Form DCF-F-DWSC15295 "Request to the Wi Support Collections Trust Fund for Child Support Financial Payment History Report From Housing Agency" - Wisconsin

What Is Form DCF-F-DWSC15295?

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

Form Details:

  • Released on April 1, 2015;
  • The latest edition provided by the Wisconsin Department of Children and Families;
  • 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 printable version of Form DCF-F-DWSC15295 by clicking the link below or browse more documents and templates provided by the Wisconsin Department of Children and Families.

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Download Form DCF-F-DWSC15295 "Request to the Wi Support Collections Trust Fund for Child Support Financial Payment History Report From Housing Agency" - Wisconsin

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DEPARTMENT OF CHILDREN AND FAMILIES
Division of Family and Economic Security
Request to the WI Support Collections Trust Fund for Child Support
Financial Payment History Report from Housing Agency
Fax request to (414) 483-7269
Provision of the Social Security Number (SSN) is voluntary; not providing it could result in an
information processing delay. However, either the SSN or KIDS Case Number must be provided to
obtain an Account History.
Information provided on this form (including any attachments) may be shared with others only for the
purpose(s) of administration of the child support program and other related programs [§49.83, Wis.
Stats.].
I am requesting a child support Financial Payment History Report for the following person. I hereby certify:
The information received will only be used to determine eligibility for subsidies available for
housing rental, and
This housing agency has a current release of information form on file that is in effect for the person
for whom information is requested.
Custodial/Non-Custodial Parent for
______________________________________________
whom information is requested:
KIDS Case Number or SSN:
______________________________________________
Period of Request (check all that apply):
Last 90 Days
Current Year to Date
Prior Calendar Year
NAME – Housing Agency
SIGNATURE – Housing Staff Person
Date Signed
Instructions for reading the Child Support Account History Report are available online at
dcf.wisconsin.gov/bcs.
Include the requesting agency’s return address inside this box:
Note:
Complete all information requested or the Trust Fund will not process this request.
DCF-F-DWSC-15295 (R. 04/2015)
DEPARTMENT OF CHILDREN AND FAMILIES
Division of Family and Economic Security
Request to the WI Support Collections Trust Fund for Child Support
Financial Payment History Report from Housing Agency
Fax request to (414) 483-7269
Provision of the Social Security Number (SSN) is voluntary; not providing it could result in an
information processing delay. However, either the SSN or KIDS Case Number must be provided to
obtain an Account History.
Information provided on this form (including any attachments) may be shared with others only for the
purpose(s) of administration of the child support program and other related programs [§49.83, Wis.
Stats.].
I am requesting a child support Financial Payment History Report for the following person. I hereby certify:
The information received will only be used to determine eligibility for subsidies available for
housing rental, and
This housing agency has a current release of information form on file that is in effect for the person
for whom information is requested.
Custodial/Non-Custodial Parent for
______________________________________________
whom information is requested:
KIDS Case Number or SSN:
______________________________________________
Period of Request (check all that apply):
Last 90 Days
Current Year to Date
Prior Calendar Year
NAME – Housing Agency
SIGNATURE – Housing Staff Person
Date Signed
Instructions for reading the Child Support Account History Report are available online at
dcf.wisconsin.gov/bcs.
Include the requesting agency’s return address inside this box:
Note:
Complete all information requested or the Trust Fund will not process this request.
DCF-F-DWSC-15295 (R. 04/2015)