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| Forms Download |
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Licking County CSEA is dedicated to providing you with quick and easy access to our services. To promote this endeavor, we are now making all of our forms available in the widely used Adobe Acrobat® PDF format.
If you haven't already installed the Adobe Acrobat Reader®, click the button below to download it for FREE. |
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 Adobe Acrobat |
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| We will be adding more forms to the page periodically, so check back often. |
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| Administrative Review and Adjustment Request form ~ Complete this form to request the CSEA to review the child support order for a redetermination based upon the Ohio Child Support Guidelines. |
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| ODJFS 7038 / Acknowledgement of Paternity Affidavit~ Completion of the Acknowledgement of Paternity is voluntary. If an alleged father acknowledges a parent and child relationship, he is responsible for the support of the child. |
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Paternity Affidavit~ Use this affidavit to name the possible father of your child to begin the
Paternity Establishment Process. Please read the affidavit carefully!
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| Please click the appropriate link below to download and print the desired Annual Report. |
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| 2002 ~ 2003 Annual Report |
| 2001 ~ 2002 Annual Report |
| 2000 ~ 2001 Annual Report |
| 1999 ~ 2000 Annual Report |
| 1998 ~ 1999 Annual Report |
| 1997 ~ 1998 Annual Report |
| 1996 ~ 1997 Annual Report |
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| ODJFS 7076 / Title IV-D Application~ This form is intended for those individuals who are not receiving OWF assistance and who have an existing Licking County case. Mail completed applications to Licking County CSEA, P.O. Box 338, Newark, OH 43058-0338. If you have any questions about completing the application, call us at 800-513-1128 or 740-349-6575. |
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| Licking County CSEA Information Form 009.AP~ The purpose of this document is to obtain initial information for Child Support services from either one of the biological or putative parents. This form should be completed in its entirety and then contact should be made with the Licking County CSEA at 740-349-6575 or 800-513-1128 to schedule an appointment. This document should accompany you on your scheduled appointment time. If you have any questions about completing this form, please contact us at the numbers provided above. |
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| Licking County CSEA Information Form 009.CTR~ The purpose of this document is to obtain initial information for Child Support services from a third party caretaker(grandmother, grandfather, aunt, uncle, etc.). This form should be completed in its entirety and then contact should be made with the Licking County CSEA at 740-349-6575 or 800-513-1128 to schedule an appointment. This document should accompany you on your scheduled appointment time. If you have any questions about completing this form, please contact us at the numbers provided above. |
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| Local Rule 19.0 ~ Effective 10/1/2000~ Local Rule 19.0 is a rule of the Common Pleas court of Licking County, Ohio, domestic Relations division. It is utilized only in Licking County and is not applicable or available to all persons. This information is provided with the understanding that the Licking County CSEA is not furnishing any legal or other professional advice. This version of Local Rule 19.0, adopted effective as of October 1, 2000, shall be effective prospectively. This means that this version of Local Rule 19.0 shall apply in judgement entries and decrees entered by the Court on or after October 1, 2000, unless otherwise ordered by the Court. |
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| Local Rule 19.0~ Local Rule 19.0 is a rule of the Common Pleas court of Licking County, Ohio, domestic Relations division. It is utilized only in Licking County and is not applicable or available to all persons. This information is provided with the understanding that the Licking County CSEA is not furnishing any legal or other professional advice. This version of Local Rule 19.0, applies to visitation orders entered before October 1, 2000. |
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| Ohio CSPC Direct Deposit Authorization ~ This form is to be used to request Direct Deposit of support to your personal bank account. |
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| Voluntary Authorization for Release of Information~ Use this form to authorize an individual to view information contained in the record of the Licking County CSEA for your case. |
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| Emancipation Notice~ This form should be used to report the emancipation of a child who was previously the subject of a child support order. |
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| Grounds for requesting a State Hearing~ This information form explains your rights to request a State Hearing. |
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| ODJFS 4059 ~ Explanation of State Hearing Procedures~ This informational form explains the procedures followed for a State Hearing. |
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| Licking County CSEA's Responsibilities and Procedures~ An informational form for cases receiving OWF benefits, this document explains the LCCSEA's responsibilities and procedures. |
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| Bank Account Deduction Request~ Complete this form to set up a bank account deduction for your child support or spousal support case. |
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| Payroll Deduction Request~ Complete this form to set up a payroll deduction for your child support or spousal support case. |
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| Parenting Affidavit~ This form should be used when a court action will be determining custody or a change of custody will be taking place. |