Person Filing: Address (if not protected): City, State, Zip Code: Telephone: Email Address: ATLAS Number: Lawyer222s Bar Number: Representing Self, without a Lawyer or Attorney for Petitioner OR Respondent SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY Case No. Petitioner / Party A ATLAS No. Date of Birth (Month, Date, Year) CHILD SUPPORT ORDER Respondent / Party B A.R.S. 247 25-503 Date of Birth (Month, Date, Year) THE COURT FINDS: 1. Party A: and Party B: Have a duty to support the following children: Child(ren)222s Name(s) Date of Birth For Clerk222s Use Only 251 Superior Court of Arizona in Maricopa County DRS81f-010119 ALL RIGHTS RESERVED Page 1 of 8 American LegalNet, Inc. www.FormsWorkFlow.com Case Number: 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 by reference. 3. CHILD SUPPORT: Party A Party B is ordered to pay child support in the amount of $ per month to pursuant to the Arizona Child Support Guidelines without deviation. Party A Party B is obligated to pay child support to Party A Party B 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. Party A Party B is obligated to pay child support to Party A Party B 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. Party A Party B is obligated to pay child support to Party A Party B 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. 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. 251 Superior Court of Arizona in Maricopa County DRS81f-010119 ALL RIGHTS RESERVED Page 2 of 8 American LegalNet, Inc. www.FormsWorkFlow.com Case Number: Reason(s) for deviation: 4. SUPPORT ARREARS: Party A Party B owes child support arrearages to Party A Party B 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 . The Court finds no child support arrearages due and owing. No evidence was presented in support of child support arrearages. 5. PAST SUPPORT: It is appropriate to award Party A Party B 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. Temporary support or voluntary / direct support payments in the amount of $ were paid during the period above; therefore the past support is adjusted to $ . It is appropriate to award Party A Party B 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. Temporary support or voluntary / direct support payments in the amount of $ were paid during the period above; therefore the past support is adjusted to $ . The Court finds no past support amount due and owing. 251 Superior Court of Arizona in Maricopa County DRS81f-010119 ALL RIGHTS RESERVED Page 3 of 8 American LegalNet, Inc. www.FormsWorkFlow.com Case Number: No evidence was presented in support of past child support. The Court finds no temporary support or voluntary / direct support payments were paid. No evidence was presented in support temporary support or voluntary / direct support payments. 6. INTEREST: The Court finds interest in the amount of $ due to Party A Party B For the period of: to . IT IS ORDERED THAT: 1. CHILD SUPPORT JUDGMENT: Party A Party B shall pay child support to 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 . 2. SUPPORT ARREARAGES JUDGMENT: Party A Party B is granted judgment against in the amount of $ as and for child support arrearages for the period of through the date of 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 . Party A Party B shall pay, in addition to his OR her current support payment, the amount of $ per month toward this judgment, payable on the first day of each month, beginning until paid in full. NO Judgment for child support arrearages is entered. 251 Superior Court of Arizona in Maricopa County DRS81f-010119 ALL RIGHTS RESERVED Page 4 of 8 American LegalNet, Inc. www.FormsWorkFlow.com Case Number: 3. PAST SUPPORT JUDGMENT: Party A Party B is granted a past support judgment against Party A Party B in the additional amount of $. Party A Party B shall pay the additional amount of $ per month toward this judgment, payable on the first day of each month commencing until paid in full. OR NO Judgment for past support is entered. 4. PAYMENTS AND CLEARINGHOUSE: All payments, plus the statutory handling fee, shall be made through the Support Payment Clearinghouse pursuant to an Order of Assignment, or 223Income Withholding Order224 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 Party A222s or Party B222s 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 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. 5. TOTAL MONTHLY PAYMENTS: Party A Party B shall make total monthly payments to Party A Party B 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: $ Current spousal maintenance payment: $ Support arrearage payment: $ Clearinghouse handling fee: $ $ 5.00 TOTAL MONTHLY PAYMENT: $ 251 Superior Court of Arizona in Maricopa County DRS81f-010119 ALL RIGHTS RESERVED Page 5 of 8 American LegalNet, Inc. www.FormsWorkFlow.com Case Number: 6. MEDICAL, DENTAL, VISION CARE INSURANCE FOR MINOR CHILDREN: Party A OR Party B 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. OR Party A OR Party B shall be individually responsible for providing medical insurance for the minor child(ren) of the parties as soon as it becomes accessible and available at a reasonable cost, as neither party currently has the ability to obtain such medical insurance. Medical, dental, and vision insurance, payments and expenses are based on the information in the Parent222s Worksheet for Child Support attached hereto and