Forms: Washington State Division of Child Support
Washington State Department of Social and Health Services Home page

Division of Child Support

DCS Forms


Form Title Use
27-096, 27-096(Spanish) Permission to Share Documents for Reimbursement of Medical Expenses Used to serve a Notice of Support Owed - Medical Support on the obligated parent.
18-607, 18-607(Spanish) Child Care Verification Used to establish or enforce a child care obligation with a child support obligation if you are a custodial parent without a child support order.
09-989 Confidentiality Statement - Tribal Employee Used by Tribal employee's who have access to SEMS to agree to federal and state confidentiality requirements.
18-700, 18-700sp(Spanish) Direct Deposit Authorization Used by Custodial Parents (CPs) to authorize direct deposit to their bank account.
18-701, 18-701sp(Spanish) Request for Income Information for Purposes of Entering a Child Support Order You can use this form to ask the Division of Child Support (DCS) for income information about the other party to your child support order.
18-176A, 18-176Asp(Spanish) Address Disclosure Request Used by CPs and NCPs (or their attorneys)to request the address of dependent children or to request the home or work address of the other party to the child support order.
09-693, 09-693sp(Spanish) Declaration of Lawful Custody Used to help expedite the establishment or enforcement of Child Support by the legal custodian/physical custodian of a child in a non-assistance case.
09-728 Washington State Addendum To Box 2 Of Plan Administrator Response Medical insurance plan administrators use this form to respond to a National Medical Support Notice.
18-463
18-463 Form with Instructions
New Hire Reporting Methods and Instructions Used by the New Hire Reporting program to explain the program and reporting methods.
18-464 Introduction to New Hire Reporting Used to provide employers information about the New Hire Reporting program.
18-681, 18-681sp(Spanish) Request for Collection of Uninsured Health Care Expenses Used to collect medical expenses.
18-682, 18-682sp(Spanish) Detail Sheet - Unreimbursed Health Care Expenses Used to request medical reimbursement.
18-683, 18-683sp(Spanish) Monthly Summary Sheet - Unreimbursed Health Care Expenses for Children Used to request medical reimbursement.
09-280B, 09-280Bsp(Spanish) Petition for Modification - Administrative Order Formal petition to modify a child support order.
09-741, 09-741sp(Spanish) Request For Review Of Child Support Order Used to request a review and modification to a child support order.
WPF DRPSCU 01.1550 Financial Declaration Used as a declaration of income and expenses.
WPF DRPSCU 09-0200, WPF DRPSCU 09.0200SP (Spanish) Confidential Information Form (INFO) Used by CPs and NCPs to provide a court confidential information in a modification process.
WPF DRPSCU 09-0210, WPF DRPSCU 09-0210SP (Spanish) Addendum to Confidential Information Form Used by CPs and NCPs as an addendum to the Confidential Information Form (INFO).
18-078, 18-078sp(Spanish) Application for Nonassistance Support Enforcement Services Anyone can request the services of DCS for enforcement of an existing child support order, or establishment of a child support obligation.
14-057, 14-057sp(Spanish) Child Support Enforcement Referral Must be used with the Application for Nonassistance Support Enforcement Services (18-078)
14-057B, 14-057Bsp(Spanish) Noncustodial Parent Child Support Enforcement Application Used with the WSCSS Child Support Schedule Worksheets and the 16-107 Noncustodial Parents Rights and Responsibilities.
14-057D, 14-057Dsp(Spanish) Child Support Referral Continuation Used as a continuation sheet for the DSHS 14-057 for cases involving more than three children.
14-341, 14-341sp(Spanish) Application to Convert Payment Services Only (PSO) Case to Full Collection Services Case Used by in-state CPs and NCPs to apply for case conversion from PSO to full collection services.
18-433, 18-433sp(Spanish) Declaration of Support Payments Form states a history of Child Support Payments over a 10 year period.
18-483 Employer Payment Identification Instructions To process payments, the Division of Child Support (DCS) needs specific information for each employee covered by your payment. The information you provide helps us quickly distribute payments to the families due support. This is a user fillable file.
18-484, 18-484sp(Spanish) Automatic Payment Authorization and Electronic Funds Transfer Information Payments can be automatically deducted from a bank account. More about payments...
18-560 Employment Termination Notice Use this form to report termination of employees for whom you had a requirement to withhold child support or enroll the employee's children in a health insurance plan.
16-072, 16-072sp(Spanish) Nonassistance Support Enforcement Information Division of Child Support policies information and public assistance.
16-107, 16-107sp(Spanish) Noncustodial Parent's Rights and Responsibilities An overview of the Division of Child Support and our child support policies.
17-063, 17-063sp(Spanish) Authorization to Disclose Personal Information Either a custodial or non-custodial parent can grant written permission for someone of their choosing to discuss case specific information with DCS. More about disclosure...
09-392, 09-392SP Petition for Late Hearing - Administrative Orders A non-custodial parent, who missed the initial hearing period, can request that DCS review the facts and the administrative order. More about administrative orders...
09-520, 09-520sp(Spanish) Request for Conference Board Conference boards provide a speedy, informal method of resolving grievances. More about conference boards...
18-097, 18-097sp(Spanish) Statement of Resources and Expenses A non-custodial parent completes this income and expense statement at the request of DCS staff, usually to negotiate a payment plan.
09-508, 09-508sp(Spanish) Waiver of Statute of Limitations Defense The non-custodial parent acknowledges via signature that a child support obligation is owed for the children listed on the form. If you waive your right to defense of the statue of limitations, DCS may negotiate a more liberal repayment plan.
WSCSS Schedule(Eng),
WSCSS Schedule - RDP(Eng),
WSCSS Worksheets(Eng),
WSCSS Worksheets - RDP(Eng),
WSCSS Schedule(SP),
WSCSS Worksheets(SP)
Washington State Child Support Schedule The Washington State Child Support Schedule(WSCSS) is developed by the Administrator of the Courts to be used for establishment or modification of a child support obligation. 2012 - Documents labeled RDP are for Registered Domestic Partnership. More about establishment... More about modification...