NON-CUSTODIAL PARENT INFORMATION

NON-CUSTODIAL PARENT NAME First * Middle Last * SOC SEC # *(No Dashes) Case Number *

* Required Fields The following fees will be assessed: ● Credit card processor fee: 2.55% of the credit card payment. Payment Amount must be between $1 and $9,999.99. Only American Express®, MasterCard®, Visa®, Discover®, JCB®, and Maestro® cards are accepted. If you have your credit/ debit card linked to an e-wallet account such as Apple Pay, Google Pay, PayPal, or Venmo you can make your payment using these alternate payment options. You must use a Safari (iOS) or Chrome (Android) browser when making a payment through Venmo. Completion of a credit card payment transaction is contingent upon the authorization of payment by your credit card company. Payments will be applied to the child support account in 5 - 6 business days.