Arizona > Local County > Coconino > Superior Court > Children And Family Law
Child Support Order - Arizona
| Child Support Order Form. This is a Arizona form and can be used in Children And Family Law Superior Court Coconino Local County . |
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(1) Name of Person Filing: _____________________________ Person filing is the: Petitioner Respondent Mailing Address (if not protected): ______________________ City, State, Zip Code: _________________________________ Phone Number: ______________________________________ Representing Self, Without an Attorney (If Attorney) State Bar Number: _________________________ Attorney E-Mail Address: ______________________________ For Clerk Use Only SUPERIOR COURT OF ARIZONA, COUNTY OF (2)____________________________________ (3)____________________________________ Petitioner (4)_________________________________ Respondent (5) Case No. ______________________________ (6) ATLAS No._____________________________ CHILD SUPPORT ORDER THE COURT FINDS that: 1. (7) _________________________________ owe a duty to support the following children: Name (9) _________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ and (8) _______________________________ Date of Birth ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ 2. Child Support Guidelines. The required financial factors and any discretionary adjustments pursuant to the Arizona Child Support Guidelines are as set forth in the Child Support Worksheet, attached and incorporated herein by reference. 3. Child Support. (10) ____________________________is obligated to pay child support to _______________________ pursuant to the Arizona Child Support Guidelines in the amount of $___________ per month without deviation. Page 1 of 6 Arizona Supreme Court May 17, 2011 Child Support Order American LegalNet, Inc. www.FormsWorkFlow.com Case No._____________________ (11) Application of the child support guidelines in this case is inappropriate or unjust. The Court has considered the best interests of the child in determining that a deviation is appropriate. After deviation the child support is $__________ per month to be paid by __________________. Explain reason for deviation: ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 4. (12) Past Support. ________________________ owes ________________________ past support in the amount of $____________ for the time period starting __________________ and ending ___________________. No evidence was presented in support of any past child support. 5. (13) Arrears. ____________________owes child support arrearages to ________________ in the total amount of $_____________for the time period of _________ through __________. No evidence was presented in support of any child support arrearage. 6. (14) Past Care Expenses. It is appropriate to award ____________________ a judgment for past care expenses, including all pregnancy, childbirth, and past medical care for a child, in the total sum of $______________. The evidence does not support a judgment for pregnancy, childbirth, or past care expenses. IT IS ORDERED that: A. (15) Child Support. ______________________shall pay child support to _______________ in the sum of $____________per month, payable on the 1st day of each month commencing ___________________by wage assignment. (16) Past Support. _____________________is granted a past support judgment against ___________________ in the sum of $_______________ as and for past support for the period of ________________ through __________________ together with interest at the legal rate of 10% per annum until paid in full. _______________________ shall pay, in addition to his/her current child support payment, the amount of $____________ per month towards this judgment, payable on the first (1st) day of each month starting ___________ until paid in full. No judgment for past support is entered. B. Page 2 of 6 Arizona Supreme Court May 17, 2011 Child Support Order American LegalNet, Inc. www.FormsWorkFlow.com Case No._____________________ C. (17) Arrearage Judgment. _____________________________is granted judgment against ___________________ in the sum of $___________as and for child support arrearages for the period of _______________through _________________ together with interest at the legal rate of 10% per annum until paid in full. ____________________________shall also pay, in addition to his/her current child support payment, the amount of $_____________per month towards this judgment, payable on the first (1st) day of each month starting __________ until paid in full. No judgment for child support arrears is entered. D. (18) Past Care Expenses. ________________________________is granted judgment against ________________ in the total amount of $_________ as and for past care and support, together with interest at the legal rate until paid in full. ____________________________ shall pay the additional sum of $________ per month towards this judgment, payable on the 1st day of each month starting_______________ until paid in full. No judgment for past care and support is entered. E. Payments. All payments, plus the statutory handling fee, shall be made through the Support Payment Clearinghouse pursuant to an Order of Assignment signed this date. Any time the full amount of support ordered is not withheld, the obligor remains responsible for the full monthly amount ordered. Payments not made directly through the Support Payment Clearinghouse shall be considered gifts unless otherwise ordered. All payments shall be made payable to and mailed directly to: Support Payment Clearinghouse P.O. Box 52107 Phoenix, AZ 85072-2107 Payments must include the obligor's name, ATLAS number, and Social Security Number. Pursuant to A.R.S. §25-322, the parties shall submit current address information in writing to the Clerk of the Superior Court and the Support Payment Clearinghouse immediately. The obligor shall submit the names and addresses of their employers or other payors within 10 days. The parties shall submit address changes within 10 days of the change. F. Medical, Dental, and Vision Insurance, Non-Covered Expenses, and Cash Medical Support. 1. Insurance: (A.R.S. § 25-320(J)) (19) a. Petitioner will provide: medical dental that is accessible an
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