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:_____________________________ Attorney or Party Without Attorney (Name and Address): COURT USE ONLY Case Number:_________________

Phone Number:__________________ E-mail: _________________ FAX Number:____________________ Atty. Reg. #: _____________

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. 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).

2. The parties stipulate and agree that the

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

R7/07

STIPULATION REGARDING CHILD SUPPORT MODIFICATION

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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.

VERIFICATION AND ACKNOWLEDGEMENT
I swear/affirm under oath that I have read the foregoing Stipulation and that the statements set forth therein are true and correct to the best of my knowledge.

______________________________________
Petitioner Signature Date

______________________________________
Co-Petitioner Signature Date

______________________________________
Address

______________________________________
Address

______________________________________
City State Zip Code

______________________________________
City State Zip Code

______________________________________
Home Phone # Cell #

______________________________________
Home Phone # Cell #

Subscribed and affirmed, or sworn to before me in the County of ________________________, State of ____________________, this _______ day of ________________, 20 ____. My Commission Expires:

Subscribed and affirmed, or sworn to before me in the County of _________________________, State of ___________________, this ________ day of ________________, 20 ____. My Commission Expires:

Notary Public/Clerk

Notary Public/Clerk

______________________________________
Petitioner's Attorney Signature, if any

______________________________________
Co-Petitioner's Attorney Signature, if any

JDF 1404

R7/07

STIPULATION REGARDING CHILD SUPPORT MODIFICATION

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