CIRCT 1426A – 03-08
IN THE CIRCUIT COURT OF JACKSON COUNTY, MISSOURI
Case No. ________________________
AFFIDAVIT OF CREDIT BY CUSTODIAN PARENT
Direct Payment: I have received a direct payment for child support/maintenance in the amount of
$__________ from the non-custodial parent. Note: Credit may only be given for past-due support
debt. NOTE: Credit may not be given for a payment not yet due. Credit for direct payment on
all open IVD cases must be reported directly to the appropriate case worker.
Explanation of Credit: _______________________________________________________________
Payment Forgiven: I hereby forgive the non-custodial parent’s child support/maintenance past-due
support debt in the amount of $___________. NOTE: Credit may not be given for a payment not
yet due. Credit for a direct payment on all open IVD cases must be reported directly to the
appropriate case worker.
The facts in this Affidavit are true to my best knowledge and belief and are made under penalty of perjury.
Custodial Parent’s Signature
This affidavit must be completed and signature witnessed by a court clerk or notary before filing with the
In witness thereof:
Date Court Clerk Witnessing Signature
Subscribed and sworn to before me on _______________________________________________________
My commission expires:___________ _______________________________________________