Other Source Health Insurance Information - child support office - portal cs oag state tx 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the date at the top of the form. This is essential for tracking your submission timeline.
3. Fill in the Obligee/Obligor Name and SSN, along with the Case and Cause numbers. Ensure accuracy as this information is critical for identification.
4. Provide the Employer Address where applicable, ensuring all details are complete and legible.
5. For each child covered under another health insurance source, enter their name, date of birth (DOB), and Social Security Number (SSN). Include their enrollment date as well.
6. Indicate the type of coverage provided by marking the appropriate boxes: Medical, Dental, Vision, Prescription Drug, or Mental Health.
7. Complete the insurance carrier's name, telephone number, group number, policy number, and address fields accurately.
8. Finally, provide your contact information including last name, first name, position/title, telephone number, and email address before submitting.

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