Child Support Petition Form

CHILD SUPPORT PETITION

Court Name:   County:   Case No.:

Petitioner Name:   Address:

Petitioner Phone:   Email:

Respondent Name:   Address:

Respondent Phone:   Email:

RECITALS

WHEREAS, the Petitioner is the parent or legal custodian of the following minor child(ren) for whom support is sought:

WHEREAS, the Court has jurisdiction over the parties and the minor child(ren) pursuant to applicable family law statutes and the parties' residency and/or previous legal filings; and

WHEREAS, the Petitioner seeks an order establishing the Respondent's child support obligations, including but not limited to periodic support, health insurance, contribution to extraordinary expenses, and enforcement remedies.

NOW, THEREFORE, the Petitioner petitions this Court and requests that the Court enter an order as set forth below.

1. JURISDICTION

Petitioner alleges that this Court has jurisdiction over the parties and the minor child(ren) under statutory provisions governing child support because:

1. Petitioner is a resident at:
2. Respondent is a resident at:
3. Other jurisdictional facts, if any:

2. PARTIES

Petitioner: ; Respondent: .

3. CHILD(REN) AND PARENTAGE

The minor child(ren) for whom support is sought are listed above. Petitioner alleges parentage as follows: Petitioner is the biological or legal parent of the child(ren) and Respondent is alleged to be the other parent. If parentage is contested, Petitioner requests the Court order genetic testing as necessary.

4. REQUEST FOR SUPPORT

Petitioner requests the Court enter an order requiring Respondent to pay child support in accordance with the applicable child support guidelines as follows:

Petitioner further requests that the Court order the Respondent to pay:

5. HEALTH INSURANCE

Petitioner requests that the Court order health insurance coverage for the minor child(ren). Check the appropriate request(s):

Respondent shall provide and maintain health insurance covering the child(ren) when available at a reasonable cost.
Respondent shall reimburse Petitioner for uncovered medical expenses in proportion to parental incomes.
Current health insurance policy holder:

6. TEMPORARY RELIEF

Pending final determination, Petitioner requests temporary orders as follows:

Require Respondent to enroll child(ren) in available health insurance pending final hearing.

7. INCOME AND FINANCIAL DISCLOSURE

Petitioner certifies that the following are true to the best of Petitioner’s knowledge and requests the Court require the Respondent to complete mandatory financial disclosure.

Petitioner requests that the Court order production of pay stubs, tax returns for the prior two years, and a sworn financial statement from each party.

8. ARREARAGES AND CREDITS

If the Respondent has failed to pay prior support obligations, Petitioner requests the Court determine arrearages, apply credits for amounts paid, and enter an enforceable judgment for any unpaid balance. Known arrearage amount (if any):

9. ENFORCEMENT AND REMEDIES

Petitioner requests that, if Respondent fails to comply with any order, the Court order available remedies including wage withholding, interception of tax refunds, suspension of licenses, contempt proceedings, and any other enforcement authorized by law.

10. NOTICE AND SERVICE

Petitioner requests that Respondent be served with this Petition and that all notices and orders be sent to the addresses provided above. Service address for Respondent (if different):

11. CERTIFICATION

I certify under penalty of perjury under the laws of this jurisdiction that the information contained in this Petition is true and correct to the best of my knowledge, information, and belief.

12. CLOSING PROVISIONS

Governing Law: This Petition shall be governed by the family law statutes and rules of procedure of the jurisdiction in which it is filed.

Entire Agreement: This Petition, together with any orders entered by the Court, constitutes the entire statement of claims and requests for relief made by Petitioner in this matter.

Severability: If any provision of this Petition is held invalid or unenforceable, the remaining provisions shall remain in full force and effect.

Amendments and Waiver: No amendment to this Petition shall be effective unless in writing and signed by the party seeking the amendment; waiver of any breach shall not constitute a waiver of subsequent breaches.

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