Fill and Sign the Colorado Stipulation 497300331 Form

 District Court _________________________________________ County, Colorado Court Address: In Re: Petitioner: Respondent/Co-Petitioner: COURT USE ONLY Attorney or Party Without Attorney (Name and Address) : Phone Number: E-mail: FAX Number: Atty. Reg.#: Case Number: Division Courtroom STIPULATION FOR IMMEDIATE ACTIVATION OF AN INCOME ASSIGNMENT The parties stipulate and agree to the immediate activation of an income assignment. _______________________________ ___________________________________ Date Obligor _______________________________ ___________________________________ Date Obligee __________________________________________________________________________________ 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 _________, ______, at ________________________________________ (date) (month) (year) (city or other location, and state OR country) ________________________________________ __________________________________________ (printed name of Obligor) (printed name of Obligee) ________________________________________ __________________________________________ (Obligor’s Signature Obligee’s signature ________________________________________ __________________________________________ (Obligor’s Attorney Signature, if any) (Obligee’s Attorney Signature, if any) JDF 1812 R8-17 STIPULATION FOR IMMEDIATE ACTIVATION OF AN INCOME ASSIGNMENT © 2017 Colorado Judicial Department for use in the Courts of Colorado PAGE 1 OF 1