Forms

Apply for Child Support Services - A parent who is not receiving public assistance and wants to apply for county child support services can use the online form or the PDF form listed below. Both forms describe the services available and explain the applicant's responsibilities.

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Print out the Full Child Support Services Application (PDF).

This form is also available in other languages:

• Hmong - Full Child Support Services Application (PDF)
• Somali - Full Child Support Services Application (PDF)
• Spanish - Full Child Support Services Application (PDF)

Apply only for Income Withholding Services - A parent uses this form to apply for Income Withholding-only services. The county child support office will use this information to process automatic income withholding.Income Withholding-Only Services Application (PDF)

This form is also available in other languages:

• Hmong - Income Withholding-Only Services Application (PDF)
• Somali - Income Withholding-Only Services Application (PDF)
• Spanish - Income Withholding-Only Services Application (PDF)
  

Income Withholding for Spousal Support - A parent who receives support uses this form to initiate court-ordered income withholding for spousal support not involving child support.Income Withholding for Spousal Support (PDF)

Referral to Support and Collections - If you receive MinnesotaCare or Medical Assistance, and have not already applied for services with your financial worker, use this form to apply for child support services. The child support office can help you establish parentage or initiate child support enforcement services.

Referral to Support and Collections (PDF)

This form is also available in other languages:

• Hmong - Referral to Support and Collections (PDF)
• Somali - Referral to Support and Collections (PDF)
• Spanish - Referral to Support and Collections (PDF)

Request review of child support case - Parents may use this form to request the county child support office review their court order to determine if it should be changed (modified). Parents can also respond to a request for review using this form. Financial Statement (PDF)

Request review of medical coverage only - Parents may use this form to request the county child support office review the medical portion of their court order only. Parents can also respond to a request for review using this form. Medical Modification Information Sheet DHS-6019-ENG (PDF)

Automatic Withdrawal for Your Child Support Payments - Parents with an open child support case who are not court-ordered to pay by income withholding use this form to authorize automatic recurring withdrawal from their checking or savings account as a payment option.
Automatic Withdrawal for Your Child Support Payments (PDF)

Direct Deposit for Child Support - This form explains the benefits of directly depositing child support to a checking or savings account. It includes a Direct Deposit Authorization form.Direct Deposit for Child Support (PDF)

This form is also available in other languages:

• Hmong - Direct Deposit for Child Support (PDF)
• Somali - Direct Deposit for Child Support (PDF)
• Spanish - Direct Deposit for Child Support (PDF)

Request for Exception to Direct Deposit - The state child support office sends support payments by direct deposit. Parents who receive child support use this form to request an exception to direct deposit.
Request for Exception to Direct Deposit (PDF)

Get a Stored Value Card - To sign up for direct deposit to a U.S. Bank ReliaCard®, read the U.S. Bank ReliaCard® Pre-Acquisition Disclosure document (PDF) and complete the U.S. Bank ReliaCard® enrollment form (PDF).

After completing the enrollment form, return it to the Child Support Payment Center by:

• Mailing it to the Minnesota Child Support Payment Center EFT ARW P.O. Box 64329, St. Paul, MN 55164-0329 or faxing it to 651-431-7469.

Claim paternity: Minnesota Voluntary Recognition of Parentage - Parents who are not married to each other use this legal form to voluntarily establish paternity for a child born to them. When both parents agree that the man is the biological father, they sign this form to make him the legal father.
Minnesota Voluntary Recognition of Parentage (PDF)

This form is also available in other languages:

• Hmong - Minnesota Voluntary Recognition of Parentage (PDF)
• Somali - Minnesota Voluntary Recognition of Parentage (PDF)
• Spanish - Minnesota Voluntary Recognition of Parentage (PDF)

Deny paternity: Minnesota Voluntary Recognition of Parentage Revocation Form - This is a legal form to cancel a voluntary paternity establishment created by a previously filed Recognition of Parentage form.

Minnesota Voluntary Recognition of Parentage Revocation Form (PDF)

This form is also available in other languages:

• Hmong - Minnesota Voluntary Recognition of Parentage Revocation Form (PDF)
• Somali - Minnesota Voluntary Recognition of Parentage Revocation Form (PDF)
• Spanish - Minnesota Voluntary Recognition of Parentage Revocation Form (PDF)

Deny parentage of wife's child: Minnesota Voluntary Recognition of Parentage Spouse's Non-parentage Statement - Spouses may sign this form when they are not the biological parent and do not wish to be the legal parent of their wife's child. To remove a spouse's legal name from the child's birth certificate and end their legal relationship to the child, this form must be filed in conjunction with a Minnesota Voluntary Recognition of Parentage Form signed by the mother and biological father of the child.

Minnesota Voluntary Recognition of Parentage Spouse's Non-parentage Statement (PDF)

This form is also available in other languages:

• Hmong - Minnesota Voluntary Recognition of Parentage Spouse's Non-parentage Statement (PDF)
• Somali - Minnesota Voluntary Recognition of Parentage Spouse's Non-parentage Statement (PDF)
• Spanish - Minnesota Voluntary Recognition of Parentage Spouse's Non-parentage Statement (PDF)

Cancelling a non-parentage statement: Minnesota Spouse's Non-parentage Statement Revocation Form - This is a legal form to cancel a previously signed Spouse's Non-parentage Statement.
Minnesota Spouse's Non-parentage Statement Revocation Form (PDF)

This form is also available in other languages:

• Hmong - Minnesota Spouse's Non-parentage Statement Revocation Form (PDF)
• Somali - Minnesota Spouse's Non-parentage Statement Revocation Form (PDF)
• Spanish - Minnesota Spouse's Non-parentage Statement Revocation Form (PDF)

Unreimbursed and/or Uninsured Medical/Dental Expenses Packet - Either parent can use this packet to begin collection of unreimbursed and/or uninsured medical or dental expenses from the other parent. The packet contains information, notices and instructions.
Unreimbursed and/or Uninsured Medical Dental Expenses Packet (PDF)

Authorization for Release of Child Support Information to a Third Party - Parents use this form to give permission to the Minnesota Department of Human Services and the county child support office to discuss private information about their child support case with a third person, entity or agency not otherwise entitled to the information.
Authorization for Release of Child Support Information to a Third Party (PDF)

Request to Close Support Case - Parents who applied for child support services use this form to ask the child support office to close their case.
Request to Close Support Case (PDF)