Uniform Child Support Order Form - Michigan
This order is entered after hearing. after statutory review. on stipulation/consent of the parties.
The friend of the court recommends child support be ordered as follows.
If you disagree with this recommendation, you must file a written objection with on or
before 21 days from the date this order is mailed. If you do not object, this proposed order will be presented to the court for entry.
Attached are the calculations pursuant to MCL 552.505(1)(h) and MCL 552.517b.
IT IS ORDERED, unless otherwise ordered in item 12 or 13: Standard provisions have been modified (see item 12 or 13):
1. The children who are supported under this order and the payer and payee are:
Children's names, birthdates, and annual overnights with payer:
Children's names Date of birth Overnights
Effective , the payer shall pay a monthly child support obligation for the children named above.
Children supported: 1 child 2 children 3 children 4 children 5 or more children
Base support: (includes support plus or minus premium adjustment for health-care insurance)
Support: $ $$$$
Premium adjust. $ $$$$
Subtotal: $ $$$$
Ordinary medical: $ $$$$
Child care: $ $$$$
Other: $ $$$$
SS benefit credit: $ $$$$
Total: $ $$$$
Support was reduced because payer's income was reduced.
Court telephone no.
FOC 10 / 52 (8/14) UNIFORM CHILD SUPPORT ORDER, PAGE 1
Defendant's name, address, and telephone no.
Plaintiff's name, address, and telephone no.
STATE OF MICHIGAN CASE NO.
UNIFORM CHILD SUPPORT ORDER (PAGE 1)
EX PARTE TEMPORARY
MCL 552.14, MCL 552.517, MCL 552.517b(3), MCR 3.211
Original - Court
1st copy - Plaintiff
2nd copy - Defendant
3rd copy - Friend of the court
Plaintiff's source of income name, address, and telephone no.
Plaintiff's attorney name, bar no., address, and telephone no. Defendant's attorney name, bar no., address, and telephone no.
Defendant's source of income name, address, and telephone no.
(Continued on page 2.)
Uniform Child Support Order Form - Michigan PDF
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