REQUEST FOR NOTICE TO EMPLOYER - Office of Harris …
Government agencies do not use this form.
Submit request on agency letterhead.
HARRIS COUNTY CAUSE NO_________________ IN THE ________ DISTRICT COURT
(If cause number not provided, $5 search fee is applied) (51.318(b)(3) Gov’t Code)
STYLE: ______________________________ VS. ______________________________
EMAIL: CHILDSUPPORT@
FAX: 832-927-0135
MAIL: MARILYN BURGESS, DISTRICT CLERK
ATTENTION: CHILD SUPPORT PAYMENT RECORD
POST OFFICE BOX 4651 HOUSTON, TEXAS 77210
HARRIS COUNTY CHILD SUPPORT PAYMENT HISTORY $1/page (51.318(b)(11) Gov’t Code)
How many copies? ___ (Certified at no additional charge)
Select one:
___ Email: _________________________________@______________
___ Fax Number: ________________________________________
___ Mail: Applicable postage will be charged. Request will be sent to address provided.
CUSTOMER NAME: ___________________________________________________________
CUSTOMER ADDRESS: ________________________________________________________
CITY: ______________________________ _____ STATE: _____ ZIP: ________
PHONE NUMBER: _____________________________________________________
WHEN PAYING BY DEBIT/CREDIT CARD, YOU WILL BE CONTACTED WITH FURTHER INSTRUCTIONS TO COMPLETE THE PAYMENT PROCESS.
FOR DISTRICT CLERK OFFICE USE ONLY
TRANSACTION NO: _____________________ RECIEPT NO: ________________
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This request is for payments received by the Harris County Child Support Registry prior to the redirection of all child support payments to the State Disbursement Unit (SDU). The payment record reflects non-custodial parent payments received by the Harris County Child Support Registry. Payments received by the Office of the Attorney General can be obtained directly through their office.
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