Division of Child Support Forms

Form Name Form Number Form Description

Address Disclosure Request

18-176A, 18-176Asp (Spanish)

Used by parents or their attorneys to request the address of dependent children and home or work addresses of the other party to the child support order.

Application for Non-assistance Support Enforcement Services 18-078, 18-078sp (Spanish)

Use to request the services of DCS for enforcement of an existing child support order or the establishment of a child support obligation.


Application to Convert Payment Services Only (PSO) Cases to Full Collection Services Cases

14-341, 14-341sp (Spanish)

Used by in state parents to apply for case conversion from payment services only (PSO) to full collection services.


Authorization to Disclose Personal Information 17-06317-063sp (Spanish)

Parents can grant written permission for someone of their choosing to discuss case specific information with DCS.Search our FAQs to learn more about disclosure…


Automatic Payment Authorization and Electronic Funds Transfer Information

18-48418-484sp (Spanish)

Used by noncustodial parents to authorize DCS to deduct support payments from their account by Electronic Funds Transfer (EFT).  Payments can be automatically deducted from a bank account.  Search our FAQs to learn more about payments...


Child Care Verification 18-60718-607sp (Spanish)

Used to obtain childcare costs to enforce or establish a childcare obligation.


Child Support Enforcement Referral 14-05714-057SP (Spanish)

Must be used with the Application for Non-assistance Support Enforcement Services (18-078) for case set-up.


Child Support Referral Continuation 14-057d14-057dsp (Spanish)

Used as a continuation sheet for the DSHS 14-057 for cases involving more than three children.


Confidential Information Form (INFO) WPF DRPSCU 09-0200, WPF DRPSCU 09-0200sp (Spanish)

Used by parents to provide the court confidential information in a modification process.


 Confidential Information Form (Addendum) WPF DRPSCU 09-0210, WPF DRPSCU 09-0210sp (Spanish)

Used by parents as an addendum to the Confidential Information Form (INFO)


Confidentiality Statement - Tribal Employee 09-989

Used by Tribal employees who have access to SEMS, to agree to federal and state confidentiality requirements.


Declaration of Lawful Custody 09-69309-693sp (Spanish)

Used by legal or physical custodians to declare that children are in their lawful custody and can help expedite the establishment or enforcement of Child Support.


Declaration of Support Payments 18-433. 18-433sp (Spanish)

Used by the receiving parent to provide a record of child support payments received from the paying parent.


Detail Sheet - Unreimbursed Health Care Expenses 18-682, 18-682sp (Spanish)

Used by parents to provide DCS with the details of uninsured health care expenses incurred.


Direct Deposit Authorization 18-700, 18-700sp (Spanish)

Used by receiving parents to authorize direct deposit to their bank account.


Employer Payment Identification Instructions 18-483

Used to provide employers with information on how to remit child support payments and provides employees with a payment remittance form. This is a user fillable file.


Employment Termination Notice 18-560

Employers use this form to report termination of employee for whom they had a requirement to withhold child support or enroll the employee's children in a health insurance plan.


Financial Declaration WPF DRPSCU 01.1550, WPF DRPSCU 01.1550sp (Spanish)

Used as a declaration of income and expenses.


Introduction to New Hire Reporting 18-464

Information about the New Hire Reporting Program.


New Hire Reporting Methods and Instructions 18-463

Information to employers on how to report newly hired and rehired employees.


Non-Assistance Support Enforcement Information 16-072, 16-072sp (Spanish)

Division of Child Support policies and non-assistance cases information.


Noncustodial Parent Child Support Enforcement Application 14-057B, 14-057Bsp (Spanish)

Use this application with both WSCSS Child Support Schedule Worksheets and the 16-107 Noncustodial Parent’s Rights and Responsibilities.


Noncustodial Parent's Rights and Responsibilities 16-107, 16-107sp (Spanish)

This is an overview of the Division of Child Support and its policies.


Permission to Share Documents for Reimbursement of Medical Expenses 27-096, 27-096sp (Spanish)

Use this form to serve a Notice of Support Owed – Medical Support to the obligated parent.


Petition for Modification - Administrative Order 09-280B, 09-280Bsp (Spanish)

Formal petition to modify an administrative child support order.


Request for Collection of Uninsured Health Care Expenses 18-681, 18-681sp (Spanish)

Use to inform either parent that DCS may be able to collect uninsured health care expenses.


Request for Conference Board 09-520, 09-520sp (Spanish)

Conference boards provide a speedy, informal method of resolving grievances. Search our FAQ to learn more about enforcement and conference boards ...


Request for Income Information for Purposes of Entering a Child Support Order 18-701, 18-701sp (Spanish)

Use to ask the Division of Child Support for income information about the other party to your child support order.


Request for Review of Child Support Order 09-741, 09-741sp (Spanish)

Use to request a review and modification to a court order for child support.


School Statement 18-551, 18-551sp (Spanish)

Use to obtain educational institution graduation and enrollment information to determine eligibility for continued child support.


Statement of Resources and Expenses 18-097, 18-097sp (Spanish)

A paying parent completes this income and expense statement, usually to negotiate a payment plan.


Waiver of Statute of Limitations Defense 09-508, 09-508sp (Spanish)

DCS may offer a reduced or deferred repayment plan if the form is signed by the paying parent. The paying parent waives the right to raise a statute of limitations defense.


Washington State Addendum to Box 2 of Part B - Plan Administrator Response 09-728

Medical insurance plan administrators use this form to respond to a National Medical Support Notice.


Washington State Child Support Schedule WSCSS Schedule (English), WSCSS Worksheets (English), WSCSS Worksheets (Spanish), WSCSS Pamphlet (Spanish)

The Washington State Child Support Schedule (WSCSS) developed by the Administrator of the Courts for establishment or modification of a child support obligation. Search our FAQ to learn more about establishment and modification.