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Affidavit For Termination of Child Support CS95 - Missouri

Affidavit For Termination of Child Support Form. This is a Missouri form and can be used in Child Support Circuit Court Statewide .
 Fillable pdf Last Modified 4/17/2012
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IN THE ________ JUDICIAL CIRCUIT COURT, _____________________________, MISSOURI Judge or Division: Petitioner: Case Number: MACSS Case ID: Petitioner's Address: SSN (last four digits) or DOB: vs. Respondent: Respondent's Address: SSN (last four digits) or DOB: (Date File Stamp) Affidavit for Termination of Child Support (This form may be used only where a claim is made that no child remains entitled to support.) I, ______________________________, am receiving support paying support for ____________________________ (hereinafter referred to as the child), whose age is _____________________ and who is no longer entitled to support because: (Check all which are applicable): The child died on __________________________ (date). The child married on __________________________ (date). The child entered active duty in the military on __________________________ (date). The child has become self-supporting, and the custodial parent has relinquished the child from parental control by express or implied consent. The child has attained the age of 21. The child is enrolled in and attending a secondary (high) school program of instruction but has attained the age of 21. The child has attained the age of 18 and has not graduated from secondary (high) school or completed a graduation equivalence degree program and, upon reaching age 18, was not attending and progressing toward completion of a secondary (high) school program of instruction. has graduated from secondary (high) school or completed a graduation equivalence degree program but did not enroll in an institution of vocational or higher education by October 1 following graduation or completion of the graduation equivalence degree program. has enrolled in an institution of vocational or higher education by October 1 following graduation from secondary (high) school or completion of a graduation equivalence degree program, but failed to achieve grades sufficient to reenroll at such institution or failed to complete sufficient credit hours in each semester (at least 12 semester hours or the equivalent). when enrolled and attending an institution of vocational or higher education (course load of at least 12 hours), received failing grades in half or more of his/her course load in any one semester. when enrolled and attending an institution of vocational or higher education, the child failed to provide the noncustodial parent with documentation of grades from the education institution as requested by the non-custodial parent. The child is not physically or mentally incapacitated from supporting himself or herself, and the child's circumstances do not manifestly dictate that child support should continue. Other _____________________________________________________________________________________________ I swear/affirm under the penalty of perjury that these facts are true to my best knowledge and belief. ______________________________________ Signature of Person Paying/Receiving Support OSCA (01-12) CS95 1 of 3 _________________________________ Date 452.340, 509.030 RSMo American LegalNet, Inc. www.FormsWorkFlow.com Notice to Parent Receiving Support If you agree with the statements in this Affidavit and agree to termination of the obligation to pay support for the child, you may, but are not required to, file an Acknowledgement with the Court. Upon your filing of an Acknowledgement, a judgment terminating the obligation to pay support for the child will be entered. If you disagree with the statements in this Affidavit and object to termination of the obligation to pay support for the child, you must file with the Court an Answer which states the reasons the obligation to pay support for the child should continue. Upon your filing of an Answer, the Court will treat this Affidavit as a request for hearing. Your failure to file an Acknowledgment or Answer with the Court within 30 days of your receipt of this Affidavit may result in entry by default of a judgment terminating the obligation to pay support for the child. Certificate of Service of Parent Receiving Support I certify that on ___________________________ (date), I filed the original Affidavit with the Circuit Clerk of __________________________ (County/City of St. Louis), Missouri at __________________________________ (address), and mailed a copy to ________________________________________________ (name), the parent paying support, at __________________________________________ (address), _____________________________ (city), ___________ (state). ___________________________________________ Signature of Parent Receiving Support Sheriff's or Server's Return I certify that I served this Affidavit at ________________________________________________________________ (address) in _________________________ (County/City of St. Louis), ________________ (state), on ___________________ (date), at ______________ (time), by: (Check one) delivering a copy of the Affidavit and Answer and Acknowledgement forms to _______________________ (name); leaving a copy of the Affidavit and Answer and Acknowledgement forms at the dwelling place or usual abode of _________________________________________ (name), with __________________________ (name), a person of _________________________________________ (name)'s family over the age of 15 years. other (describe) ________________________________________________________________________________ _____________________________________________________ Printed Name of Sheriff or Server _______________________________________________________________ Sheriff or Server Must be sworn before a notary public if not served by an authorized officer (Seal) Subscribed and sworn to before me on ___________________________ (date). My commission expires: __________________ Date ___________________________________ Notary Public Sheriff's Fee (if applicable) Service Fee $ Sheriff's Deputy Salary Supplemental Surcharge $ Mileage $ Total $ 10.00 (______ miles @ $.______ per mile) _______________________________________________ Sheriff or Server OSCA (01-12) CS95 2 of 3 452.340, 509.030 RSMo American LegalNet, Inc. www.FormsWorkFlow.com Complete for Out of State Service 1) I am authorized to serve process in civil actions within the state or territory where the Affidavit was served. 2) My official title is ____________________________ of __________________________ County, _______________ (state). Subscribed and sworn before me this _____________________ (date). I am: (check one) the clerk o
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