COURT OF COMMON PLEAS DIVISION OF DOMESTIC RELATIONS CUYAHOGA COUNTY, OHIO : CASE NO. __________________________________ : DATE _____________________________________ : JUDGE _____________________________________ : __________________________________________ PLAINTIFF JUDGMENT ENTRY ORDER TO REPORT/SEEK EMPLOYMENT Order on Obligor Order on Obligee vs ___________________________________________ DEFENDANT : : IT IS ORDERED, ADJUDGED AND DECREED THAT ________________________ (OBLIGOR) shall seek employment, if able to engage in employment, and to immediately notify the Cuyahoga Support Enforcement Agency (hereinafter C.S.E.A.), IN WRITING, upon commencement of employment (including self-employment), receipt of additional income/monies, obtaining ownership of asset of value of $500.00 or more, the receipt of benefits, or of the opening of an account at a financial institution. The OBLIGOR shall include a description of the nature of any employment and the business address and telephone number of any employer, or a description of the nature of any account opened at any financial institution, along with the name, and business address of that financial institution, and account number(s). IT IS FURTHER ORDERED that as long as the OBLIGOR is not gainfully employed he/she shall report in person to C.S.E.A. every MONTH regarding his/her employment status or receipt of additional income/monies. The OBLIGOR is further ordered to comply with the request of C.S.E.A. or the court to provide information regarding his/her health insurance benefits, Federal Income Tax return from the previous year, all pay stubs within the preceding six (6) months, all other records evidencing the receipt of any other salary, wages, or compensation within the preceding six (6) months. Said records include but are not limited to: proof of employment status, financial institution accounts and any benefits (i.e. unemployment, sub-pay, sick leave, Workers' Compensation, severance pay, retirement, disability or annuities, Social Security and Veteran's Administration). The OBLIGOR is further ordered to immediately notify C.S.E.A., IN WRITING, of his/her current mailing address and residence address, telephone number and driver’s license number, as well as any change in this information until further order of Court. The OBLIGOR'S failure to provide any income/benefits information pursuant to this order, or failure to comply with the foregoing order to report and order of notification shall be considered contempt of Court, punishable by a fine and/or jail sentence. Attorney fees and Court costs may then be assessed against the OBLIGOR held in contempt. ORDER ON OBLIGEE The OBLIGEE is ordered to immediately notify C.S.E.A., IN WRITING, of any reason for which the support order should terminate, including but not limited to death, marriage, emancipation (age 18 or high school completion/termination), enlistment in Armed Services, deportation, or change of legal custody of the child. The OBLIGEE is further ordered to comply with the request of C.S.E.A. or the Court to provide information regarding his/her health insurance benefits, Federal Income Tax return from the previous year, all pay stubs within the preceding six (6) months, all other records evidencing the receipt of any other salary, wages, or compensation within the preceding six (6) months. Said records include but are not limited to: proof of unemployment status, financial institution accounts and any benefits (i.e. unemployment, sub-pay, sick leave, Workers' Compensation, severance pay, retirement, disability or annuities, Social Security and Veteran's Administration). The OBLIGEE is further ordered to immediately notify the C.S.E.A., IN WRITING, of his/her current mailing address, residence address, telephone number and driver’s license number, as well as any change in this information until further order of Court. The OBLIGEE'S failure to provide any income/benefits information pursuant to this order, or failure to comply with the foregoing order of notification shall be considered contempt of Court, punishable by a fine and/or jail sentence. THIS ORDER TO REPORT SUPERSEDES ANY PRIOR ORDER TO REPORT ISSUED UNDER THIS CASE NUMBER. COSTS ADJUDGED AGAINST _________________________. IT IS SO ORDERED. _________________________________________________ JUDGE DR0706116 Order to Report/Seek Employment American LegalNet, Inc. www.FormsWorkflow.com