Child Support Services App - Cases w/out Order

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Colorado Division of Child Support Services (CSS)

Application for Child Support Services
Please complete this application to the best of your ability. Providing as much information as possible will help us establish and enforce your child support order. If you do not know the answers to the questions, or do not have the information, leave the fields blank. You can discuss your specific situation with your county.

Tell Us About Yourself
Legal Name*
First NameMiddle NameLast Name
Maiden Name*
Other
CSS Tip: “Other” means different last names you may have used. This includes other married last names, or the name used before a legal name change.
Date of Birth*

MonthDayYear
Date
Personal Identification Number*
Social Security Number, Taxpayer Identification Number, Do not have one
Gender
Ethnicity
Where were you born?

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How can we reach you?
Home Phone*
Please enter a valid phone number.
Work Phone
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
Which number would you like us to use to contact you?
Would you like to receive text messages about your child support case?
Email Address
example@example.com
Where do you live today?

CSS Tip: You cannot use a PO Box as a residential address.
Address*

Street Address

Apartment / Unit #

CityState / Province

Postal / Zip CodeCountry
Can you receive mail here?

YesNo
IF NO, please provide an address where you can receive mail

Street Address

Apartment / Unit #

CityState / Province

Postal / Zip CodeCountry
Are you currently working?

YesNoI am a full-time student
IF YES, Where do you work? Please list the name of your current employer.
Employer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
IF NO, What date did you last work?

MonthDayYear
Date
Why are you currently unemployed?

DisabilityLaid OffOther
When will you graduate?
Primary Contact

CSS Tip: This is someone who will always know whereyou are, even if you move. This person willonly be contacted if you cannot be reached.
Primary Contact Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Primary Contact Address

Street Address

Apartment / Unit #

CityState / Province

Postal / Zip CodeCountry

Tell Us More About the Other Parent's Family
Do you have information about the other parent's mother?

YesNo
IF YES, Please complete the following
Mother's First Name
Mother's Last Name or Maiden Name
Mother's Phone Number
Please enter a valid phone number.
Mother's Address

Street Address

Apartment / Unit #

CityState / Province

Postal / Zip CodeCountry
Do you have information about the other parent's father?

YesNo
IF YES, Please complete the following
Father's Name

First NameLast Name
Father's Phone Number
Please enter a valid phone number.
Father's Address

Street Address

Apartment / Unit #

CityState / Province

Postal / Zip CodeCountry

Tell Us More About Your Relationship with the Other Parent
Were you ever married to the other party?

YesNo
If yes, complete the following
What was the date of the marriage, common law or civil union?

MonthDayYear
Date
Where did the marriage take place?
Date of separation

MonthDayYear
Date
Date of divorce

MonthDayYear
Date
Where was the divorce filed?

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
When did you last have contact with the other parent?

MonthDayYear
Date
Does the other parent have other biological children?

YesNoDo not know
IF YES, Please provide the names of the biological child (ren),if known. Please provide the name of the other parent of the biological child(ren), if known. Is there any other information that will help us locate the other parent?

Tell Us About the Child (ren) Who Need Support

Type a question*

	Child 1	Child 2	Child 3
Legal First Name
Last Name
Date of Birth
Personal Identification Number (SSN or TIM, None, Unknown)
Gender (Male, Female, Other)
What city was the child born in?
What state was the child born in?
What country was the child born in?
What county was the child conceived in?
What city was the child conceived in?
What state was the child conceived in?
What country was the child conceived in?
Who is the Mother on the birth certificate?
Who is the Father on the birth certificate?
Has parentage (paternity) been established? (Yes, No, or Do not Know)
How was paternity established? (DNA testing, Acknowledgement of Paternity or Court Order)
Has the other parent ever lived with or provided support for the child in Colorado? (Yes, No, or Do not know)
When did the other parent provide support for this child?
Where did the other parent provide support for this child?
What type of support did the other parent provide for this child? (Money , clothing, food, medical bills, daycare bills, transportation or other bills)
Has the child ever received public assistance from a state or tribe? (Yes, No, Do not know)
Where did the child receive public assistance? (List the county, state or tribe)
What type of public assistance did the child receive? (Foster Care, Medicaid, TANF)

Tell Us More About Your Situation
Type a question

YesNo
IF YES, Name of the court where the order was established
Child Support Order Number
Child Support Order Location

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
When did you last receive support?
Is an attorney already involved in your case? CSS Tip: You are not required to have an attorney to apply for or receive child support services

YesNo
IF YES, Please porvide contact information for your attorney
Name of Law Firm
Attorney Name

First NameLast Name
Attorney Phone Number
Please enter a valid phone number.
Attorney Address

Street Address

Apartment / Unit #

CityState / Province

Postal / Zip CodeCountry
Does the other party have an attorney?

