Children

a. Children's Basic Information

Child's Name Write the full name of the first child who needs support. Date of Birth Write the first child's birth date. Child's Name Write the full name of the second child who needs support. Date of Birth Write the second child's birth date. Child's Name Write the full name of the third child who needs support. Date of Birth Write the third child's birth date. Child's Name Write the full name of the fourth child who needs support. Date of Birth Write the fourth child's birth date. Child's Name Write the full name of the fifth child who needs support. Date of Birth Write the fifth child's birth date. Child's Name Write the full name of the sixth child who needs support. Date of Birth Write the sixth child's birth date. Petitioner is responsible for providing Check this if you (the person who started the case) will provide health insurance for the children.

b. Health & Medical Support

medical Check this if the petitioner will provide medical insurance for the children. dental Check this if the petitioner will provide dental insurance for the children. vision care Check this if the petitioner will provide vision (eye) care insurance for the children. Respondent is responsible for providing Check this if the other parent (the person responding to the case) will provide health insurance for the children. medical Check this if the respondent will provide medical insurance for the children. dental Check this if the respondent will provide dental insurance for the children. vision care Check this if the respondent will provide vision (eye) care insurance for the children. shall be individually responsible for providing medical insurance for the minor child(ren) Check this if no parent has health insurance now, but one parent must get it once it becomes available at a fair price. Petitioner Check this if the petitioner must get insurance once it becomes available. Respondent Check this if the respondent must get insurance once it becomes available.

c. Children's Basic Information

Child's Name Write the full name of the first child this tax exemption covers. Date of Birth (Month, Day, Year) Enter the first child's date of birth, with month, day, and year. Petitioner Check this if the petitioner gets to claim this child on their taxes. Respondent Check this if the respondent gets to claim this child on their taxes. For Calendar Year Write the year or years this parent can claim the child on taxes. Child's Name Write the full name of the second child this tax exemption covers. Date of Birth (Month, Day, Year) Enter the second child's date of birth, with month, day, and year. Petitioner Check this if the petitioner gets to claim this child on their taxes. Respondent Check this if the respondent gets to claim this child on their taxes. For Calendar Year Write the year or years this parent can claim the child on taxes. Child's Name Write the full name of the third child this tax exemption covers. Date of Birth (Month, Day, Year) Enter the third child's date of birth, with month, day, and year. Petitioner Check this if the petitioner gets to claim this child on their taxes. Respondent Check this if the respondent gets to claim this child on their taxes. For Calendar Year Write the year or years this parent can claim the child on taxes. Child's Name Write the full name of the fourth child this tax exemption covers. Date of Birth (Month, Day, Year) Enter the fourth child's date of birth, with month, day, and year. Petitioner Check this if the petitioner gets to claim this child on their taxes. Respondent Check this if the respondent gets to claim this child on their taxes. For Calendar Year Write the year or years this parent can claim the child on taxes. Child's Name Write the full name of the fifth child this tax exemption covers. Date of Birth (Month, Day, Year) Enter the fifth child's date of birth, with month, day, and year. Petitioner Check this if the petitioner gets to claim this child on their taxes. Respondent Check this if the respondent gets to claim this child on their taxes. For Calendar Year Write the year or years this parent can claim the child on taxes. Child's Name Write the full name of the sixth child this tax exemption covers. Date of Birth (Month, Day, Year) Enter the sixth child's date of birth, with month, day, and year. Petitioner Check this if the petitioner gets to claim this child on their taxes. Respondent Check this if the respondent gets to claim this child on their taxes. For Calendar Year Write the year or years this parent can claim the child on taxes.