20.C Good Cause Withdrawal Statement

Below is the Good Cause Withdrawal Statement. To use the form, please click the link below to the document and download. Then, fill in the blanks and save the document. For the signature, you an type your name or use an electronic signature.  You will need to provide this document to your child support case manager.

Click Here to Download the Document 

Good Cause Withdrawal Statement.pdf

Version Number:  1

Last Revised Date:  May 1, 2022

Last Reviewed: November 6, 2023