Free ______________________County, Colorado District Court - Colorado

District Court Denver Juvenile Court ___________________ County, Colorado Court Address:

In re: The Marriage of: Parental Responsibilities concerning: ______________________________________________________ Petitioner: and Co-Petitioner/Respondent:

COURT USE ONLY Case Number:

Division

Courtroom

SUPPORT ORDER Petitioner:
Mailing Address: Residential Address: Name of Employer: Employer Address: Date of Birth: _______________________

Co-Petitioner/Respondent:
Mailing Address: Residential Address: Name of Employer: Employer Address:

Date of Birth: _______________________

The following are the minor children who are the subject of this Order: Full Name of Child

Sex

Date of Birth

The Court Orders the
maintenance to

Petitioner

Co-Petitioner/Respondent to pay (name of party).

child support and/or

a. Payments shall be paid

weekly

bi-weekly

twice a month

monthly

other: _________________.

b. The first payment is due on ____________________________ (date). c. Total arrears owed as of _____________________ (date) for Child Support $____________ and/or
Maintenance $___________.

d. Total retroactive support as of _______________________ (date) that accrued prior to the entry of a
support order for the time period of ________________ to _______________ shall be $______________.

e. Emancipation occurs when the last or only child reaches the age of 19; unless the child is still in high
school, in which case support continues until the end of the month following graduation; or until the child(ren) otherwise emancipate as may be determined by the Court. Child support may be changed or amended upon motion of a party when any of the children reach 19.
JDF 1117 R7/09 SUPPORT ORDER Page 1 of 2

The total monthly obligation is as follows:

$ _____________ Current Child Support $ _____________ Current Maintenance $ _____________ Payment toward Arrears (child support) $ _____________ Payment toward Arrears (maintenance) $ _____________ Payment toward Retroactive Support

For a total monthly payment of $ ___________
Upon payment in full of the Retroactive Support and/or Arrears, the monthly payment is reduced to $_______________. The Court orders the immediate activation of an income assignment against the Obligor, pursuant to §14-14111.5, C.R.S. The income assignment must be paid through the Family Support Registry, pursuant to §26-13-114(6)(a), C.R.S. The income assignment shall be paid directly to the Obligee. or This Order is not subject to the immediate activation of an income assignment because either: Both parties have entered into a written agreement. If a payment is missed a wage assignment will be established. The Court finds there is good cause not to require the immediate activation of an income assignment because:

The Court orders the medical or

Petitioner or

Co-Petitioner/Respondent, or other:

Either party to secure and maintain insurance coverage for the child(ren),

medical and dental and/or

when it is provided by his/her employer or acquired individually, at a reasonable cost as defined in §14-10115(10), C.R.S. Each party shall cooperate and exchange information necessary to provide insurance If not all children, please identify the names of the children that this party will be

benefits for the child(ren). providing insurance for:

The Court finds medical or medical and dental insurance is not currently available to either party at a reasonable cost and does not order either party to provide coverage for the children at this time, but does order the parties to provide coverage when it becomes available at a reasonable cost. Payments shall continue until further Order of the Court. Payments shall be: Mailed to the Family Support Registry or P. O. Box 2171 Denver, CO 80201-2171 Mailed directly to the appropriate party.

Date: ________________________________

______________________________________ Judge Magistrate

JDF 1117 R7/09

SUPPORT ORDER

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