Get Jfs 01854 Form

The CSEA hereby requests ODJFS to submit the following debtor for Ohio income tax refund offset. Name of Obligee JFS 01854 12/2004 Date Page 1 of 1. The CSEA will notify me of its decision on this request for collection within 30 days from the date a completed signed and dated JFS 01854 request form is received by the CSEA. 800 Obligor s SSN Obligee Case No* Order No* REQUEST FOR COLLECTION OF A CHILD SUPPORT OVERPAYMENT I hereby request the child support overpayment on the support order listed above be collected through an Ohio income tax refund offset. I understand that a child support overpayment must meet the following criteria before the debtor is submitted for tax offset. All current child support orders in the case must have been terminated by a court or administrative order s and The court or administrative termination order has established the obligee received a child support overpayment and The obligee must owe 150 or more in overpaid child support. Obligor s Signature Telephone Number daytime Date of Signature For Agency Use Only The County CSEA has verified that a child support overpayment in the amount of exists and meets all the submission criteria for Ohio income tax refund offset. 800 Obligor s SSN Obligee Case No* Order No* REQUEST FOR COLLECTION OF A CHILD SUPPORT OVERPAYMENT I hereby request the child support overpayment on the support order listed above be collected through an Ohio income tax refund offset. I understand that a child support overpayment must meet the following criteria before the debtor is submitted for tax offset. I understand that a child support overpayment must meet the following criteria before the debtor is submitted for tax offset. All current child support orders in the case must have been terminated by a court or administrative order s and The court or administrative termination order has established the obligee received a child support overpayment and The obligee must owe 150 or more in overpaid child support. 800 Obligor s SSN Obligee Case No* Order No* REQUEST FOR COLLECTION OF A CHILD SUPPORT OVERPAYMENT I hereby request the child support overpayment on the support order listed above be collected through an Ohio income tax refund offset. I understand that a child support overpayment must meet the following criteria before the debtor is submitted for tax offset. All current child support orders in the case must have been terminated by a court or administrative order s and The court or administrative termination order has established the obligee received a child support overpayment and The obligee must owe 150 or more in overpaid child support.