Name: Mailing Address: Daytime Telephone Representing Self, Without a Lawyer IN THE SUPERIOR COURT OF ARIZONA, YAVAPAI COUNTY Regarding the matter of DO Petitioner vs SIMPLIFIED/SUMMARY TEMPORARY CHILD SUPPORT ORDER Respondent THE COURT FINDS: 1. This case has come before this Court for a Temporary Child Support Order. This Court has [ ] taken testimony or [ ] determined testimony is not required, has jurisdiction over the parties under the law, and has determined the provisions of this Order are fair and reasonable under the circumstances and in the best interest(s) of the child(ren) . 2. The following child(ren) is/are the subject(s) of this Order. 3. CHILD SUPPORT. Child Support has been determined [ ] in accordance with the Arizona Child Support Guidelines OR [ ] by party agreement free of coercion or duress OR [ ] Other [ ] The Court finds the Guidelines amount is inappropriate or unjust because: [ ] [ ] [ ] 4. The child support order would have been $ . The child support order after deviation is $ . Pursuant to the Parent’s Worksheet for Child Support Amount reviewed by the Court, the Obligor has the ability to pay the ordered child support. The amount of child support requested is less than or equal to 150% of the amount the Obligor is willing to pay. Other THE COURT ORDERS: 1. 2. 3. [ ] Petitioner OR [ ] Respondent shall pay child support to the other party in the amount of $ per month, BEGINNING (date) until further order of the court. Payments to made in the manner indicated in the Order of Assignment. The entry of this Order does not prejudice the rights of the parties to have a final determination of child support made by trial or hearing. Other Date Superior Court of Arizona in Yavapai County January 2006 Judicial Officer Page 1 of 1 American LegalNet, Inc. www.FormsWorkflow.com