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Affidavit for termination of child support administrative ...

missouri department OF social services FAMILY support DIVISION Affidavit FOR termination OF child support / administrative ORDER MO 886-4513 (11 12) (Over) CS 699 (11 12) IDENTIFYING INFORMATION IV D CASE NUMBER: ORDER NUMBER: CUSTODIAN NAME: social SECURITY NUMBER: CUSTODIAN ADDRESS: NONCUSTODIAL PARENT NAME: social SECURITY NUMBER: NONCUSTODIAL PARENT ADDRESS: Affidavit for termination of child support / administrative Order I, _____ am the parent ordered to pay child support the parent/custodian owed child support for _____ whose date of birth is _____. This child no longer meets requirements in missouri state law ( Section , RSMo) for current child support to continue because (check all that apply): The child died on _____ (date).

missouri department of social services family support division affidavit for termination of child support/administrative order mo 886-4513 (11–12) (over) cs–699 (11–12) ... notary public embosser seal or stamp state of county (or city of st. louis) …

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