Fill and Sign the 03en014e Order Modifying Child Support Form

OKDHS issued 3-15-2007 03EN014E Page 1 of 9 IN THE DISTRICT COURT OF COUNTY STATE OF OKLAHOMA ) Dist. Ct. Case No. ) ) OAH Case No: ) ) OK IV-D FGN: ) ) Obligor: ) ) Custodial Person: (Insert Case style above as it is on your original Order.) Page 2 of 9 03EN014E OKDHS issued 3-15-2007 The Court, being informed by evidence pr esented and hearing from the parties, find that this Court has jurisdiction over the parties and the subject matter of this action. The Court, therefore, FINDS, ORDERS AND DECREES AS FOLLOWS: 1. CHILDREN. The mother or father of the minor chil d(ren) in the above case was ordered to pay $ per month for child support on for the child(ren) listed below: Date of order Child's name Date of birth 2. MODIFICATION. Since that order was entered t here has been a substantial and material change in circumstances as follows: A child for whom the order was ent ered has turned 18 and is no longer regularly enrolled and attending high school. The father's income has changed. The mother's income has changed. The living arrangements of the child(ren) have changed. The child care expenses have changed. There has been a change in health insur ance or it was not addressed in a previous order. Other: 3. CHILD SUPPORT. Because of these material changes in circumstances, the Motion to Modify Child Support is granted. The mother or father is the Obligor and is ordered to pay for the support of the above-named minor child(ren) the sum of $ per month beginning on ,20 , and on the same da y of each month thereafter until further order of this Court or until the minor child(ren) reaches the age of 18 years, or until the age of 20 years, provided the child(ren) is regularl y enrolled in and attending high school. Page 2 of 9 03EN014E OKDHS issued 3-15-2007 OKDHS issued 3-15-2007 03EN014E Page 3 of 9 4. CHILD SUPPORT COMPUTATION FORM. The child support is calculated according to the Oklahoma child support guidelines as follows: (select \ one) The child support obligation is set in accordance with the child support guidelines without deviation and a copy of the child support computation sheet is attached hereto. The Court deviates from the amount of support in accordance with the child support guidelines as it resu lts in an amount that is inequitable, unreasonable under the circumstances, and/or not in the best interests of the child(ren), and in support of the deviation the Court finds the following: Pursuant to 10 O.S. § 7003-8.8(B )(3)(c), deviation is determined necessary in order for the parent to meet the obligations of a court-imposed individual treatment and service plan. Other: 5. MEDICAL SUPPORT. OKDHS inquired into the av ailability of health care insurance and: (select one) Medical support through group plan. Mother Father shall obtain health insurance coverage for the minor child(ren) immediately or whenever such insurance is available through an employer or other group plan. Alternative medical support. Neither parent is required to provide health insurance coverage through an employer-s ponsored or other group plan at this time because medical support is being provided through the following alternative coverage: Indian Health Services. The child(ren) is eligible or believed to be eligible for Indian Health Services. The parent s shall cooperate fully in taking the necessary action th rough the appropriate tribe to enroll the child(ren). The tribal member parent shall provide a c opy of the card or other documentation to the child support enforcement office to verify the child(ren) is enrolled and eligible for Indian Health Services. If th e child(ren) is determined by the tribe not to be eligible for Indian Health Services, Mother Father shall OKDHS issued 3-15-2007 03EN014E Page 3 of 9 Page 4 of 9 03EN014E OKDHS issued 3-15-2007 obtain health insurance coverage for the minor ch ild(ren) whenever such insurance is available through an employer or other group plan. Department of Defense. The child(ren) is believed to be eligible for or enrolled in the Department of Def ense managed health care program, TRICARE. The name of the Departme nt of Defense sponsor (military service member or Department of Defense employee) is . The parents shall cooperate fully in enro lling the child(ren) in the Defense Enrollment Eligibility Reporting System (DEERS) . The parent(s) shall provide a copy of the identification card for the child(ren) to the child support enforcement office to verify the child(re n) is enrolled in DEERS. In the event the child(ren) is not receiving TRICARE coverage through DEERS, Mother or Father shall provide health insurance coverage for the minor child(ren) whenever such insurance is available through an employer or other group plan. Other alternative coverage. Mother Father shall provide health care coverage for the mi nor child(ren) in this case as follows: The parent providing the health care coverage shall provide proof of coverage to the child support enfo rcement office and shall keep the coverage in effect until fu