Free ISSUED BY THE BUTLER COUNTY DOMESTIC RELATIONS COURT - Ohio

C-41 eff. 1/06 Rev. 12/1/08

INSTRUCTIONS FOR SUBMITTING AN AGREED ENTRY (NO HEARING REQUIRED)
BUTLER COUNTY DOMESTIC RELATIONS COURT DISCLAIMER: This form has been provided to you as a public service of the Butler County Domestic Relations Court. If you choose to represent yourself and use this form, please understand that state law prohibits the staff of the Domestic Relations Court to provide legal advice. Local Rules of Court are available online at www.butlercountyohio.org/drCourt and from the Clerk of Courts' Office for $5.00. If you have questions regarding your legal rights, or your responsibilities, you must contact an attorney. You can call Legal Aid at 241-9400 or the Butler County Bar Association at 896-6671. DEFINITION: A written statement of the parties which becomes an order of the court. This occurs when both parties to a case are able to agree to all issues and do not need a decision or adjudication by the Judge or Magistrate. STEPS FOR FILING AN AGREED ENTRY WITH NO HEARING REQUIRED: 1. A completed Agreed Entry-No Hearing Required Form (Form DR716) and 4 copies must be completed and submitted to the Butler County Domestic Relations Case Management Office for review. The Case Management Office will determine if your petition complies with the Ohio Revised Code, Ohio Rules of Civil Procedure and local rule of court. 2. If you are filing an agreed entry for modification of child support to guideline amount, you must complete and attach the following forms: a. Child Support Calculation Sheet; b. A Completed Appendix B ­ Affidavit of Available Health Care Coverage; c. An original IV-D application; d. Withholding Order (Form DR201); e. An Affidavit of Income (DR602A) must be completed and exchanged by the parties before the agreed entry is filed. 3. If you are filing an agreed entry for modification of spousal support to guideline amount, you must complete and exchange an Affidavit of Income (Form DR602A) with the other party. 4. If you are filing an agreed entry for modification of health insurance responsibility, you must complete the following forms: a. A Health Insurance Disclosure Affidavit (Form DR 617)to be exchanged between the parties; b. Withholding Order/Qualified Medical Child Support Order Information Sheet (Form DR 201) to be attached.

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5. If you are filing an agreed entry for modification of residential parent status under a shared parenting plan for school purposes only, or agreed entry for restoration of maiden name, there are no additional forms needed.

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