Child Support Addendum

SUPERIOR COURT OF FULTON COUNTY

STATE OF GEORGIA

FAMILY DIVISION

,

Petitioner,

and

,

Respondent.

CIVIL ACTION

FILE NO.____________________

CHILD SUPPORT ADDENDUM

 The parties have agreed to the terms of this Order and this information has been furnished

by both parties to meet the requirements of OCGA §19-6-15. The parties agree on the terms

of the Order and affirm the accuracy of the information provided, as shown by their

signatures at the end of this addendum.

 This addendum includes findings of fact and conclusions of law and fact made by the Court,

in compliance with OCGA §19-6-15.

Application of Child Support Guidelines. The statutory requirements of OCGA §19-6-15

have been applied in reaching the amount of child support provided under the Final Order in this

action. The specifics are as follows:

1. Gross Income - The Father’s gross monthly income (before taxes) is $ ; the

Mother’s gross monthly income is $ (before taxes).

2. Number of Children - The number of children for whom support is being provided under

this order is .

3. Attachments

- The Child Support Worksheet and Schedule E are attached and made a part of

this Addendum, along with any other applicable schedules.

4. Child Support Amount – The ___________________ shall pay to the , for the

support of the minor children, the sum of

Dollars ($

) per month, beginning on , 20 .

5. Duration of Child Support

[You must check & complete only one of the following paragraphs.]

 (a) Beyond Age 18 for High School - The child support shall continue monthly thereafter

until each child reaches the age of eighteen, dies, marries, or otherwise becomes emancipated;

provided that if a child becomes eighteen years old while enrolled in and attending secondary

school on a full-time basis, then the child support shall continue for the child through the

Child Support Addendum

Fulton County Family Division

month when the child has graduated from secondary school or through the month when the

child reaches twenty years of age, whichever occurs first.

 (b) Stops at Age 18 - The child support shall continue monthly thereafter until each

child reaches the age of eighteen, dies, marries, or otherwise becomes emancipated.

 (c) Until Further Order - This is not a final order, so the child support shall continue

until further order of this Court.

 (d) Until Specific Date - The child support shall continue monthly thereafter until

.

6. Deviation from Presumptive Amount

[You must check & complete only one of the following paragraphs.]

 (a) No Deviation - It has been determined that none of the Deviations allowed under

OCGA §19-6-15 applies in this case, as shown by the attached Schedule E. The amount of

support in Paragraph 4 above is the Presumptive Amount of Child Support shown on the

attached Child Support Worksheet.

 (b) Deviation - It has been determined that one or more of the Deviations allowed under

OCGA §19-6-15 applies in this case, as shown by the attached Schedule E. The

Presumptive Amount of Child Support that would have been required under OCGA §19-6-

15 if the deviations had not been applied is $ per month, as shown on the

attached Child Support Worksheet. The attached Schedule E explains the reasons for the

deviation, how the application of the guidelines would be unjust or inappropriate

considering the relative ability of each parent to provide support, and how the best interest

of the children who are subject to this child support determination is served by deviation

from the presumptive amount of child support.

7. Split Parenting - A split parenting situation occurs when the parents have two or more

children together, where at least one of the children spends more than 50% of the time with

one parent, and at least one of the children spends more than 50% of the time with the other

parent.

[You must check & complete only one of the following paragraphs.]

 (a) Not Split Parenting Case - This case does not involve Split Parenting.

 (b) Split Parenting Case - This is a Split Parenting case. Separate Child Support

Worksheets have been filed for the children living with the Mother and for the children

living with the Father, and a Child Support Order Addendum has been entered in this action

for each parent. At this time, the Mother is obligated to pay the sum of $ __

per

month to the Father, and the Father is obligated to pay the sum of $________________ per

month to the Mother.

[If you checked (b) above, you must check & complete only one of the following sub-paragraphs.]

 (1) Net Payment - For so long as these amounts remain in effect, the ______________

shall pay only the difference between the two amounts (which is $ ) to the

Child Support Addendum

Fulton County Family Division

________

, who shall not be required to pay the child support obligation to

the other parent.

 (2) Zero Payment - The parents’ child support obligations are equal. For so long as

the amounts remain equal, neither parent shall pay any child support payment to the other

parent.

 (3) Full Payment From Each - Each parent shall pay the full amount of his or her

child support obligation to the other.

8. Health, Dental & Vision Insurance for Children

[You must check & complete all parts of only one of the following paragraphs, (a) or (b).]

 (a) Insurance Available - The following insurance for the children involved in this

action is available at a reasonable cost to the through that

parent’s employer or the PeachCare program:

 Health (medical, mental health and hospitalization)  Dental  Vision.

So long as it remains available to that parent, the shall maintain the

types of insurance checked above for the benefit of the minor children, until each child

reaches the age of eighteen, dies, marries, or otherwise becomes emancipated; except that if

a child becomes eighteen years old while enrolled in and attending secondary school on a

full-time basis, then the insurance shall be continued for the child until the month when the

child has graduated from secondary school or through the month the child reaches twenty

years of age, whichever occurs first.

