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Services when you became eligible to receive ADC or Medicaid. I, the undersigned, , request Child Support Services from the County Child Support Enforcement Agency. I understand and agree to the following conditions: A. I am a resident of the County in which services are requested. B. Recipients of child support services shall cooperate to the best of their ability with the CSEA. (See attached rights and responsibility information). The Child Support Enforcement Agency can assist you in provid.

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