Free APPEARANCE OF CHILD SUPPORT CREDITOR OR REPRESENTATIVE - New Jersey

Procedural Form B 281

UNITED STATES BANKRUPTCY COURT DISTRICT OF NEW JERSEY In re Bankruptcy Case No. Debtor Address: Social Security No(s).: Employer's Tax Identification No(s). [if any]: APPEARANCE OF CHILD SUPPORT CREDITOR* OR REPRESENTATIVE I certify under penalty of perjury that I am a child support creditor* of the above-named debtor, or the authorized representative of such child support creditor, with respect to the child support obligation which is set out below. Name: Organization: Address: Telephone Number: ______________________ Date X_________________________________ Child Support Creditor* or Authorized Representative Chapter ___________

______________________________________________________________________________ ______________________________________________________________________________ Summary of Child Support Obligations
Amount in arrears: $________________________________ Amount currently due per week or per month: on a continuing basis: If child Support has been assigned: Amount of Support which is owed under assignments: $ ___________________________________ ___________________________________ Amount owed primary child support creditor (balance not assigned): $__________________________________ (per week) (per month) $____________________________________ Attach an itemized statement of account ____________________________________________________________________________________________ ____________________________________________________________________________________________ * Child support creditor includes both creditor to whom the debtor has a primary obligation to pay child support as well as any entity to whom such support has been assigned, if pursuant to Section 402(a)(26) of the Social Security Act or if such debt has been assigned to the Federal Government or to any State or political subdivision of a State.

__________________________________________________________________________________________________________________ Procedural Bankr. Form B-281 (added 12/94)