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This document is used to apply for services related to paternity, child support, and health care coverage for minor children, as per Title IV-D of the Social Security Act.
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How to fill out verified statement and application

How to fill out VERIFIED STATEMENT AND APPLICATION FOR IV-D SERVICES
01
Obtain the VERIFIED STATEMENT AND APPLICATION FOR IV-D SERVICES form from your local child support agency or their website.
02
Read the instructions carefully to ensure you understand the purpose of the form.
03
Fill out your personal information accurately, including your full name, address, phone number, and email.
04
Provide details about the other parent or the child, as requested in the form.
05
Indicate the services you are requesting, such as locating the non-custodial parent or establishing paternity.
06
Attach any required documentation that supports your application.
07
Review your completed application for any errors or missing information.
08
Sign and date the form where indicated.
09
Submit the completed form to your local child support agency, either in person or by mail.
Who needs VERIFIED STATEMENT AND APPLICATION FOR IV-D SERVICES?
01
Parents seeking child support enforcement services.
02
Individuals wanting assistance in locating a non-custodial parent.
03
Custodial parents looking to establish paternity.
04
Families requiring help with ensuring regular child support payments.
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What is VERIFIED STATEMENT AND APPLICATION FOR IV-D SERVICES?
The VERIFIED STATEMENT AND APPLICATION FOR IV-D SERVICES is a legal document used to request assistance from IV-D agencies, which provide child support enforcement services.
Who is required to file VERIFIED STATEMENT AND APPLICATION FOR IV-D SERVICES?
Typically, parents or legal guardians seeking child support services are required to file the VERIFIED STATEMENT AND APPLICATION FOR IV-D SERVICES.
How to fill out VERIFIED STATEMENT AND APPLICATION FOR IV-D SERVICES?
To fill out the VERIFIED STATEMENT AND APPLICATION FOR IV-D SERVICES, individuals need to provide personal information such as names, addresses, and details about the child support case, and then sign the document to verify its accuracy.
What is the purpose of VERIFIED STATEMENT AND APPLICATION FOR IV-D SERVICES?
The purpose of the VERIFIED STATEMENT AND APPLICATION FOR IV-D SERVICES is to formally request child support assistance and to ensure that all necessary information is provided for the IV-D agency to proceed with enforcement.
What information must be reported on VERIFIED STATEMENT AND APPLICATION FOR IV-D SERVICES?
The information that must be reported includes personal identification details, the names of the children involved, custody information, and any relevant financial details related to child support.
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