Form Dcf F Dwsc14363 PDF Details

In the realm of child support, grievances regarding the timeliness or execution of necessary actions by local child support agencies are a significant concern. The Department of Children and Families (DCF), through its Division of Family and Economic Security, provides a formal means to address these issues via the DCF F DWSC14363 form, known as the Administrative Complaint form. This crucial document is designed for individuals who believe their case has suffered due to delays or omissions by their local child support agency in taking actions mandated by federal regulations or state laws. The process begins when the affected party completes and submits this form, triggering a requirement for the agency to examine the presented facts and subsequently inform the complainant about their determination—whether an error was indeed made, or explaining the reason behind the inaction. Vital to the child support program's integrity and its associated administrations, the information filled out on this form, inclusive of any supplementary documentation, is shareable only within the sphere of child support and related program operations, as per Wisconsin statutes. This provision underscores the form’s role not only as a procedural tool but also as a safeguard for the privacy and rights of the individuals it serves.

QuestionAnswer
Form NameForm Dcf F Dwsc14363
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesdcf_f_dwsc14363 dcf complaint wisconsin form

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DEPARTMENT OF CHILDREN AND FAMILIES

Division of Family and Economic Security

ADMINISTRATIVE COMPLAINT

If you believe that your local child support agency has delayed or not taken a mandatory action on your case as required by federal regulation or state law, please complete this form.

Once this form is submitted, your local child support agency is required to review the facts in your case and notify you of a determination of whether or not an error has occurred or why a required action has not been taken.

Information provided on this form (including any attachments) may be shared with others only for the purpose (s) of administration of the child support program and other related programs [Wis. statutes, s. 49.83].

Name

 

Date

 

 

 

 

Address

 

 

 

 

 

City/State/Zip Code

 

 

 

 

Home/Cell Phone Number

Work Phone Number

(

)

(

)

IV-D Case Number or Court Case Number

Social Security Number (SSN) or KIDS Personal Identification Number (PIN)

Either your SSN or KIDS PIN Number is necessary for us to process your complaint. Failure to provide this information may result in a delay in processing your request.

Name of Other Parent

I request a review of my case. I believe that an error has occurred or an action was not taken that should have been taken on my case.

(Please describe the action that you think should have been taken but was not taken and when you think the action should have occurred. Also describe any information provided to you by your caseworker. Include copies of any evidence to support your request.)

Signed

 

Date

DCF is an equal opportunity employer and service provider. If you have a disability and need to access this information in an alternate format, or need it translated to another language, please call (608) 266-9909 or (800) 947-3529 (WTRS) TTY (Toll Free).

DCF-F-DWSC14363 (R. 04/2011)