LaGrange County Child Support
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Address or Phone Number Change Form
Date
(mm-dd-yyyy)
ISETS#
Are you the custodial parent (receiving child support)?
Yes
No
If you are the custodial parent you can complete this form, but we cannot change your address until you present a photo ID at the Prosecutors Office or Clerks Office. You can also submit your address change in writing if it is notarized.
If you are the non custodial parent (paying child support) please submit form.
Custodial or Non-Custodial Parent
Last Name
First Name
Middle Initial
SSN
Phone
Email
Street Address
City
State
Zip
Other Party Details
Name
SSN
Phone
Street Address
City
State
Zip
Employer Details
Employer Name
Phone
Address
City
State
Zip
Comments
Signature
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