Child Support Services Forms

Below are copies of some of the forms we most often send to customers.

Hacer clic aquí para encontrar la versión en español de estos formularios. 

Please note some information is in PDF (Portable Document Format) and requires the Adobe Acrobat Reader.

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 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 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 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.

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

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.

Welcome Letter for Custodial Parents who are Receiving MassHealth Benefits (F30034)

Welcome Letter for Custodial Parents who are Receiving Benefits from the Department of Transitional Assistance (DTA) (F30035)

Welcome Letter for Parents who Pay (or will pay) Child Support (F30037)

Welcome Letter for Custodial Parents who Submitted an Application for DOR Services (F30070)

Welcome Letter for Parents who Pay in Income Withholding Only Cases (F30077)

Welcome Letter for Custodial Parents in Income Withholding Only Cases (F30078)