Affidavit of Support Obligation Termination Request Form
Provide information about the existing obligation and your request. Applicable processes and evidence requirements may vary.
Requester’s full name
*
First Name
Last Name
Requester’s email address
*
example@example.com
Other party’s full name
*
First Name
Last Name
Obligation or order reference number, if available
Issuing court or agency and location, if known
Date the obligation or order was issued, if known
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for requesting termination
*
Requested effective date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Upload supporting documents, if available
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Additional information relevant to locating or reviewing the obligation
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