Iowa Department of Human Services REQUEST AND AFFIDAVIT TO SATISFY DELINQUENT CHILD SUPPORT ATTACHMENT A ! (If Obligee Only) This affidavit serves as my request for satisfaction. I understand that.

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How to fill out the IA DHS 470-3546 online

The IA DHS 470-3546 form, also known as the request and affidavit to satisfy delinquent child support, is an essential document for individuals seeking to formally acknowledge satisfaction of child support obligations. This guide provides a comprehensive overview of how to complete the form online with clarity and confidence.

Follow the steps to fill out the IA DHS 470-3546 online effectively.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Fill out the heading section with your name and the relevant county. Make sure to enter your complete legal name as it appears on any court documents.
  3. In the body of the affidavit, state your eligibility for child support and include the names of any children involved, as indicated in Attachment A.
  4. Identify the court orders eligible for satisfaction. List each relevant court order number in the spaces provided, ensuring proper alignment with the details of Attachment A.
  5. Select one of the provided options regarding your support obligations. Carefully read each option and mark the box for the choice that reflects your intentions regarding any arrearages.
  6. Acknowledge your understanding of your right to legal counsel. This section informs users of their rights, so ensure it is completed accurately.
  7. Sign and date the affidavit in the designated areas. If multiple parties are involved, ensure that all necessary signatures are collected.
  8. Complete the notary section. This area must be completed by a notary public and involves their signature and commission expiration date.
  9. Review your completed form for accuracy. Ensure that all sections are filled out appropriately and that no information is missing.
  10. Once finished, you can choose to save your changes, download the form, print it for physical submission, or share it as required.

Complete your documents online today to ensure your submissions are processed efficiently.

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dhs.iowa.gov/sites/default/files/470-3546.pdf

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Contact support

How can I check the status of my food stamp case Iowa?

To see if you are eligible for SNAP, visit https://hhs.iowa.gov/how-to-apply. If you already receive SNAP, you can access your account information on the web at https://.connectebt.com/. There is no charge for using this online access. You can report any changes to your SNAP case by calling 877-347-5678.

Members should call Iowa Medicaid Member Services for help at 1-800-338-8366 or locally in the Des Moines area at 515-256-4606.

Most Iowa Medicaid members are enrolled in the IA Health Link managed care program. MKSN members receive coverage from the IA Health Link program. This program gives you health coverage through a Managed Care Organization (MCO) that you get to choose.

Customer Service Call Centers: Report changes to your Supplemental Nutrition Assistance Program (SNAP), Cash Assistance or Medicaid Case at 1-877-347-5678.

For problems or concerns regarding your local DHS office contact the Central Office at 1-800-972-2017 or by email at contactdhs@dhs.state.ia.us.

Call and request from: DHS Contact Center – 1-855-889-7985.

Call 1-888-229-9223 (toll free nationwide) 24 hours a day, seven days a week. The customer website, .childsupport.ia.gov, provides case information, allows you to view payments, make updates, view information about our services.

IDPH and DHS will fully transition into the Iowa Department of Health and Human Services (HHS) by July 1, 2023.

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