Fillable Printable Child Support Remittance Form - Indiana

Child Support Remittance Form - Indiana

Indiana State Central Collection Unit (INSCCU)

Child Support Remittance Form

ISETS Case #

Payor SS# (last 4 digits)

Court Cause Number

Telephone

If one check or money order is submitted for several cases, a separate form

is required for each case. This form is located at www.INSCCU.com

Payment Amount

Mail Payments to: INSCCU

P.O. Box 7130

Indianapolis, IN 46207-7130

Payor

Address

City, State Zip

PLEASE PRINT (complete first and last name)

Custodial Party Name

Indiana State Central Collection Unit (INSCCU)

Child Support Remittance Form

ISETS Case #

Payor SS# (last 4 digits)

Court Cause Number

Telephone

If one check or money order is submitted for several cases, a separate form

is required for each case. This form is located at www.INSCCU.com

Payment Amount

Mail Payments to: INSCCU

P.O. Box 7130

Indianapolis, IN 46207-7130

Payor

Address

City, State Zip

PLEASE PRINT (complete first and last name)

Custodial Party Name

Indiana State Central Collection Unit (INSCCU)

Child Support Remittance Form

ISETS Case #

Payor SS# (last 4 digits)

Court Cause Number

Telephone

If one check or money order is submitted for several cases, a separate form

is required for each case. This form is located at www.INSCCU.com

Payment Amount

Mail Payments to: INSCCU

P.O. Box 7130

Indianapolis, IN 46207-7130

Payor

Address

City, State Zip

PLEASE PRINT (complete first and last name)

Custodial Party Name