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No Insurance Form. This is a Ohio form and can be use in Clermont County (Court Of Common Pleas).
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Tags: No Insurance, DR-404, Ohio County (Court Of Common Pleas), Clermont
No Insurance
Neither party presently has health insurance available for the benefit of the minor child/ren. Each
party shall immediately inform the other party and Clermont County CSE if health insurance coverage
for the child/ren becomes available at a reasonable cost through a group health insurance policy
offered by his/her employer or through any other group health care policy, contract, or plan available
to either party, and shall obtain said insurance for the benefit of the minor child/ren.
(Mother/Father) shall be responsible for the first $100.00 per year per child of any medical,
dental, orthodontal, optical, prescription, psychiatric, psychological, or counseling expenses not paid
by insurance. Any additional such expenses shall be divided between the parties in amounts equal to
their percentage of total income as found in the child support worksheet as follows: Mother shall pay
percent and Father shall pay
percent.
Form DR- 404
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