DR 716 Eff. 1/1/2015 Rev. 6/2015 IN THE COURT OF COMMON PLEAS DIVISION OF DOMESTIC RELATIONS BUTLER COUNTY, OHIO ______________________________________ Plaintiff/1st Petitioner/Petitioner ______________________________________ Address ______________________________________ ______________________________________ Telephone ______________________________________ DOB vs./-and: _______________________________________ Defendant/2nd Petitioner/Respondent _______________________________________ Address ______________________________________ Telephone ______________________________________ DOB AGREED ENTRY (NO HEARING REQUIRED) FINAL APPEALABLE ORDER NON FINAL APPEALABLE ORDER : : : Case No_______________ Magistrate ______________ : : Judge __________________ This is an agreed entry regarding modification of child support and the agreed amount is in compliance with Ohio child support guidelines. No hearing is required. This is an agreed entry regarding modification of health insurance responsibilities for the below listed children and the parties have also calculated child support pursuant to ORC 3119.01-3119.02, 3319.29-3319.32. The parties agree that the amount is in compliance with the Ohio Child Support Guidelines. No hearing is required. This is an agreed entry modifying the prior shared parenting plan to change the parent designated as residential parent for school purposes only. No hearing is required. This is an agreed entry establishing temporary spousal support. No hearing is required. This is an agreed entry establishing temporary property issues. No hearing is required. The following are the children of the parties: Name________________________ D.O.B:________ Name ________________________ D.O.B:________ American LegalNet, Inc. www.FormsWorkFlow.com Name ________________________ D.O.B:________ Name ________________________ D.O.B:________ This AGREED ENTRY applies to: All of the above children or Only these children: _____________________________________ THE PARTIES AGREE AS FOLLOWS (Please check all that apply): Shared Parenting: The parties have shared parenting of their child(ren) and __________________________________________ (name of parent) shall be designated the residential parent for school purposes. Spousal Support: Plaintiff/Defendant shall pay spousal support as follows: The temporary spousal support order shall be: $ monthly, to be paid in the following manner: $ per on spousal support. The support should be made payable in increments that coincide with obligor's pay periods. Child Support: The support order does not change OR The support order is hereby amended pursuant to O.R.C. (Ohio Revised Code) 3119.021 as follows (worksheet is attached): Mother/Father shall pay child support as follows: The current Support Order shall be: $ monthly, to be paid in the following manner: $ per on child support ($ per month, per child), plus $ per on spousal support, plus $ per on _________________________________ and The current Cash Medical Support Order shall be: $ monthly, to be paid in the following manner: When private health insurance IS being provided by a party in accordance with this order: $ per on child support ($ per month, per child). When private health insurance IS NOT being provided by a party in accordance with this order: for the $ per on child support ($ per month, per child), which includes the 2% processing fees. American LegalNet, Inc. www.FormsWorkFlow.com  Support Arrears Order shall be: The prior order regarding the payment of arrears shall remain the same ($_________ per ___________); OR Obligor shall pay the arrears at a rate of 20% of the current order ($_____ per __________); OR Obligor shall pay the sum of $ _______ per __________on support arrears. Arrears are $_________due obligee, $__________ due State of Ohio, and CSEA processing charge arrears of $______________ as of , plus 2% CSEA processing fee for a total deduction of $ per effective . Arrears are preserved; waived; OR offset against new support order. Arrears are $ ______________ as of ____________; OR Arrears are current as of___________. Health Insurance Coverage (check one): Mother/Father shall provide the primary health insurance for the parties' minor child(ren). Mother/Father shall provide the primary health insurance for the parties' minor child(ren). Mother/Father shall provide the secondary health insurance for the parties' minor child(ren) whenever it is available through their employment at a reasonable cost. Each parent shall provide health insurance for the child(ren) whenever it is available through their employment at a reasonable cost. The parties shall divide all uncovered health care expenses as follows: Father shall pay _______% and Mother shall pay _________%. NOTE: THE FOLLOWING LANGUAGE APPLIES TO ALL PARENTING ORDERS: IT IS FURTHER ORDERED the duty of support shall continue beyond the age of majority as long as the child continuously attends on a full-time basis any recognized and accredited high school. A child support order shall not remain in effect after the child reaches nineteen years of age unless the order provides that the duty of support continues under circumstances described in O.R.C. 3119.86(A)(1)(a) or (b). IT IS FURTHER ORDERED all support under this order shall be withheld or deducted from the income or assets of the Obligor pursuant to a withholding or deduction notice or appropriate Court order issued in accordance with sections 3121.02 to 3121.07 of the O.R.C. or a withdrawal directive issued pursuant to section 3123.37 of the O.R.C. and shall be forwarded to the Obligee in accordance with section 3121.50 of the O.R.C. IT IS FURTHER ORDERED until such time as a withholding or deduction order is in effect, the Obligor shall discharge his or her obligation by making payments directly to the CSEA or the division of child support in the Ohio Department of Job and Family Services, as appropriate." IT IS FURTHER ORDERED the Obligor is restrained from making said payments directly to the Obligee, and the Obligee is enjoined from accepting direct payments from the Obligor. Any American LegalNet, Inc. www.FormsWorkFlow.com payments of support not made through the CSEA or the division of child support in the Ohio Department of Job and Family Services, as appropriate, shall be deemed a gift. EACH PARTY TO THIS SUPPORT ORDER MUST NOTIFY THE CHILD SUPPORT ENFORCEMENT AGENCY IN WRITING OF HIS OR HER CURRENT MAILING ADDRESS, CURRENT RESIDENCE ADDRESS, CURREN