(1) Identify the obligee and obligor by name and address, and shall list the last four digits of the obligor's Social Security number or numbers, if known;
(2) Name the court which entered the support order and set forth the date of such entry;
(3) Allege that the support obligor is at least thirty days in arrears in the payment of child support; and
(4) State the total amount of accrued support which has not been paid by the obligor.
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