rther order of the Court. In the event that the parent ordered to provide alternative health ca re coverageis no longer providing it, Mother Father shall provid e health insurance cove rage for the minor child(ren) whenever such insurance is available through an employer or other group plan. Other: Uncovered expenses. Mother shall pay per cent and Father shall pay per cent of the reas onable and necessary medica l, dental, orthodontic, optometric, psychological, or any other physical or mental health expenses for the minor child(ren) not covered by insu rance or other health care plan. If Page 4 of 9 03EN014E OKDHS issued 3-15-2007 OKDHS issued 3-15-2007 03EN014E Page 5 of 9 reimbursement is required, the Custodial Person who incurs the expense shall be reimbursed by the Obligor within 30 days of receipt of documentation of the expense. 6. CHILD CARE. (select one) The Obligor's share of child care exp enses is included in the child support amount ordered in paragraph 3 above. T he Custodial Person shall provide timely documentation to the Obligor of said expenses. Child care is not currently being expen ded, but should such expenses occur, the Obligor is ordered to pay per cent of monthly employment or education-related child care expenses of said child(ren), as additional child support, commencing on the same day and to be paid in the same manner, a\ s any current child support set out in paragraph 3 above. The Custodial Person shall provide timely documentation to the Obligor of said expenses. 7. METHOD OF PAYMENT. All child support payments shall be made by employer's check, cashier's check, money order, or government check, payable to Oklahoma Department of Human Services, identified with the above FGN number on the face of the payment (or Social Security number if no FGN available) and mailed to: Oklahoma Centralized Support Registry P. O. Box 268849 Oklahoma City, OK 73126-8849 PAYMENTS MADE IN ANY MANNER OTHER THAN AS SPECIFIED IN THIS COURT ORDER SHALL BE CONSIDERED GIFTS AND SHALL NOT BE CREDITED TO THE AMOUNT OWED. 8. INCOME ASSIGNMENT. An immediate income assignment is ordered pursuant to 12 O.S. § 1171.3(G)(1). A portion of the Obligor's monthly or other periodic income shall be assigned to the Custodial Person or appr opriate in an amount sufficient to ensure payment of the monthly su pport obligation, including any arrearage and judgment payments. The assignment is effective i mmediately; provided however, that the Obligor remains responsible for making payments directly to OKDHS in any month when an income assignment is not in effect or does not pay the full amount due under this order. OKDHS issued 3-15-2007 03EN014E Page 5 of 9 Page 6 of 9 03EN014E OKDHS issued 3-15-2007 9.ADDRESS OF RECORD FOR SERVICE OF PROCESS AND ADDRESS AND EMPLOYMENT CHANGES. Title 43 O.S. § 112A requires all parties and Custodial Persons to inform the Central Case Registry of the current address of record for service of process in support, visitati on, and custody actions. The fo llowing applies to the Obligor and any Custodial Person subjec t to this order. Any changes (names and addresses) in your address of record, your employer, and your health insurance must be provided in writing to the Central Case Re gistry within 30 days of the change at the following address: Central Case Registry P. O. Box 528805 Oklahoma City, Oklahoma 73152-8805 OKDHS issued 3-15-2007 03EN014E Page 7 of 9 from the date they become delinquent, and the interest shall be collected in the same manner as the payments upon whic h the interest accrues. Orders issued by other states may have a different interest rate for unpaid child support. 12. OBLIGOR'S EMPLOYMENT INFORMATION. Employer's name: Address: Phone number: 13. ENFORCEMENT. The OKDHS Child Support Enforcement Division may enforce this order in any court with jurisdiction to enforce child support orders, including administrative court. The Obligor understands th at until (1) all past-due child support is paid in full, and (2) the Obligor is current on all support obligations, multiple enforcement remedies may be used. These re medies include, but are not limited to, interception of state and federal tax refunds, and pursuant to 56 O.S. § 240. 23, intercepting or seizing periodic or lump-sum payments from: (1) a state or local agency, including unemployment compensation, workers' compensation, and other benefits, and (2) judgments, settlements, and lotteries; attaching and seizi ng assets of the obligor held in financial institutions; attaching public and private retirement funds; imposing liens in accordance with 43 O.S. § 135; and increa sing the monthly payment on ch ild support, for purposes of securing past-due support, in an amount not to exceed five per cent of the total child support order. Such increase may not be made more than once every 12 months. 14. ADDITIONAL ORDERS. JUDGE OF THE DISTRICT COURT OKDHS issued 3-15-2007 03EN014E Page 7 of 9 Page 8 of 9 03EN014E OKDHS issued 3-15-2007 Page 8 of 9 03EN014E OKDHS issued 3-15-2007 OKDHS issued 3-15-2007 03EN014E Page 9 of 9