Idph Child Support Statement

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The following statements MUST be completed. - IDPH

    http://dph.illinois.gov/sites/default/files/forms/ems-renewal-notice-011717.pdf
    Illinois Department of Public Health Emergency Medical Services (EMS) Systems Renewal Notice/Child Support/Personal History Statement ONLINE RENEWAL AND PAYMENT CAN BE MADE AT www.dph.illinois.gov. The following statements MUST be completed. I am up-to-date with child support payments.

Renewal Notice - idph.state.il.us

    http://www.idph.state.il.us/forms/opr/Child%20Support%20Statement.pdf
    court-ordered child support do not apply to you, check the third statement:“I do not have to pay child support.” Sign and submit the top portion of this form to your EMS system for renewal. Note any name or address changes or corrections in the appropriate space. If you have questions for Independent and/or Trauma Nurse Specialist renewals ...

The following statements MUST be completed.

    http://www.idph.state.il.us/ems/forms/EMS_Renewal_Notice.pdf
    I am more than 30 days delinquent in complying with a court-ordered child support order. I do not have to pay child support. I have NOTbeen convicted of a felony. I HAVEbeen convicted of a felony. If you have been convicted of a felony, attach a statement, in your own words, of the circumstances surrounding the incident.

SYSTEM ENTRANCE PACKET - REGIONVIIEMS.COM

    http://regionviiems.com/wp-content/uploads/2017/08/SCC-System-Entry-Packet-1-13.pdf
    The EMT-P is required to complete IDPH requirements (child support, felony statement, payment, etc.) on-line prior to licensure expiration date. 9. Paramedics who do not meet the above requirements will not be recommended for relicensure. 10. This policy and procedure is on file at the Illinois Department of Public Health and is in

Relicensure Morris Hospital

    https://www.morrishospital.org/resources/emergency-medical-services-system/system-resources/relicensure/
    IDPH License; Child Support/Felony Conviction Statement; Receipt of Payment to IDPH; AHA-CPR provider or Instructor card; ACLS provider or Instructor card (If working for ILS/ALS Agency and/or your Primary in MHEMSS) PALS provider or Instructor card (If working for ILS/ALS Agency and/or your Primary in MHEMSS) PHTLS or ITLS recommended but not ...

Region VII EMS Licensure REGIONVIIEMS.COM

    http://regionviiems.com/ems-licensure/
    8. Complete the Child Support and Felony conviction statements. Anyone convicted of a felony or delinquent on child support may not be able to complete their renewal online and may need to contact IDPH as directed. NAME CHANGE: Your IDPH license is a legal document and should match your legal name on your driver’s license.

Forms & Protocols OSF EMS

    https://www.osfhealthcare.org/ems/paems/forms/
    a. Sign the Child Support Statement (PDF - 131.2 KB) in the box on the upper left portion of the license renewal notice. b. Enter your Social Security Number, Drivers License Number, and Date of Birth on the Child Support Statement. c. Verify the name and address printed on the form. Print any changes on the lines provided. d.

Forms & Publications IDPH

    http://dph.illinois.gov/forms-publications
    This page contains a comprehensive list of IDPH’s forms and publications organized by topic. Please browse this collection of forms and publications. If you can not find the form or publication that you are looking for, type a search term into the search tool at the top of the page.

Home [www.illinois.gov]

    https://www.illinois.gov/hfs/ChildSupport/Pages/default.aspx
    Apply for Child Support Services Understanding Child Support Services Brochures and Forms Make a Payment Access Your Case Information Child Support Guidelines-Income Shares Popular Resources Online Services Payment History Child Support FAQs

Illinois Voluntary Acknowledgment of Paternity

    https://www.illinois.gov/hfs/SiteCollectionDocuments/hfs3416b.pdf
    a copy from state and local registrars, county clerks, Department of Human Services offices, Child Support Services offices or by going to the . Forms and Brochures section of the Child Support Services website. This form is available in English and Spanish upon request and on the HFS website (www.childsupport.illinois.gov). The Spanish version



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