Post Court Quantitative Survey
IL Division of Child Support Services
1.
Did your court appearance concern child support?
Yes
No
2.
Are you currently ordered to pay child support?
Yes
No
If yes, when was your child support order entered? If you are unsure, an approximate date is fine.
3.
Choose the response below that correctly describes your court proceeding when the amount of child support was set.
I was present in court
I was absent from court and an order was entered
I had an attorney appear on my behalf
4.
Was the number of overnights visits you have with your child taken into consideration when your child support order was set?
Yes
No
5.
Did you provide documents to the court when the child support order was set?
Yes
No
6.
Did you provide a financial affidavit to the court when the child support order was set?
Yes
No
7.
If a financial affidavit was used, who did you receive assistance in preparing the financial affidavit?
Legal assistance agency
Website or online tutorial
HFS representative
Attorney
Personal family or friend
Other
I did not receive assistance
8.
Do you provide support in your household for biological or adopted children other than those on this current child support order?
Yes
No
If yes, how many children and what is your relationship to each child?
9.
Do you provide support for other children in your household that are not either biological or adopted?
Yes
No
If yes, how many children and what is your relationship to each child?
10.
Do you provide support for children
not
in your household other than those on this current child support order?
Yes
No
11.
If you provide support for children
not
in your household other than those on this current child support order, is the child support paid:
By court order
Not by court order
12.
Do you receive support for children in your household other than those on this current child support order?
Yes
No
13.
If you receive support for children in your household other than those on this current child support order, is the support you receive paid:
By court order
Not by court order
14.
Was the issue of the payment for health insurance for the minor child discussed as part of today’s support order?
Yes
No
15.
Did someone explain how your child support was calculated?
Yes
No
16.
Do you understand how your child support was calculated?
Yes, someone explained this to me
Yes, I used one of the available online tools to learn
No, someone explained this to me, but I still have questions.
No, no one explained this to me.
If no, what part of the calculation did you not understand or was confusing?
17.
What is your age?
Under 18
18-24
25-34
35-44
45-54
55+
18.
What is your gender?
Male
Female
Other
Prefer not to say
19.
What is your race/ethnicity?
White or Caucasian
Hispanic or Latino
Black or African American
Native American or American Indian
Asian/Pacific Islander
Other
20.
What is the highest level of school you have completed?
Some high school
High school degree or equivalent
Some College/Trade School
Bachelor’s degree
Post Graduate degree
Other (please specify)
21.
What is your current employment status?
Employed full time
Employed part-time
Unemployed
Student
Self employed
Retired
Unable to work
22.
What is your location? (provide a zip code where you reside)
23.
What is your annual household income?
Under $10,000
Between $10,000 and $50,000
Between $50,000 and $100,000
Between $100,000 and $150,000
Over $150,000
Current Progress,
0 of 23 answered