montgomery County CSEA. Information may be mailed to Montgomery County CSEA, 14 W Fourth Street, PO Box 8744 Dayton, OH 45401. You will receive an acknowledgment from this office confirming receipt of the information that you have submitted.
     
    PIN Reset pdf_icon
    This form can be completed if you would like to check the status of payments on the states automated response line (IVR), or the internet ( http://jfs.ohio.gov/Ocs/paymentstatus.stm).  The first time user telephone PIN# is the last four digits of your SSN followed by the word "kids".  The IVR telephone number is 1-800-860-2555.
     
    Request for Termination of Administrative Order pdf_icon
    The obligee can request to terminate an administrative order for support by completing a notarized form that also erases arrearages owed to the obligee. The obligee cannot be receiving Cash (previously known as OWF) or Medical benefits at the time the form is completed.
    Arrearages owed to the State of Ohio, that accrued from any period of time during which the obligee received Public Assistance (OWF), cannot be forgiven by the obligee. CSEA is authorized to collect those arrearages. The form is reviewed and accepted or denied by the Montgomery County CSEA's Hearings Unit.