IN THE CIRCUIT COURT OF TH E FIRST JUDICIAL CIRCUIT, IN AND FOR SANTA ROSA COUNTY, FLORIDA IN RE: , Petitioner Case No. ___________________ and Division: , Respondent ****************************************************************************** ORDER TERMINATING CHILD SUPPORT AND/OR ALIMONY PAYMENTS 1. That the child support and/or alimony provision of the previous Order dated the Day of , 20 , is canceled and the payors obligation thereunder is terminated as of the Day of , 20 .2. The Court reserves jurisdiction to reinstate the payors obligation if the situation or any of the facts alleged in the petition should change. 3. ( ) The Court reserves jurisdiction to establish any arrearage in child support and/or alimony that may have accrued prior to the entry of this Order, or ( ) The arrearage in child support and/or alimony is established at $ As of Of which $ Is due and owing to the State of Florida and/or $ Is due and owing directly to the payee/custodial parent. 4. The above arrearage, if established, shall be paid as follows: ( ) In a lump sum to be paid on or before the Day of , 20 . ( ) At the rate of $ Per , with a payment beginning and continuing in a like manner until such time as paid in full. Said payments shall be made ( ) to the State Disbursement Unit, P.O. Box 8500, Tallahassee, Florida 32314-8500, and shall include the appropriate processing fee, or ( ) directly to the payee/custodial parent. DONE AND ORDERED in chambers at Milton, Santa Rosa County, Florida this day of_____________________________, 200_____. _________________________________ CIRCUIT JUDGECopies To: Petitioner: Respondent: This Day of , 20 By: , Deputy Clerk