Child Support Obligation Generator

Basic Information

Petitioner's Full Legal Name *

The petitioner is the person who filed the case REQUIRED

Petitioner's Mailing Address *

REQUIRED

Petitioner's Phone Number *

REQUIRED

Respondent's Full Legal Name *

The respondent is the other parent REQUIRED

Respondent's Mailing Address *

REQUIRED

Respondent's Phone Number *

REQUIRED

Case Number (if known)

County *

REQUIRED

Children Information

Enter information for each child covered by this child support order.

Child 1

Child's Full Name *

Date of Birth *

Child Support Amount

Enter the child support payment details based on the Child Support Worksheet.

Who will pay child support? *

Petitioner will pay child support Respondent will pay child support

Monthly Child Support Amount * This amount should come from the Child Support Worksheet (Line 15)

Support Payments Begin *

Day of Month Payment is Due * Enter a number from 1 to 31

Payment Method *

Through the Child Support Enforcement Division (CSED) Directly to the other parent

Wage Withholding

Federal and state law require automatic wage withholding for child support unless both parties agree otherwise.

Wage Withholding *

Yes, child support shall be deducted from the obligor's wages No, we agree to waive wage withholding at this time

Health Insurance Coverage

Specify who will provide health insurance for the children.

Health Insurance Coverage *

Option 1: Petitioner shall provide health insurance for the child(ren) Option 2: Respondent shall provide health insurance for the child(ren) Option 3: Both parties shall share health insurance costs

Uncovered Medical Expenses

How will uncovered medical expenses be divided? *

In proportion to each parent's gross income (as shown on Child Support Worksheet) Equally (50/50) Petitioner pays all uncovered medical expenses Respondent pays all uncovered medical expenses Other arrangement

Petitioner's percentage of combined income (%) From Child Support Worksheet Line 6

Respondent's percentage of combined income (%) From Child Support Worksheet Line 6

Additional Issues

Tax Exemptions

Specify who will claim the child(ren) as dependents for tax purposes.

Tax Exemption Assignment *

Petitioner shall claim all child(ren) each year Respondent shall claim all child(ren) each year Parents shall alternate years claiming the child(ren) Parents shall split the exemptions (each claims specific children) Other arrangement

Work-Related Child Care

Will there be work-related child care expenses? *

No work-related child care is needed Yes, there will be work-related child care expenses

Other Expenses

Will there be other expenses to address (extracurricular activities, private school, etc.)? *

No other expenses need to be addressed Yes, there are other expenses to address

Modification and Termination

Child support shall terminate when each child:

Review Your Information

Please review all the information you've entered before generating the child support order.

Send via Email

Optionally enter an email address to receive the completed document as a PDF attachment.

Recipient Email Address The PDF will be sent as an attachment to this email address

Before You Sign

Both parents should read and understand the entire order
Child support amounts should be based on the Child Support Guidelines
It is highly recommended to consult with an attorney
Both signatures must be notarized
This order must be filed with the court as part of your case
Child support may be modified if there is a material change in circumstances

Child Support Obligation and Order

Basic Information

Children Information

Child 1

Child Support Amount

Wage Withholding

Health Insurance Coverage

Petitioner's Health Insurance Details

Respondent's Health Insurance Details

Uncovered Medical Expenses

Additional Issues

Tax Exemptions

Work-Related Child Care

Other Expenses

Modification and Termination

Review Your Information

Send via Email

Before You Sign