Transcription of IV-D Child Support Services Application/Referral
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IV-D Child Support Services Application/Referral
DHS-1201 (Rev. 6-15) Previous edition may be used. MS Word 1 IV-D Child Support Services Application/Referral FOR OFFICE USE ONLY Michigan Department of Health and Human Services Date Requested Date Provided Date Filed Program 748 Provided Office of Child Support (OCS) Please check your relationship to the children for whom you are applying for Child Support Services : IV-D Case No. MDHHS Case No. County District Unit Worker Custodial Parent Non-Custodial Parent or Alleged Father Other Caretaker, Specify Custodial Parent - Complete all sections of the form, enter information about you in Section A. Non-Custodial Parent or Alleged Father Complete all sections of the form except Section F, enter information about you in Section B. Other Caretaker - Complete all sections of the form, enter information about you in Section A. Complete information about each parent who is not in the home in Section B.
Please check your relationship to the children for whom you are applying for child support services:
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