Enrollment in the Health Benefits for Immigrant Adults (HBIA) program will be temporarily paused effective July 1, 2023.

Enrollment in the Health Benefits for Immigrant Seniors (HBIS) program will be temporarily paused effective Nov. 6, 2023.

Application For Child Support Services (Title IV-D)

Complete the on-line application for free child support services if you live in Illinois and the dependent child(ren) lives with you. Online Child Support Application

The form is written in English only. If you require the form to be written in Spanish, download and fill out the application, print, and mail it to our office.

Esta forma es escrita en inglés solamente. Si necesita que la forma sea en Español, bajar y llenar la solicitud, imprimir y enviarla por correo a nuestra oficina.

NOTE: If you are applying for free child support services, and you live in Illinois, and the dependent child(ren) does NOT live with you, please complete the following application form:
HFS 1283N English Child Support Application for a Parent not Living with the Child/ren (pdf) OR
HFS 1283NS Solicitud Para Servicios de Manutención de Ninos (TÍtulo IV-D) Para el Padre / Madre Que No Vive Con Sus Hijos

Complete the online form below. Once you begin the process of filling out the application, you cannot save the document and go back later to finish. If you close the document before selecting the submit button, all information you entered will be lost.
Any information that you do not know, please enter “don't know” in the blank.
Read the Child Support Program Fact Sheet. It explains the services we provide.

Please make sure you have the following information available before completing this application:

Applicant's Information (including Social Security Number)
Other Parent's Information (if known, Address, Date of Birth, Social Security Number, Employer, etc)
Child's Information (including Date of Birth, Social Security Number)
Other Important Information (If you were married-Date of Divorce, State/County & Docket Number)

For every Non-Custodial Parent (NCP), you must fill out a separate application

If you are NOT the biological or legal parent of the child, complete the application HFS 1283A
Application for Child Support Services (Title IV-D) For A Caretaker Who Is Not the Biological or Legal Parent , or call 1-800-447-4278 for a different application.

Application for Child Support Services (Title IV-D)

* indicates required field

Section 1

Applicant's Information:

Title

Your County

Use this on-line application only if your county is listed in the selection box.

Application Date

Your Last Name

Your First Name

Your Middle Initial

Your Street Address

Your City

Your State

Your Zip Code + Four (if known)

Your Relationship to Child

Your Date of Birth

Your Age

Your Sex

Your Social Security Number

Your Race

Your Cell Phone #

Your E-mail Address

Other Parent's Information:

Other Parent Last Name

Other Parent First Name

Other Parent Middle Initial

Other Parent Street Address

Other Parent City

Other Parent State

Other Parent Zip Code + Four (if known)

Relationship to Child

Date of Birth

Age

Other Parent Social Security Number

Parent Race

Other Parent Home Telephone #

Other Parent Work Telephone #/Extension

Other Parent Cell Telephone #

Other Parent E-mail Address

Name of Employer or Income Source

Employer Street Address

Employer City

Employer State

Employer Zip Code + Four (if known)

Is the other parent in the military?

Which branch of service?

Make and Model of Car

License Plate #

Other Parent's Relatives: (Mother)

Other Parent's Relatives: (Father)

Does the other parent have additional children with someone else? If you know the other children's names, list them here.

Child's Information:

Child's Last Name

Child's First Name

Child's Middle Initial

Child's Sex

Child's Date of Birth (mm/dd/yyyy)

Child's Place of Birth (City/State)

Child's Social Security Number

Child's Race

Child2 Last Name

Child2 First Name

Child2 Middle Initial

Child2 Sex

Child2 Date of Birth (mm/dd/yyyy)

Child2 Place of Birth (City/State)

Child2 Social Security Number

Child2 Race

Child3 Last Name

Child3 First Name

Child3 Middle Initial

Child3 Sex

Child3 Date of Birth (mm/dd/yyyy)

Child3 Place of Birth (City/State)

Child3 Social Security Number

Child3 Race

Child4 Last Name

Child4 First Name

Child4 Middle Initial

Child4 Sex

Child4 Date of Birth (mm/dd/yyyy)

Child4 Place of Birth (City/State)

Child4 Social Security Number

Child4 Race

Child5 Last Name

Child5 First Name

Child5 Middle Initial

Child5 Sex

Child5 Date of Birth (mm/dd/yyyy)

Child5 Place of Birth (City/State)

Child5 Social Security Number

Child5 Race

If you have more than 5 children, please provide the same information in the box below.

Other Important Information:

Do you have a child support order?

Are/were you married to the other parent of the child? (If yes, you must enter a date below.)

If yes, marriage date?

Are you and the other parent of the child divorced?

If yes, divorce date?

State of Divorce Order

County of Divorce Order

If you were not married and have a child support order, please fill in the following information. Date of Child Support Order

Order or Docket #

City of Support Order

County of Support Order

State of Support Order

All information you provide is kept confidential but we understand that domestic violence may also be an issue for you or your family. For your protection, we can mark your case with a Family Violence Indicator.

Do you want your case marked with a Family Violence Indicator?

What is your language preference?

IMPORTANT: PLEASE READ! By selecting the Submit button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting Submit you consent to be legally bound by this Agreement's terms and conditions.

I understand the Division will protect my privacy as required by law, and I authorize the Division to disclose information about my case to the courtor another party necessary in the course of establishing and enforcing, paternity and child support orders, for as long as I am a client.

I authorize the Division of Child Support Services to explore, pursue or utilize all sources of information legally available in support of its investigations on my behalf and to choose the appropriate course of legal action. I have received and read the program fact sheet provided at hfs/SiteCollectionDocuments/hfs3316.pdf. To the best of my knowledge, the information I have supplied is true, correct and complete.

Please attach any supporting documents such as a divorce decree, parenting time orders, existing child support order or any payment records, if applicable. Only one attachment is allowed. Scan multiple documents as one and attach.

Attachments

Multiple files can be uploaded by holding down Shift or Ctrl while selecting.

Application For Child Support Services (Title IV-D)

Application for Child Support Services (Title IV-D)

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