(1) The parent who maintains the insurance shall provide the other parent with an

insurance identification card or such other acceptable proof of insurance coverage

and shall cooperate with the other parent in submitting claims under the policy.

(2) All money received by one of the parties for claims processed under the

insurance policy shall be paid within five (5) days after the party receives the money,

to the other party (if that other party paid the applicable health care service provider)

or to the applicable health care provider (if the provider has not been paid by one of

the parties).

 (b) Insurance Not Available - Insurance (other than Medicaid) is not available at this

time to either party at a reasonable cost. If health insurance for the children later becomes

available to the parent who is required to pay child support for these children, then that

parent must obtain the following types of insurance, unless it is then being provided by the

other parent:

 Health (medical, mental health and hospitalization)  Dental  Vision.

When insurance has been obtained by either party, Paragraphs 8 (a)(1) and (2) shall apply.

9. Uninsured Health Care Expenses - The shall pay %

and the shall pay % of all expenses incurred for the

Child Support Addendum

Fulton County Family Division

children’s health care (including medical, dental, mental health, hospital and vision care)

that are not covered by insurance. The party who incurs a health care expense for one of the

children shall provide verification of the amount to the other party. That other party shall

reimburse the incurring party (or pay the health care provider directly) for the appropriate

percentage of the expense, within fifteen (15) days after receiving the verification of a

particular health care expense.

10. Parenting Time Amounts - The approximate number of days of parenting time per year

according to the visitation order is days for the Father and days for the Mother.

11. Social Security Benefits

[You must check & complete only one of the following paragraphs.]

 (a) Not Received - The children do not receive Title II Social Security benefits under

the account of the parent ordered to pay child support.

 (b) Received - The children receive Title II Social Security benefits under the account of

the parent ordered to pay child support. The benefits received by the children shall be

counted as child support payments, and shall be applied against the final child support order

to be paid by that parent.

(1) If the amount of benefits received is less than the amount of support ordered, the

obligor shall pay the amount exceeding the Social Security benefit.

(2) If the amount of benefits received is equal to or more than the amount of

support ordered, the obligor’s responsibility is met and no further support shall be

paid.

(3) Any Title II benefits received for the children’s benefit shall be retained by the

custodial parent or nonparent custodian for the children’s benefit, and it shall not be

used as a reason for decreasing the final child support order or reducing arrearages.

12. Modification

[You must check & complete only one of the following paragraphs.]

 (a) Not Modification Action - This is an initial determination of child support, not a

modification action.

 (b) Support Not Modified - This action is a modification action, but the order does not

modify the amount of child support that was previously ordered for these children The date

of the initial support order concerning this child support case was:

.

 (c) Support Amount Modified - The Order modifies the amount of child support that

was previously ordered for these children. The basis for the modification is:

 (1) Substantial change in the income and financial status of the Father;

 (2) Substantial change in the income and financial status of the Mother;

 (3) Substantial change in the needs of the Children;

 (4) The noncustodial parent failed to exercise visitation provided under the prior

order;

 (5) The noncustodial parent has exercised more visitation than was provided in

the prior order.

The date of the initial support Order concerning this child support case was: .

Child Support Addendum

Fulton County Family Division

13. Continuing Garnishment for Child Support - Whenever, in violation of the terms of the

order, there shall have been a failure to make the support payments, so that the amount

unpaid is equal to or greater than the amount payable for one month, the payments required

to be made may also be collected by the process of continuing garnishment for support.

14. Income Deduction Order

[You must check & complete only one of the following paragraphs: (a), (b) or (c).]

 (a) An Income Deduction Order shall be entered by the Court, under OCGA § 19-6-32,

for payment of the child support and alimony (if any) provided. The Income Deduction

Order shall take effect:

[To finish (a), you must check either (1) or (2). Do not check both.]

 (1) immediately upon entry by the Court.

 (2) upon accrual of a delinquency equal to one month’s support. The Income

Deduction Order may be enforced by serving a “Notice of Delinquency,” as

provided in OCGA §19-6-32 (f).

 (b) The parties agree that an Income Deduction Order is not immediately necessary.

 (c) The Court finds that there is good cause not to require income deduction, having

determined that income deduction will not serve the children’s best interests and that there

has been sufficient proof of timely payment of any previously ordered support.

Parties’ Consent (if applicable) - We knowingly and voluntarily agree on the terms of this Order.

Each of us affirms that the information we have provided in this Addendum is true and correct.

_______________________________

Father’s Signature

Child Support Addendum

Fulton County Family Division

______________________________

Mother’s Signature

ORDER

The Court has reviewed the foregoing Child Support Addendum, and it is hereby

made the Order of this Court.

This Order entered on

, 20 .

________________________________________,

JUDGE

SUPERIOR COURT OF FULTON COUNTY

ATLANTA JUDICIAL CIRCUIT

Child Support Addendum

Fulton County Family Division