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Are the specific-purpose payments made considered support payments? Question 2 Are the specific-purpose payments made under a court order or written agreement? ...

Are the specific-purpose payments made considered support payments? Question 4 Are the specific-purpose payments for the maintenance of the recipient, children of the recipient, or both? ...

Are the payments made or received considered support payments? Question 1 Are the amounts payable and receivable under a court order or written agreement? ...

Are the payments made or received considered support payments? Question 3 Are the payments for the maintenance of the recipient, the recipient's children, or both? ...

Are the payments made or received considered support payments? Question 4 Are the amounts an allowance payable on a periodic basis? ...

Are the payments made or received considered support payments? Question 6 Can the recipient use the payments as he or she sees fit? ...

Are the specific-purpose payments made considered support payments? Question 5 Does the court order or written agreement state that the recipient will include the payments in his or her income and that the payer can deduct them? ...

Are the payments made or received considered support payments? Question 5 Are the payments made directly to the recipient? ...

Are the specific-purpose payments made considered support payments? Question 3 Does either of the following situations apply? ...

RC4612 Application to Not be Considered a Selected Listed Financial Institution For best results, download and open this form in Adobe Reader. ...