Fill and Sign the Dr 1151 Amend of Agreement on Claiming Tax Exemption for Children 10 15 Domestic Relations 490101904 Form

DR -115.1 ( 10/15 )(cs) AS 25.24.220(g) AMENDMENT OF AGREEMENT RE TAX EXEMPTION IN THE SUPERIOR COURT FOR THE STATE OF ALASKA AT In the Matter of the Dissolution ) of the Marriage of ) ) ) and ) ) , ) ) CASE NO. Party A and Party B. ) ) AMENDMENT OF AGREEMENT ON CLAIMING TAX EXEMPTION FOR CHILDREN (Note: This form may only be used prior to the granting of a decree.) We agree to amend paragraph E on page 15 of our petition as follows: Agreement concerning claiming the child(ren) as dependent(s) for tax purposes We agree that the parent who has physical custody of the child(ren) for a period less than the other parent may not claim the exemption in any tax year if on December 31 of that year the parent was behind in child support payments in an amount more than four times the monthly child support obligation. AS 25.24.232. VERIFICATION I say on oath or affirm under penalty of perjury that I have read the above amendment and believe that all statements made in it are true. I further certify that my signature is voluntary and not the result of fear, threat, coercion or restraint. Signature of Party A Signature of Party B Date Date Subscribed and sworn to or affirmed before me at , Alaska Subscribed and sworn to or affirmed before me at , Alaska on . on . Clerk of Court, Notary Pu blic or other person authorized to administer oaths. My Commission Expires: Clerk of Court, Notary Public or other person authorized to administer oaths. My Commission Expires: (SEAL) (SEAL)