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Application And Affidavit To Obtain Termination Of Child Support Form. This is a Nebraska form and can be use in District Court Statewide.
Tags: Application And Affidavit To Obtain Termination Of Child Support, DC1, Nebraska Statewide, District Court
COURT
COUNTY . .
. . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
:
STATE OF NEBRASKA
FORM NO. DC1 New 9/97
Neb. Rev. Stat. ' 42-371.01
CASE NUMBER:
Index
CHILD SUPPORT TERMINATION No.
APPLICATION AND AFFIDAVIT
:
Calendar No.
IN THE DISTRICT COURT OF
:
Plaintiff(s)
-against-
JUDICIAL SUBPOENA
COUNTY, NEBRASKA
:
APPLICATION
AND AFFIDAVIT
:
TO OBTAIN
:
TERMINATION OF
CHILD SUPPORT
:
Petitioner
vs.
Respondent Defendant(s)
......................................................
I,
, obligor, hereby swear that the
child,
, D.O.B.:
/
/
, for
whom THE currently obligated to pay child support YORK
I am PEOPLE OF THE STATE OF NEW is no longer my obligation for the following reason:
“ the child has reached nineteen years of age. Certified copy of birth certificate attached. Note: Child support
shall continue only until the child reaches the age of majority, termination of child support is automatic providing
TO
the age and date of birth of the child is known by the court.
“ the child has married. Certified copy of marriage license and certificate of marriage attached.
“ the child has died. Certified copy of death certificate attached.
“ the child has been emancipated by an order from:
,a
GREETINGS: competent jurisdiction. Certified copy of the court order attached.
court of
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
I hereby request that my child support obligation for the abovethe be terminated on the
the Honorable
at child
Court
day of
,
.
,
County of request that the clerk of located at a copy of this application to the last known address of the obligee,
I hereby
court send
which in room
is
.
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
Obligee=s:
(Street)
(City)
(State)
(Zip)
or adjourned date, to testify and give evidence as a witness in this action on the part of the
I understand that if there is any unpaid child support obligations, principal and interest, owed prior to the requested
date of termination, this termination does not relieve those prior obligations. In the event the obligee does not file an
objection within thirty days after the clerk=s notice to the obligee was mailed, I hereby request that the child support for the
above child be terminated by to comply with this subpoena is punishable as a contempt of court and will make you liable to
Your failure court order as requested.
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
result of your failureaffirm, under penalty of perjury, that the foregoing affidavit is true.
I hereby swear, or to comply.
Witness, Honorable
Signature of Obligor
Court in
Obligor=s:
County,
, one of the Justices of the
day of
(Street)
Subscribed and sworn on oath before me on this
, 20
.
(City)
(State)
day of
(Zip)
,
.
(Attorney must sign above and type name below)
Clerk of District Court/Notary Public
(Seal)
Attorney(s) for
CLERK'S SERVICE OF NOTICE ON OBLIGEE AND ASSIGNEE
A true and accurate copy of this application and affidavit to obtain termination of child support was sent by the clerk
of the district court to: 1.) “ the obligee at the above address, and to: 2.) “ the Department of Health and Human
Services if there is an active assignment of support, by depositing copies thereof in the U.S. mail, postage prepaid on this
day of
,
. Clerk of Court: P.O. Address
____
Office and
NOTICE TO OBLIGEE
The court shall terminate child support if no written objection has been filed within thirty days after the date the
clerk's notice to the obligee was mailed, the forms and procedures have Telephone No.:with, and the court believes that a
been complied
hearing on the matter is not required. As obligee, if you do not file a Facsimile No.:
written objection within thirty days after the
date the notice was mailed, child support for this child may be terminated without further notice to you.
E-Mail Address:
Mobile Tel. No.:
This form is provided by the State Court Administrator as required by Neb. Rev. Stat. ' 42-371.01 RRS 1943 but should be reviewed by your attorney.
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