Form 344A Rev 05/16 The Family Court of the State of Delaware In and For New Castle Permanent Kent Interim Sussex County CONSENT SUPPORT ORDER Petitioner / Name Street Address (including Apt) P.O. Box Number City/State/Zip Code Attorney Name Obligor DOB v. Respondent / Name Obligor DOB File # Petition # Type DCSS # OS # Street Address (including Apt) P.O. Box Number City/State/Zip Code Attorney Name Interpreter needed? Yes Language: Employer (Name and Address) No Interpreter needed? Yes Language: Employer (Name and Address) No IV-D Non IV-D In the interest of DOB: DOB: Attendance: Petitioner Respondent present present Attorney Attorney telephone telephone video video attendance not required attendance not required DOB: DOB: failed to appear failed to appear On / / after a mediation conference, the parties agreed: 1. The parties agree that _ _____________________________ has a duty to support the above named child(ren) based on: Parentage was adjudicated by prior court order dated / / . Voluntary Acknowledgement of Paternity dated / / signed and filed with the Office of Vital Statistics. Parentage adjudicated herein based upon: Genetic test results reflect probability of paternity is at least 99%. Cost to be paid by Father Mother DCSS. Mother swore/affirmed _____________________ was the only man with whom she had sexual intercourse within probable time of conception, and: Both parties knowingly and intelligently waived any right to genetic testing. admits parentage and there is no reason to question the admission. failed to appear for genetic testing, mediation, (or) Commissioner's hearing. Presumption of Parentage: Child(ren) was(were) born during the marriage or within 300 days after divorce. Child(ren) resided with obligor for 2 years immediately following birth and obligor held child(ren) out as his/her own. Child(ren) was(were) conceived by assisted reproduction and obligor agreed in writing to be the child(ren)'s parent. She is the mother and gave birth to the child(ren). Other Delaware Office of Vital Statistics shall ( child(ren)'s birth registration reflect: upon presentation of the order is requested to) amend the is the child(ren)'s parent. His place of birth is Change of the child(ren)'s name(s) to: 2. Obligor is ordered to pay $ per month current support, effective / / , based on: Delaware Child Support Calculation(s) dated / / , attached and incorporated by reference. Deviation from Child Support Calculation (see discussion) Obligor has a back support obligation (or) as set by the court (See discussion.). credit as of / / as agreed by the parties. , of $ to be calculated by DCSS. .Total includes: as of / ). current ); American LegalNet, Inc. www.FormsWorkFlow.com 3. 4. Total payment is $ every month payable to DCSS support; arrears/retroactive support (includes medical support of $ genetic test costs (Balance: $ as of / Form 344A Rev 05/16 5. Income attachment is authorized payable to DCSS. If at any time full payment is not secured by income attachment, Obligor shall make payment to DCSS at P.O. Box 12831, Wilmington DE 19850. The currently applicable consumer credit protection limit is 50 55 60 65%. The issuance of income attachment shall be stayed. Payments shall be made directly to ________________. Attachment, payable to DCSS, shall issue upon the filing of a verified notice of default in payment for seven (7) working days. 6. Father, Mother, The first parent to whom it becomes available at less than 10% of gross income Both parents shall provide HEALTH INSURANCE covering the child(ren) when available and shall provide all necessary documents to allow for use of the health insurance whenever the child(ren) is in the other party's care. A National Medical Support Notice may issue to the employer of any obligated parent for the following coverage: Medical Dental Vision Prescription Drug Mental Health other: Health insurance coverage is currently offered through a parent's employer but the policy is either unreasonable in cost or inaccessible by the child(ren). Therefore neither parent is required at this time to provide health insurance for the child(ren). Whenever a child is without health insurance coverage, each parent has a duty to acquire coverage if it becomes available and the cost to cover the parent and his/her child(ren) is less than 10% of the parent's gross income. Neither parent shall cancel ordered coverage regardless of cost without a subsequent order relieving them of the responsibility. 7. All CASH MEDICAL SUPPORT is allocated % to Father and % to Mother. CASH MEDICAL SUPPORT means medical expenses for the child(ren) not reimbursed by insurance. All requests for payment of cash medical support must include supporting documentation and payment shall be made within a reasonable time. A petition for contribution to or reimbursement for a medical expense may be brought at any time. However, any right of reimbursement is presumed waived unless a petition for reimbursement is filed with the Court by December 31 of the second year following the date of treatment. This presumption may be rebutted for good cause shown. One or more children reside in shared equal placement. If one parent is not equally contributing to shared incidental 8. expenses, the Court may impose any appropriate sanction including, but not limited to, finding that the support formula is rebutted or imposing a current support obligation against the offending parent as if the child resided primarily with the other parent. 9. Miscellaneous provisions The parties shall report any changes of drivers license number, address (including incarceration or release from incarceration), telephone number, employer, employer address or telephone number to the Family Court in: New Castle County (302)255-0300 Kent County(302)672-1000 Sussex County (302)855-7400 Pursuant to UIFSA, Delaware is the tribunal with continuing, exclusive jurisdiction over this obligation. The Obligor is incarcerated. The requirement of payment on this Order is suspended until Obligor's release from incarceration. Unpaid current support obligation will accrue as arrears. A Delaware Order to pay current support remains in effect until the youngest child has reached 18 and is no longer enrolled in high school, or 19, whichever occurs first. Thereafter payment shall continue in the total amount until any balance is paid. If current support has terminated and/or all back support and arrears has been paid in full, DCSS is autho