JDF 1404 R 2 / 1 8 STIPULATION REGARDING CHILD SUPPORT MODIFICATION Page 1 of 2 District Court County, Colorado Court Address: In re: The Marriage of: The Civil Union of: Parental Responsibilities concerning: Petitioner: and Co - Petitioner/Res pondent: COURT USE ONLY Attorney or Party Without Attorney (Name and Address) : Phone Number: E - mail: FAX Number: Atty. Reg. #: Case Number: Division Courtroom ST IPULATION REGARDING CHILD SUPPORT MODIFICATION The parties stipulate and agree to the following Stipulation Regarding Child Support Modification: 1. The Petitioner Co - Petitioner /Respondent is currently paying $ child support per month pursuant to an agreement between the parties or prior court order . 2. The parties stipulate and agree that the Petitioner Co - Petitioner /Respondent shall pay child support pursuant to the Colorado Child Support Guidelines, 24714 - 10 - 115, C.R.S. in the amount of $ , due and payable by (date), commencing on (date). 3. This amount will continue until fur ther Order of the Court. Payments shall be mailed to: Obligee or Family Support Registry (P.O. Box 2171 Denver, CO 80201 - 2171). Note : Both parties have entered into a written agreement however; if a payment is missed a wage assignment will be established. 4. Th Swo rn Financial Statements are filed with this Stipulation. 5. The parties have minor child(ren). Full Name of Child Present Address Sex Date of Birth 6. Other Information: American LegalNet, Inc. www.FormsWorkFlow.com JDF 1404 R 2 / 1 8 STIPULATION REGARDING CHILD SUPPORT MODIFICATION Page 2 of 2 7. If applicable. We have provided a copy of this Stipulation (JDF 1404) to the Office of Child Support Enforcement , as they are involved in our case. The parties request that this Stipulation Regarding Child Support Modification be entered as an Order of this Court. By checking this box, I am acknowledging I am filling in the blanks and not changing anything else on the form. By checking this box, I am acknowledging that I have made a change to the original content of this form. SIGNATURE (Printed name of Petitioner) Signature of Petitioner Date City State Zip Code Home Phone Cell Phon e Attorney Signature, if any (Printed name of Co - Petitioner/Respondent) Signature of Co - Petitioner/Respondent Date City State Zip Code Home Phone Cell Phon e Co - ture, if any American LegalNet, Inc. www.FormsWorkFlow.com