<p> IN THE CIRCUIT COURT OF JACKSON COUNTY, MISSOURI</p><p>______Petitioner, and Case No. ______</p><p>______Respondent. AFFIDAVIT OF CREDIT BY CUSTODIAN PARENT</p><p>Custodial Parent: ______Non-Custodial Parent ______</p><p>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. </p><p>Explanation of Credit: ______</p><p>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. </p><p>The facts in this Affidavit are true to my best knowledge and belief and are made under penalty of perjury.</p><p>______(Date) Custodial Parent’s Signature</p><p>This affidavit must be completed and signature witnessed by a court clerk or notary before filing with the court.</p><p>In witness thereof:</p><p>______Date Court Clerk Witnessing Signature</p><p>Subscribed and sworn to before me on ______</p><p>My commission expires:______Date Notary Public Send all completed forms to:</p><p>Department of Civil Records Child Support Section 415 E. 12th Street - Room 305 Kansas City, Missouri 64106-2706</p><p>CIRCT 1426A – 03-08</p>