Child Support Remittance Form - Indiana
Indiana State Central Collection Unit (INSCCU)
Child Support Remittance Form
ISETS Case #
Payor SS# (last 4 digits)
Court Cause Number
Telephone
If one check or money order is submitted for several cases, a separate form
is required for each case. This form is located at www.INSCCU.com
Payment Amount
Mail Payments to: INSCCU
P.O. Box 7130
Indianapolis, IN 46207-7130
Payor
Address
City, State Zip
PLEASE PRINT (complete first and last name)
Custodial Party Name
Indiana State Central Collection Unit (INSCCU)
Child Support Remittance Form
ISETS Case #
Payor SS# (last 4 digits)
Court Cause Number
Telephone
If one check or money order is submitted for several cases, a separate form
is required for each case. This form is located at www.INSCCU.com
Payment Amount
Mail Payments to: INSCCU
P.O. Box 7130
Indianapolis, IN 46207-7130
Payor
Address
City, State Zip
PLEASE PRINT (complete first and last name)
Custodial Party Name
Indiana State Central Collection Unit (INSCCU)
Child Support Remittance Form
ISETS Case #
Payor SS# (last 4 digits)
Court Cause Number
Telephone
If one check or money order is submitted for several cases, a separate form
is required for each case. This form is located at www.INSCCU.com
Payment Amount
Mail Payments to: INSCCU
P.O. Box 7130
Indianapolis, IN 46207-7130
Payor
Address
City, State Zip
PLEASE PRINT (complete first and last name)
Custodial Party Name
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