Affidavit Regarding Minor Children · Step 3 of 5
What You Are Asking For
a. General Information
Petitioner
Check this if the Petitioner is the parent who must pay child support under option a.
Respondent
Check this if the Respondent is the parent who must pay child support under option a.
Petitioner
Check this if the Petitioner is the parent who receives the child support under option a.
Respondent
Check this if the Respondent is the parent who receives the child support under option a.
in the amount of $
Enter the monthly child support amount in dollars, following the guidelines with no changes.
Petitioner
Check this if the Petitioner is the parent who must pay child support under option b.
Respondent
Check this if the Respondent is the parent who must pay child support under option b.
Petitioner
Check this if the Petitioner is the parent who receives the child support under option b.
Respondent
Check this if the Respondent is the parent who receives the child support under option b.
in the amount of $
Enter the monthly amount the guidelines give before any rounding is applied.
rounding adjustment to the exact guideline amount for ease of calculation to $
Enter the rounded monthly amount that makes the figure easier to use.
Petitioner
Check this if the Petitioner is the parent who must pay child support under option c.
Respondent
Check this if the Respondent is the parent who must pay child support under option c.
Petitioner
Check this if the Petitioner is the parent who receives the child support under option c.
Respondent
Check this if the Respondent is the parent who receives the child support under option c.
in the amount of $
Enter the monthly amount the guidelines give before any change is made.
b. Child Support
After deviation, the child support order is $
Enter the new monthly amount after the court changes it from the guideline figure.
Petitioner
Check this if the Petitioner is the parent who must pay child support under option d.
Respondent
Check this if the Respondent is the parent who must pay child support under option d.
Petitioner
Check this if the Petitioner is the parent who receives the child support under option d.
Respondent
Check this if the Respondent is the parent who receives the child support under option d.
in the amount of $
Enter the monthly amount the guidelines give before any change is made.
After deviation, the child support order is $
Enter the new monthly amount after the court changes it from the guideline figure.
Reason(s) for deviation:
Explain why the child support amount is different from the standard guideline amount. Give clear reasons the court can review.
[ ] Petitioner owes child support arrearages
Check this box if the petitioner is the one who owes past-due child support.
[ ] Respondent owes child support arrearages
Check this box if the respondent is the one who owes past-due child support.
[ ] Petitioner
Check this box if the past-due child support should be paid to the petitioner.
[ ] Respondent in the total amount of
Check this box if the past-due child support should be paid to the respondent.
in the total amount of $
Enter the full dollar amount of child support that is past due and unpaid.
for the time period of
Enter the start date of the time period when the unpaid support added up.
through
Enter the end date of the time period when the unpaid support added up.
plus accrued interest on prior child support arrearages due of $
Enter the dollar amount of interest that has built up on the past-due support.
calculated through the date of
Enter the date used to figure out the interest amount.
[ ] The court finds no child support arrearages due and owing.
Check this box if no past-due child support is owed by either person.
[ ] No evidence was presented in support of child support arrearages.
Check this box if no proof was shown in court about past-due child support.
[ ] It is appropriate to award
Check this box if it is fair to give extra money for support owed between filing the petition and when current support starts.
[ ] Petitioner an additional judgment for past support
Check this box if the petitioner should receive this extra past support judgment.
[ ] Respondent an additional judgment for past support
Check this box if the respondent should receive this extra past support judgment.
judgment for past support in the amount of $
Enter the dollar amount of extra past support owed for the time between filing and when current support begins.
[ ] It is appropriate to award
Check this box if it is fair to give extra money for support owed since the date the couple separated.
[ ] Petitioner an additional judgment
Check this box if the petitioner should receive this separation-based past support judgment.
[ ] Respondent an additional judgment
Check this box if the respondent should receive this separation-based past support judgment.
judgment in the amount of $
Enter the dollar amount of past support owed since separation, but not more than three years before filing.
Petitioner shall pay child support to
Check this box if the Petitioner is the one who must pay child support.
Respondent shall pay child support to
Check this box if the Respondent is the one who must pay child support.
shall pay child support to Petitioner
Check this box if the Petitioner is the one who receives child support.
shall pay child support to Respondent
Check this box if the Respondent is the one who receives child support.
in the amount of $
Enter the dollar amount of child support to be paid each month.
shall be paid on the 1st day of each month beginning
Enter the date the monthly child support payments start.
SUPPORT ARREARAGES JUDGMENT:
Check this box if the court is ordering payment of past-due support (arrearages).
Petitioner is granted judgment against
Check this box if the Petitioner is awarded the back-support judgment.
Respondent is granted judgment against
Check this box if the Respondent is awarded the back-support judgment.
is granted judgment against Petitioner
Check this box if the Petitioner is the one ordered to pay the back support.
Respondent in the amount of $
Check this box if the Respondent is the one ordered to pay the back support.
in the amount of $
Enter the total dollar amount of past-due child support owed.
for the period of
Enter the start date of the period the back support covers.
through
Enter the end date of the period the back support covers.
plus additional accrued interest on prior child support judgments of $
Enter the extra interest amount that has built up on earlier child support judgments.
calculated through the date of
Enter the date through which the interest was figured.
Petitioner shall pay, in addition to
Check this box if the Petitioner must pay extra each month toward the back support.
Respondent shall pay, in addition to
Check this box if the Respondent must pay extra each month toward the back support.
in addition to Petitioner's
Check this box if this extra payment is added to the Petitioner's regular support payment.
Respondent's current support payment
Check this box if this extra payment is added to the Respondent's regular support payment.
the sum of $
Enter the extra dollar amount to be paid each month toward the back support.
payable on the first day of each month, beginning
Enter the date these extra monthly payments start.
PAST SUPPORT JUDGMENT:
Check this box if the court is ordering a separate judgment for past support.
Petitioner is granted judgment against
Check this box if the Petitioner is awarded the past support judgment.
Respondent is granted judgment against
Check this box if the Respondent is awarded the past support judgment.
is granted judgment against Petitioner
Check this box if the Petitioner is the one ordered to pay the past support.
Respondent in the additional amount of $
Check this box if the Respondent is the one ordered to pay the past support.
in the additional amount of $
Enter the extra dollar amount of past support that is owed.
Petitioner may claim
Check this if the petitioner can claim the children only after paying all support owed by December 31.
Respondent may claim
Check this if the respondent can claim the children only after paying all support owed by December 31.
Petitioner may unconditionally claim
Check this if the petitioner can claim the children no matter what.
Respondent may unconditionally claim
Check this if the respondent can claim the children no matter what.
Petitioner
Check this to show the exemption is given to the petitioner for tax purposes.
Respondent
Check this to show the exemption is given to the respondent for tax purposes.
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