CHILD SUPPORT CLASS ACTION QUESTIONNAIRE

Name First Last
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Home Phone - (###) - ### ####
Work Phone - (###) - ### ####
Mobile Phone - (###) - ### ####
Email
Are you the parent/custodian of a child who is owed child support? Yes No
Were you owed or are you owed back child support? Yes No
Name(s) of child/children, date(s)s of birth:
Between 1987 and today, has your child support arrears (back pay) been reduced or eliminated by the Family Court? Yes No
Age of the child at the date of the hearing:
Current age of children/children: (“Child” is used for descriptive purposes. Your “child” can be over the age of 18 and you may still have a case.)
You can be an out of state resident and still have a claim if your child support is/was being collected by the Bureau for Child Support Enforcement (Child Advocate) in West Virginia.
County in which child support case is or was heard.
What was the name of the Child advocate lawyer assigned to your case, if you know?
What is your civil action number? (example: 09-D-1234)
What is your case number from the child advocate office? (If you know)
Do you recall the date and year the order was entered? / MM / DD YYYY
If you answered Yes to the previous question, was the Bureau for Child Support Enforcement (Child Advocate) collecting child support on behalf of your child or children? Yes No
If you know, how much were you owed in child support back pay before you went to Court? $ . Dollars Cents
After the hearing and the statute of limitations was applied, how much were you awarded? (This amount may be zero.) $ . Dollars Cents
What are your damages? (subtract the amount owed before you went to Court from the amount you were awarded after the statute of limitations was applied)? $ . Dollars Cents
Would you like to be apart of this class action and be contacted by a representative of the Webb Law Firm? Yes No

CHILD SUPPORT CLASS ACTION QUESTIONNAIRE

CHILD SUPPORT CLASS ACTION QUESTIONNAIRE

You can be an out of state resident and still have a claim if your child support is/was being collected by the Bureau for Child Support Enforcement (Child Advocate) in West Virginia.