Insurance Match Debt Inquiry Agreement and Profile Form for Child Support Portal Registration

OMB 0970-0370

Publication Date: September 23, 2020

Insurers and third-party processors must complete the Insurance Match Debt Inquiry Agreement and Profile form to register and use the Insurance Match Debt Inquiry application.

The Insurance Match Debt Inquiry application offers an easy and efficient way for insurers to notify most child support agencies about upcoming payments to claimants to determine if they owe child support.

  • Use the application to make individual inquiries or upload files containing information about upcoming payments to claimants.
  • The application compares the information submitted to individuals who owe child support.
  • Child support agencies in participating states receive matches.
  • When appropriate, agencies contact the insurer to withhold from the payment.

Contact the Insurance Match team for a brief demonstration of the Insurance Match Debt Inquiry application.

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