Dane County Department of Human Services

Parental Support Unit

Payments can be made for fees charged by the Dane County Human Services Parental Support Unit. Please have your account number available, as you will need it to enter your payment.

All fields on this form are required

Account Information

Parent/Guardian First Name

Parent/Guardian Last Name

Phone

Address

City

State

Zip

Child/Client Information

Child/Client First Name

Child/Client Last Name

Program

Account #

Amount to Pay