Fill and Sign the Co Child Support Form

 District Court ___________________________ County, Colorado Court Address: In re:  The Marriage of:  The Civil Union of:  Parental Responsibilities concerning: ______________________________________________________ Petitioner: and Co-Petitioner/Respondent: COURT USE ONLY Attorney or Party Without Attorney (Name and Address) : Phone Number: E-mail: FAX Number: Atty. Reg. #: Case Number: Division Courtroom STIPULATION REGARDING CHILD SUPPORT MODIFICATION The parties stipulate and agree to the following Stipulation Regarding Child Support Modification: 1. The  Petitioner  Co-Petitioner/Respondent is currently paying $____________ child support per month pursuant to  an agreement between the parties or  prior court order. 2. The parties stipulate and agree that the  Petitioner  Co-Petitioner/Respondent shall pay child support pursuant to the Colorado Child Support Guidelines, §14-10-115, C.R.S. in the amount of $___________, due and payable by_________________________ (date), commencing on __________________________ (date). 3. This amount will continue until further Order of the Court. Payments shall be mailed to:  Obligee or  Family Support Registry (P.O. Box 2171 Denver, CO 80201-2171). Note : Both parties have entered into a written agreement however; if a payment is missed a wage assignment will be established. 4. The Child Support Worksheet and the parties’ Sworn Financial Statements are filed with this Stipulation. 5. The parties have ______ minor child(ren). Full Name of Child Present Address Sex Date of Birth 6. Other Information: JDF 1404 R8/17 STIPULATION REGARDING CHILD SUPPORT MODIFICATION © 2017 Colorado Judicial Department for use in the Courts of Colorado Page 1 of 2 7.  If applicable. We have provided a copy of this Stipulation (JDF 1404) to the Office of Child Support Enforcement, as they are involved in our case. The parties request that this Stipulation Regarding Child Support Modification be entered as an Order of this Court.  By checking this box, I am acknowledging I am filling in the blanks and not changing anything else on the form.  By checking this box, I am acknowledging that I have made a change to the original content of this form. (Checking this box requires you to remove JDF number and copyright at the bottom of the form.) VERIFICATION AND ACKNOWLEDGEMENT I declare under penalty of perjury under the law of Colorado that the foregoing is true and correct. Executed on the ______ day of ____________, _______, ___________________________________________ (date) (month) (year) (city or other location, and state OR country ______________________________________ ______________________________________ (Printed name of Petitioner) (printed signature of Co-Petitioner/Respondent) _____________________________________ ______________________________________ Petitioner Signature Co-Petitioner Signature ______________________________________ ______________________________________ Address Address ______________________________________ ______________________________________ City State Zip Code City State Zip Code ______________________________________ ______________________________________ Home Phone # Cell # Home Phone # Cell # ______________________________________ ______________________________________ Petitioner’s Attorney Signature, if any Co-Petitioner’s Attorney Signature, if any JDF 1404 R8/17 STIPULATION REGARDING CHILD SUPPORT MODIFICATION © 2017 Colorado Judicial Department for use in the Courts of Colorado Page 2 of 2