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Get MI FOC 23 2013

I request support services under Title IV-D of the Social Security Act. I declare that the statements above are true to the best of my information knowledge and belief. Date FOC 23 3/13 Signature MCR 3. Original - Friend of the court 1st copy - Plaintiff/Attorney 2nd copy - Defendant/Attorney Approved SCAO STATE OF MICHIGAN JUDICIAL CIRCUIT COUNTY 1. Mother s last name First name 3. Date of birth CASE NO. VERIFIED STATEMENT AND APPLICATION FOR IV-D SERVICES Middle name 2. Any other names by whic.

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