Affidavit of Arrears Package

Use the forms in this package if the other parent owes past-due support for a time before your application for services and you want DOR’s help in getting a court order establishing the amount due. The package includes an Affidavit of Arrears, a worksheet and instructions to help you complete the forms.

Annual Notice of Child Support Delinquency doc format of 			Annual Notice of Child Support Delinquency

The law requires us to send this form once a year to customers who owe past-due child support (arrears). The notice explains the various actions we can take to enforce and collect past-due support and provides the customer with information about the cases on which he or she owes child support. 

Child Support Form & Application for Full Child Support Services

This form is used in two ways – use this form if you are a parent who wants to apply for DOR’s full child support enforcement services. You also use this same form if you do not want DOR’s full services, but you have a child support order. You have to complete the form to provide information to the Massachusetts case registry about the support order.

Authorization for Release of Information pdf format of 			Authorization for Release of Information

DOR will not release any information about parents or children to unauthorized third parties. If you want to allow a family member or other person to get information about your child support case, you must sign the Authorization for Release of Information form and return it to DOR

Bank Levy Notice - In State pdf format of 			Bank Levy Notice - In State

DOR issues a Notice of Levy to any bank or other financial institution reporting accounts belonging to a parent who owes past-due support (arrears). The notice instructs the financial institution to freeze the accounts and then send funds in the account to DOR.  This notice is sent to financial institutions in Massachusetts.

Bank Levy Notice - Multi-State pdf format of 			Bank Levy Notice - Multi-State

If a bank or other financial institution that does not do business in Massachusetts reports accounts belonging to a parent who owes past-due support (arrears), DOR issues the Notice of Levy to Multi-State Financial Institutions, instructing the bank or other financial institution to freeze the account and then send funds in the account to DOR.

Bank Levy Response Form pdf format of 			Bank Levy Response Form

If DOR has levied your bank account and you dispute the levy, complete this form and return it to the address stated on the form within 15 days from the date of the levy notice.

Payment Stubs pdf format of 			Payment Stubs

Use these payment stubs any time you need to send child support payments to DOR.

Statement of Financial Condition pdf format of 			Statement of Financial Condition

Use this form to provide a complete list of your income, assets, liabilities and expenses if you are making an offer in settlement, requesting an equitable adjustment of arrears or any other time you are required to provide information on your assets and expenses.

Welcome Letters

DOR sends one of these letters when it begins to provide services on a case. The letter a customer receives depends upon whether the customer is in the role of custodial or noncustodial parent; whether or not a customer is a recipient of public assistance benefits; and what type of services DOR is providing. The letters provide information about how DOR will proceed on a case. To view the letter that applies to you, choose the number from the list below that matches the number in the lower left corner of the letter you received.

F30034 pdf format of 			F30034

This letter is sent to custodial parents who are receiving MassHealth benefits.

F30035 pdf format of 			F30035

This letter is sent to custodial parents who are receiving benefits from the Department of Transitional Assistance (DTA).

F30037 pdf format of 			F30037

This letter is sent to parents who pay (or will pay) child support.

F30070 pdf format of 			F30070

This letter is sent to custodial parents who submitted an application for DOR services.

F30077 pdf format of 			F30077

This letter is sent to parents who pay (or will pay) child support when the only service DOR is providing is to collect and distribute payments made by income withholding.

F30078 pdf format of 			F30078

This letter is sent to custodial parents when the only service DOR is providing is to collect and distribute payments made by income withholding.