Form CCFC185 ­ Addendum to Parenting Plan Part B Other Extraordinary Expenses Mother: Case Number County Exhibit Number Case Information Father: 1. Payment of Extraordinary Child-Rearing Costs of the Children Extraordinary child-rearing costs incurred by the parents may be included on Form 14, or the parents may agree to divide these costs on some percentage basis. The costs to be addressed are to be paid as follows: a. Extraordinary Child-Rearing Costs INCLUDED on Form 14 Extraordinary Child-Rearing Costs Paid by Father INCLUDED on Form 14 Total Amount of Expense $_________ per month $_________ per month $_________ per month _________________________________________ _________________________________________ _________________________________________ The total cost of these extraordinary child-rearing costs of the children is $___________ per month. This amount HAS been included in the child support calculation pursuant to Form 14. (You must include this amount on Form 14 - Line 6e) Extraordinary Child-Rearing Costs Paid by Mother INCLUDED on Form 14 Total Amount of Expense $_________ per month $_________ per month $_________ per month _________________________________________ _________________________________________ _________________________________________ The total cost of these extraordinary child-rearing costs of the children is $___________ per month. This amount HAS been included in the child support calculation pursuant to Form 14. (You must include this amount on Form 14 - Line 6e) b. Extraordinary Child-Rearing Costs NOT INCLUDED on Form 14 Extraordinary Child-Rearing Costs Paid by Father NOT INCLUDED on Form 14 Percentage to be Paid by Mother to Father ________ % _________________________________________ _________________________________________ _________________________________________ ________ % ________ % Mother will reimburse Father for the percentage amount of each of these extraordinary childrearing costs of the children so long as they are actually paid by Father. Except for good cause, no reimbursement of extraordinary child-rearing costs of the children will be allowed unless Father submits proof of such expense to Mother in writing within 120 days of the date said expenses were incurred. Extraordinary Child-Rearing Costs Paid by Mother NOT INCLUDED on Form 14 Percentage to be Paid by Father to Mother ________ % _________________________________________ _________________________________________ _________________________________________ ________ % ________ % Father will reimburse Mother for the percentage amount of each of these extraordinary child-rearing costs of the children so long as they are actually paid by Mother. Except for good cause, no reimbursement of extraordinary child-rearing costs of the children will be allowed unless Mother submits proof of such expense to Father in writing within 120 days of the date said expenses were incurred. Parenting Plan Part B ­ Support of Children ­ Extraordinary Expenses Form CCFC185-11/09 American LegalNet, Inc. www.FormsWorkFlow.com