Request For Name Address Change
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1HARRIS COUNTY CHILD SUPPORT
REQUEST FOR NAME/ADDRESS CHANGE
EMAIL:
FAX:
713-755-4359
MAIL TO:
CHRIS DANIEL, DISTRICT CLERK
POST OFFICE BOX 4651
HOUSTON, TEXAS 77210
ATTENTION: CHILD SUPPORT DEPARTMENT
SUBMIT THIS COMPLETED FORM WITH SIGNATURE
WHEN UPDATING ADDRESS INFO, SUBMIT COPY OF VALID STATE ISSUED
PHOTO ID (PHOTO, ADDRESS, AND SIGNATURE MUST BE CLEARLY
VISIBLE)
WHEN UPDATING LAST NAME, SUBMIT MARRIAGE CERTIFICATE COPY
AND COPY OF VALID STATE ISSUED PHOTO (PHOTO, ADDRESS, AND
SIGNATURE MUST BE CLEARLY VISIBLE)
IF LICENSE OR ID HAS EXPIRED, PROVIDE AN ADDITIONAL VALID FORM OF
ID (e.g. CREDIT CARD, PASSPORT, etc.)
**IF YOU ARE SUBMITTING AN ADDRESS CHANGE TO UPDATE THE
COURTS SYSTEM PER COURT ORDER, PLEASE SUBMIT YOUR UPDATE IN
WRITING DIRECTLY TO THE COURTS.**
CHECK ALL THAT APPLY
___ NAME CHANGE
___ ADDRESS CHANGE
(PLEASE PRINT)
TODAY’S DATE _____________
CAUSE #______________________
YOUR NAME: _______________________________________________
Select One: I am the Payor (make payments) ___ I am the Payee (receive payments) ___
ADDRESS: __________________________________________________
CITY: _____________________ STATE: _____ ZIP CODE:________
CELL: ________________________ HOME:_____________________
E-MAIL ADDRESS: ________________________________________
DRIVER’S LICENSE NO. _______________SSN ________________
SIGNATURE ______________________________________________
If you have any questions regarding this form, please call us at 713-755-7300.
HCCSNAC150824
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