Nebraska Department of Health and Human Services Nebraska Department of Health and Human Services

Application for Child Support Services


Child Information
Note: an asterisk [ * ] indicates a required field.

A minimum of one child must be entered on your application.


* Sex
  
Unknown
Do Not Have an SSN
  
  
Unknown
  
(mm-dd-yyyy)
Is your child enrolled or eligible for enrollment in a Federally recognized Tribe?
* What is your relationship to this child?
* Does this child live with you?
What is the child's relationship to the Custodial parent?
What is the child's relationship to the Non-custodial Parent?