Free CHILD SUPPORT ADDENDUM TO THE FAMILY VIOLENCE PROTECTIVE ORDER - Georgia

For your convenience, this form has been designed to be completed online. The information typed on the first page will automatically update to the other pages. Please be sure all pertinent information is completed before printing. Once the form is completed, select 'Print' to print the form. Selecting 'Reset' will clear the entire form.

Print

Reset

ORI Number ____________________

THE SUPERIOR COURT FOR THE COUNTY OF________________ STATE OF GEORGIA _____________________, Petitioner, vs. _____________________, Respondent. : : : : : CHILD SUPPORT ADDENDUM TO FAMILY VIOLENCE PROTECTIVE ORDER This Addendum is entered in conjunction with the Family Violence Protective Order dated ______________________, 20_____ and supersedes any contradictory language in that order. This Addendum is intended to fulfill the requirements of O.C.G.A. §19-6-15. _____ 1. The Respondent is ordered to pay to the Petitioner support for the minor child/ren in the amount of $___________ every ___________________ beginning the _______ of ______________________, 20_____. All payments are to be made by or to: ____ ____ ____ or ____ income deduction order child support receiver by mail directly to the Petitioner _____________________________ No._____________________ Civil Action File

In determining child support the Court finds as follows: The gross income of the father is $___________ yearly or $___________ monthly. The gross income of the mother is $___________ yearly or $___________ monthly. Child support is being determined for ______ child/ren. _____ 2. Social Security benefits of $___________ per month received by the child/ren on behalf of the Respondent have reduced the Respondent's presumptive child support obligation from $___________ to $___________ per month. Health insurance is available at a reasonable cost to Petitioner/Respondent (circle one). Petitioner/Respondent (circle one) shall provide health insurance for the parties' minor child/ren. The parent who maintains the insurance shall provide the other parent with an insurance identification card or other acceptable proof of insurance coverage and shall cooperate with the other parent in submitting claims under the policy.

_____ 3.

1

CIVIL ACTION FILE NO. _____________________ _____ 4. The Respondent shall be responsible for _____% and Petitioner shall be responsible for _____% of the uninsured health care expenses for the minor child/ren. The following deviation(s) to the child support calculations as outlined in O.C.G.A. §19-6-15 applies in this case: ______________________________________________ ______________________________________________________________________ The reason for such deviation(s) is/are: ______________________________________ ______________________________________________________________________ The presumptive amount of child support required under O.C.G.A. §19-6-15 if the deviation had not been applied is $___________ per month; however, the guidelines would be unjust or inappropriate considering the relative ability of each parent to provide support and it is in the best interest of these child/ren to deviate from the Presumptive Amount of Child Support because ________________________________ ______________________________________________________________________ Deviation from the presumptive amount of child support would not seriously impair the ability of the custodial parent to maintain minimally adequate housing, food, clothing, and other basic necessities for the child/ren being supported by this order. The Respondent's parenting time as set forth in the visitation paragraph of the main order is ____days per year. It is further Ordered: ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

_____ 5.

_____ 6.

_____ 7.

SO ORDERED this _______ day of ______________________, 20_____.

_____________________________ JUDGE, SUPERIOR COURT _______________________ County _____________________________ Print or stamp Judge's name

Rev'd 10/2008

2