YesNoDo not know
IF YES, Please complete the following
Name of Law Firm
Attorney Name

First NameLast Name
Attorney Phone Number
Please enter a valid phone number.
Attorney Address

Street Address

Apartment / Unit #

CityState / Province

Postal / Zip CodeCountry

What we need from you

To start the process, please supply the following legal documents:
1. One (1) application for each non-custodial/custodial parent
2. Copy of a state-issued birth certificate and social security card for each child
3. Copy of personal identification (i.e. driver’s license)
4. A photo of the other parent, if available; it will be returned to you
5. Verification of your income (i.e. pay stubs, tax returns)
6. Copy of Marriage Certificate (if not available, supply date of marriage and/or otherevidence of marital status)
7. Copy of Court Order(s) signed by a judge or magistrate (if not available supply date,county, state of filing and court case number):
  - Petition and/or Divorce Decree and/or Separation Agreement
  - Paternity Orders
  - Certified Copy of Child and/or Spousal Support Order
  - All modified orders
  - Allocation of Parental Responsibility Orders
  - Probate OrdersoDependency and Neglect Orders
  - Adoption Orders
  - Orders Terminating Parental Rights
8. Complete payment records of all support paid to the custodial party directly, through courtor a state disbursement unit
Please upload any of the above documents here

If the total size of the above documents is greater than 10 megabytes, please email them to Child_Support_Administration@jeffco.us. In the email, please include your name and the name of the other party in the subject line. In the body of the email, indicate that you completed the online CSS application.
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Terms and Conditions
By signing my name below, I am submitting my application for child support services to the Colorado Division of Child Support Services. By submitting this form, I understand:

CSS represents the People of the State of Colorado. No attorney-client relationship or privilege exists between either party or the CSSstaff.

CSS does not handle custody arrangements, parenting time (visitation) or property settlements.

CSS will not accept the application for services I fall the children associated with the applicant have emancipated (left home).

CSS will not enforce spousal maintenance once the current child support order ends.

If there is a change that could cause the amount of the order to be adjusted (e.g. financial or medical), a modification (change) may be initiated by CSS or by any one of the parties involved.

CSS determines the appropriate actions to be used when providing services. Each Colorado county child support office determines how specific child support cases are handled.

If I have a disability or need additional support under the Americans with Disabilities Act, I must contact my county child support office for assistance.

I must notify CSS in writing to stop child support services. The case may remain open if my children receive public assistance or if assigned arrears (outstanding payments) are owed. CSS may also close my case if required by state and federal regulations.

I must provide CSS with the information needed to establish and enforce my child support order. My case may be delayed if this information is not received and/or if another state becomes involved.

I am required to cooperate with CSS. If I do not, my case may be closed.

Caretaker/relatives (e.g., grandparent, aunt, uncle, adult sibling, stepparent, etc.) applying for childsupport, must open a case against both biological parents. CSS is unable to close only one of the two cases against the biological parents.

I may be required to complete and sign a legal document agreeing to the amount of child support arrears owed (if there is a current child support order).

I will notify CSS in writing if any of the following occurs. If I do not, my medical or childsupport payments may be affected.
1. Change to legal name, residence or mailing address, telephone or contact numbers, place of employment or health insurance.
2. Any similar changes about the other party.
3. If child support payments are made directly to the custodial parent instead of through the Family Support Registry (FSR).
4. If a child no longer lives with the custodial parent, or if the child is now living with the other parent or a caretaker.
5. If parenting time (visitation) changes for longer than one month.
6. If a private attorney or private collection agency is hired for help with child support collection, parenting time or parental custody.
7. If an action has been filed with a court that CSS was not involved with (e.g., separation, divorce, custody, etc.).
I am required to return any money I receive from CSS by mistake.

Once I receive an FSR account number, sending or receiving direct payment may result in my case being closed.

CSS will provide a yearly statement summarizing the amount of child support that has been collected.

I have an opportunity to receive the information through email if I choose this option.
I hereby certify that I personally have provided all information in this document and it is true and correct to the best of my knowledge and belief.*
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Colorado Division of Child Support Services (CSS)

Tell Us About Yourself

Tell Us About the Other Parent

Tell Us More About the Other Parent's Family

Tell Us More About Your Relationship with the Other Parent

Tell Us About the Child (ren) Who Need Support

Tell Us More About Your Situation

Tell Us About Your Child (ren's) Health Insurance Coverage

What we need from you

Terms and Conditions