Free foc109.pmd - Michigan

Approved, SCAO

Original - Court 1st copy - Friend of the court

2nd copy - Plaintiff 3rd copy - Defendant

STATE OF MICHIGAN JUDICIAL CIRCUIT COUNTY
Court address

CASE NO. MOTION FOR PAYMENT PLAN PAGE 1 OF 2
Telephone no.

Plaintiff's name and address

Defendant's name and address

v

Attorney:

Attorney:

1. Friend of the court records show that, as of a. my current support is $
Date

Date

:

per month. My youngest child in the case will be or was 18 years of age on .
. Attached is written proof from the friend of the court office.

b. My total arrears are $ c. I owe $ d. I owe $ e. I owe $ f. I owe $ g. I owe $

support arrears to

Name

, the individual payee.

support arrears to the State of Michigan. for Medicaid/confinement reimbursement arrears. in statutory fees. to
Specify agency/person

.

2. It is in the best interests of the parties and the children that a payment plan be ordered in this case. 3. I understand that the individual payee must consent to entry of an order for payment plan. The payee's consent was not given under fear, coercion, or duress. 4. I did not engage in conduct exclusively for the purpose of avoiding my support obligation. 5. I do not have the present ability and will not have the ability in the foreseeable future to pay the arrears. 6. I have gross income in the amount of $ to show proof of my income. per . I understand that I must provide adequate records

7. I have assets, solely or jointly owned, as of this date, as follows: (assets include but are not limited to vehicles, real estate, bank accounts, retirement accounts, trust funds, etc.) Continue on page 2 and attach a separate sheet if more space is needed. Description a. b. c.
(See page 2 for remainder of motion.) FOC 109 (3/09)

Net Value $ $ $

MOTION FOR PAYMENT PLAN, PAGE 1 OF 2

MCL 552.605e

Approved, SCAO

Original - Court 1st copy - Friend of the court

2nd copy - Plaintiff 3rd copy - Defendant

STATE OF MICHIGAN JUDICIAL CIRCUIT COUNTY
Court address

CASE NO. MOTION FOR PAYMENT PLAN PAGE 2 OF 2
Telephone no.

Plaintiff's name

Defendant's name

v 7. continued. Attach a separate sheet if more space is needed. Description d. e. f. g. h. i. Net Value $ $ $ $ $ $

8. If arrears are owed to the State of Michigan, I will provide notice to the Office of Child Support at least 56 days before the hearing on this matter. 9. I request: a. the court order a payment plan of $___________ per month for ___________ months toward support arrears in this case. b. that if the court declines to order the payment plan as requested above, the court order a payment plan of support arrears as found by the court to be a reasonable monthly payment over a reasonable time in accordance with my ability to pay. c. the court grant me such other and further relief as is just and appropriate. 10. I further request that once I complete this payment plan, the court enter an order discharging any remaining arrears.

Date

Signature

CERTIFICATE OF MAILING I certify that on this date I served a copy of this motion on the parties or their attorneys and to the Office of Child Support by first-class mail addressed to their last-known addresses as defined in MCR 3.203.
Date Signature

FOC 109 (3/09)

MOTION FOR PAYMENT PLAN, PAGE 2 OF 2

MCL 552.605e