Child Support And Maintenance Court Order Work Sheet - Regular

OFFICE OF THE CLERK OF THE COURT CHILD SUPPORT AND MAINTENANCE COURT ORDER WORK SHEET- Regular PAY TO: FROM: CASE #: PAYOR'S SS # EMPLOYER'S NAME AND ADDRESS: __________________________________________________ __________________________________________________ CHILD SUPPORT PAYMENT Amount: $ __________________ Effective Date: _________________ Frequency: _____ Weekly _____ Monthly _____ Annually MAINTENANCE (SPOUSAL) (end date must be provided ­ MM/DD/YYYY) End Date: _________________ _____ Bi-Weekly (every two weeks) _____ Semi- Monthly (two times a month) Amount: $ __________________ Effective Date: _________________ Frequency: _____ Weekly _____ Monthly _____ Annually ARREARAGES (end date must be provided ­ MM/DD/YYYY) End Date: _________________ (provide if possible) _____ Bi-Weekly (every two weeks) _____ Semi- Monthly (two times a month) Total Arrearage: $ ______________ Effective Date: _________________ Frequency: _____ Weekly _____ Monthly _____ Annually CHILD MAINTENANCE Periodic Payment Amount: $ ______________ End Date: _________________ _____ Bi-Weekly (every two weeks) _____ Semi- Monthly (two times a month) Amount: $ __________________ Effective Date: _________________ End Date: _________________ (provide if possible) Frequency: _____ Weekly _____ Monthly _____ Annually _____ Bi-Weekly (every two weeks) _____ Semi- Monthly (two times a month) Prepared by Attorney: ___________________________ American LegalNet, Inc. www.FormsWorkFlow.com