Child Support Order {DRS81F}

Arizona Supreme Court Page 1 of 9 DRS81F-091317 (1) Person Filing: Address (if not protected): City, State, Zip Code: Telephone Number: Email Address: [ ] Representing [ ] Self or [ ] Attorney for (If Attorney) State Bar Number: SUPERIOR COURT OF ARIZONA IN (2) COUNTY (3) Case Number : (4 ) Petitioner ATLAS Number: (5 ) CHILD SUPPORT ORDER A.R.S. 247 247 25 - 320 and 25 - 503 Respondent THE COURT FINDS: 1. , Petitioner, and , Respondent, owe a duty to support the following child(ren). Child222s Name Date of Birth FOR CLERK222S USE ONLY American LegalNet, Inc. www.FormsWorkFlow.com Case Number: Arizona Supreme Court Page 2 of 9 DRS81F-091317 If you and the other parent ARE NOT stipulating to the contents of the Child Support Order, LEAVE THE REST OF THE FORM BLANK. The judge or commissioner will complete the rest of the information and sign the order. If you and the other parent ARE stipulating to the contents of the Child Support Order, continue to complete the form using the following instructions. 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 Parent222s Worksheet for Child Support Amount, attached and incorporated herein by reference. 3. CHILD SUPPORT: a. [ ] [ ] Petitioner [ ] Respondent is obligated to pay child support to [ ] Petitioner [ ] Respondent in the amount of $ per month to pursuant to the Arizona Child Support Guidelines without deviation. b. [ ] [ ] Petitioner [ ] Respondent is obligated to pay child support to [ ] Petitioner [ ] Respondent in the amount of $ per month pursuant to the Arizona Child Support Guidelines without deviation. This amount is an appropriate amount to award for child support in this case except that the court finds it more appropriate and just to make a rounding adjustment to the exact guideline amount for ease of calculation to $ per month. c. [ ] [ ] Petitioner [ ] Respondent is obligated to pay child support to [ ] Petitioner [ ] Respondent in the amount of $ per month pursuant to the Arizona Child Support Guidelines. 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 order is $ per month. d. [ ] [ ] Petitioner [ ] Respondent is obligated to pay child support to [ ] Petitioner [ ] Respondent in the amount of $ per month pursuant to the Arizona Child Support Guidelines. 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 order is $ per American LegalNet, Inc. www.FormsWorkFlow.com Case Number: Arizona Supreme Court Page 3 of 9 DRS81F-091317 month. Further, the parties have entered into a written agreement or their agreement is on the record and is free of duress and coercion with knowledge of the amount of child support that would have been ordered under the guidelines but for the agreement. Reason(s) for deviation: 4. SUPPORT ARREARS: a. [ ] [ ] Petitioner [ ] Respondent owes child support arrearages to [ ] Petitioner [ ] Respondent in the total amount of $ for the time period of through plus accrued interest on prior child support arrearages due of $calculated through the date of . b. [ ] The court finds no child support arrearages due and owing. c. [ ] No evidence was presented in support of child support arrearages. 5. PAST SUPPORT: a. [ ] It is appropriate to award [ ] Petitioner [ ] Respondent an additional judgment for past support in the amount of $ for the period between the filing of this current petition and the date current child support is ordered to begin. b. [ ] It is appropriate to award [ ] Petitioner [ ] Respondent an additional judgment in the amount of $ for past support owed from the date of separation, but not more than three years before the date of filing the current petition. c. [ ] Temporary support or voluntary / direct support payments in the amount of $ were paid during the period above; therefore, the past support amount is adjusted to $. American LegalNet, Inc. www.FormsWorkFlow.com Case Number: Arizona Supreme Court Page 4 of 9 DRS81F-091317 d. [ ] The court finds no past support amount due and owing. e. [ ] No evidence was presented in support of past child support. f. [ ] The court finds no temporary support or voluntary / direct support payments were paid. g. [ ] No evidence was presented in support temporary support or voluntary / direct support payments. IT IS ORDERED THAT: A. CHILD SUPPORT JUDGMENT: [ ] Petitioner [ ] Respondent shall pay child support to [ ] Petitioner [ ] Respondent in the amount of $ per month. This monthly amount, payable by income withholding order, shall be paid on the 1st day of each month beginning . B. SUPPORT ARREARAGES JUDGMENT: [ ] [ ] Petitioner [ ] Respondent is granted judgment against [ ] Petitioner [ ] Respondent in the amount of $ as and for child support arrearages for the period of through together with interest on said amount at the legal rate of 10% per annum until paid in full, plus additional accrued interest on prior child support judgments of $ calculated through the date of . [ ] Petitioner [ ] Respondent shall pay, in addition to [ ] Petitioner222s [ ] Respondent222s current support payment, the sum of $ per month toward this judgment, payable on the first day of each month, beginning until paid in full. C. PAST SUPPORT JUDGMENT: [ ] [ ] Petitioner [ ] Respondent is granted judgment against [ ] Petitioner [ ] Respondent in the additional amount of $. [ ] Petitioner [ ] Respondent shall pay the additional amount of $ per month toward this judgment, payable on the first day of each month beginning until paid in full. American LegalNet, Inc. www.FormsWorkFlow.com Case Number: Arizona Supreme Court Page 5 of 9 DRS81F-091317 D. PAYMENTS AND CLEARINGHOUSE: All payments, plus the statutory handling fee, shall be made through the Support Payment Clearinghouse pursuant to an Income Withholding Order signed this date. Any time the full amount of support ordered is not withheld, the person obligated to pay (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 [ ] Petitioner222s [ ] Respondent222s name, and ATLAS number. Pursuant to A.R.S. 247 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 (party being ordered to pay) shall submit the names and addresses of his or her employers or other payors within 10 days. Both parties shall submit address changes within 10 days of the change. E. TOTAL MONTHLY PAYMENTS: [ ] Petitioner [ ] Respondent shall make total monthly payments to [ ] Petitioner [ ] Respondent in the amount of $ per month, payable on the first day of each month, beginning as follows: Monthly Payments: Current child support payment as ordered above: $ Past - d ue child s upport p ayment $ Current cash medical support payment $ Past - due cash medical support payment $ Current spousal maintenance payment $ Past - due spousal maintenance payment $ Clear inghouse handling fee: $ 5.00 TOTAL MONTHLY PAYMENT: $ F. MEDICAL, DENTAL, VISION CARE INSURANCE FOR MINOR CHILDREN: 1. [ ] Petitioner is responsible for providing [ ] medical [ ] dental [ ] vision care insurance for the minor child(ren) and shall continue to pay premiums for any medical, dental and vision policies covering the child(ren) that are currently included in the incorporated Parent222s Worksheet for Child Support. American LegalNet, Inc. www.FormsWorkFlow.com Case Number: Arizona Supreme Court Page 6 of 9 DRS81F-091317 [ ] Respondent is responsible for providing [ ] medical [ ] dental [ ] vision c