American LegalNet, Inc. www.FormsWorkflow.com American LegalNet, Inc. www.FormsWorkflow.com Case No.____________________________ THIS ATTACHMENT IS HEREBY INCORPORATED INTO THE STIPULATION AND ORDER TO AMEND JUDGEMENT In the event that this stipulation involves the suspension of a current child support order due to: A. Verification that the parties are residing together or B. The parties are not residing together but agree to the suspension of child support AND the Custodial Person/Child(ren) are not receiving Public Assistance from the State of Wisconsin (with the exception of Medical Assistance/Badger Care) The parties agree and the court hereby orders: THAT AT SUCH TIME AS THE PARTIES STOP RESIDING TOGETHER, OR THE CUSTODIAL PERSON/CHILD(REN) UNDER THIS ORDER IS/ARE RECIPIENT(S) OF THE STATE OF WISCONSIN PUBLIC ASSISTANCE, (WITH THE EXCEPTION OF MEDICAL ASSISTANCE/BADGER CARE), the child support order shall automatically re-commence without a further court hearing in the amount at which it existed at the time of the suspension, as follows: I. For Orders suspended due to parties previously residing together, who no longer do so: A: When the custodial person/child(ren) herein begin(s) receiving public assistance benefits (with the exception of Medical Assistance/Badger Care), the order shall be effective as of the first day of the month in which the public assistance benefits are disbursed. OR B: Upon written request for support from the custodial person sent to the Kenosha County Child Support Agency at 8600 Sheridan Road, Suite 301, Kenosha, WI 53143 (the order shall be effective as of the date the written request is received by the Child Support Agency from the custodial person). II. For Orders suspended due to parties’ agreement and no public assistance other than Medical Assistance/Badger Care, where parties are not residing together, but additional public assistance is now open for the custodial person/child(ren) on the case: When the custodial person/child(ren) herein begin(s) receiving public assistance benefits (with the exception of Medical Assistance/Badger Care), the order shall be effective as of the first day of the month in which the public assistance benefits are disbursed. The Child Support Agency shall send notice of the re-commencement of the order to both parents’/parties’ last known addresses. The notice shall provide the date the order is effective, the dollar amount of the order and that either parent/party may object to the order by filing an objection within 10 days of the notice with the Family Court Commissioner, Kenosha County Courthouse, Room 109, 912-56th Street, Kenosha WI 53143. Signature of Petitioner Signature of Respondent Date Date BY THE COURT: Circuit Court Judge / Family Court Commissioner Date American LegalNet, Inc. www.FormsWorkflow.com American LegalNet, Inc. www.FormsWorkflow.com American LegalNet, Inc. www.FormsWorkflow.com American LegalNet, Inc. www.FormsWorkflow.com