Form CFS560 "Child Support Certification" - Illinois

What Is Form CFS560?

This is a legal form that was released by the Illinois Department of Children and Family Services - a government authority operating within Illinois. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2013;
  • The latest edition provided by the Illinois Department of Children and Family Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CFS560 by clicking the link below or browse more documents and templates provided by the Illinois Department of Children and Family Services.

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Download Form CFS560 "Child Support Certification" - Illinois

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CFS 560
Rev. 7/2013
State of Illinois
Department of Children and Family Services
Child Support Certification
Please print:
Facility Name:
Applicant's Name:
Street Address:
City/State/Zip Code:
Phone #:
Certification
According to the Illinois Administrative Procedures Act, the Department of Children and Family Services must
require license holders and license applicants to certify their status regarding child support orders and payments.
Please read the following statements and check the appropriate box:
“I hereby certify, under penalty of perjury, that (check one):
“I am not subject to a child support order.”
“I am not more than 30 days delinquent in complying with a child support order.”
“I am more than 30 days delinquent in complying with a child support order.”
All license holders and all license applicants must complete this form. Failure to certify may result in denial of
a license application, an application for license renewal, refusal to renew the license, or revocation of the license.
Making a false statement on this form may subject the licensee or applicant to contempt of court [5 ILCS 100/10-
65(c)]. This form shall be recertified prior to the issuance of a new license.
“I hereby certify that the information contained herein is true and accurate to the best of my
knowledge.”
Signature:
Date:
To be completed by Licensing Worker:
Provider ID #:
Licensing Worker ID#:
Licensing Worker Name:
CFS 560
Rev. 7/2013
State of Illinois
Department of Children and Family Services
Child Support Certification
Please print:
Facility Name:
Applicant's Name:
Street Address:
City/State/Zip Code:
Phone #:
Certification
According to the Illinois Administrative Procedures Act, the Department of Children and Family Services must
require license holders and license applicants to certify their status regarding child support orders and payments.
Please read the following statements and check the appropriate box:
“I hereby certify, under penalty of perjury, that (check one):
“I am not subject to a child support order.”
“I am not more than 30 days delinquent in complying with a child support order.”
“I am more than 30 days delinquent in complying with a child support order.”
All license holders and all license applicants must complete this form. Failure to certify may result in denial of
a license application, an application for license renewal, refusal to renew the license, or revocation of the license.
Making a false statement on this form may subject the licensee or applicant to contempt of court [5 ILCS 100/10-
65(c)]. This form shall be recertified prior to the issuance of a new license.
“I hereby certify that the information contained herein is true and accurate to the best of my
knowledge.”
Signature:
Date:
To be completed by Licensing Worker:
Provider ID #:
Licensing Worker ID#:
Licensing Worker Name: