Form 1854b - Release Of Child Support Lien Form Page 2
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2Figure: 1 TAC §55.119(b)
I affirm under penalty of perjury that the information contained in this release is true and
accurate.
Date: _______
_________________________________
_________________________________
Print Name
Signature
E-mail Address: ________________________________
Telephone Number: ____________________
Fax Number: ____________________
I certify that _________________________ appeared before me and is known to me as the
individual whose signature appears above.
_____________
_______________________________
Date
Notary Public
Notary State: ____________________
County: ________________________
Form 1854B
RELEASE OF CHILD SUPPORT LIEN
August 2014
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