Children

a. General Information

Party A Check this if you are Party A in relation to the children. Party B Check this if you are Party B in relation to the children. Party A Check this if the other party is Party A in relation to the children. Party B Check this if the other party is Party B in relation to the children. Name: Write the full name of the first child you want the order changed for. Birth Date: Enter the first child's date of birth. Age: Write how old the first child is right now. Name: Write the full name of the second child, if you have more than one. Birth Date: Enter the second child's date of birth. Age: Write how old the second child is right now. Name: Write the full name of the third child, if you have one. Birth Date: Enter the third child's date of birth. Age: Write how old the third child is right now. Name: Write the full name of the fourth child, if you have one. Birth Date: Enter the fourth child's date of birth. Age: Write how old the fourth child is right now.

b. Child Support

The minor children have resided in Arizona since the entry of the last Arizona legal decision-making, parenting time, and/or child support Order Check this box if the children have lived in Arizona since the last Arizona order was made. I have attached an "Affidavit Regarding Minor Children". Check this box only if the children have not always lived in Arizona and you are attaching the extra affidavit form.

c. Health & Medical Support

to pay _______ % of all reasonable uncovered and/or uninsured medical, dental, vision care, prescription and other health care charges for the minor child(ren), including co-payments. Enter the percent of the child's medical bills not covered by insurance that this person should pay. Claim by: A / B Check 'A' if Party A claims this child on taxes, or 'B' if Party B claims this child. Name of Child Write the full name of the first child for the tax deduction. Starting Tax Year: Every Year / Every Other Check 'Every Year' if the same person always claims this child, or 'Every Other' if you take turns by year. Claim by: A / B Check 'A' if Party A claims this child on taxes, or 'B' if Party B claims this child. Name of Child Write the full name of the second child for the tax deduction. Starting Tax Year: Every Year / Every Other Check 'Every Year' if the same person always claims this child, or 'Every Other' if you take turns by year. Claim by: A / B Check 'A' if Party A claims this child on taxes, or 'B' if Party B claims this child. Name of Child Write the full name of the third child for the tax deduction. Starting Tax Year: Every Year / Every Other Check 'Every Year' if the same person always claims this child, or 'Every Other' if you take turns by year. Claim by: A / B Check 'A' if Party A claims this child on taxes, or 'B' if Party B claims this child. Name of Child Write the full name of the fourth child for the tax deduction. Starting Tax Year: Every Year / Every Other Check 'Every Year' if the same person always claims this child, or 'Every Other' if you take turns by year.