CASE SCREEN NOTES - Alaska Bar Association



IN THE SUPERIOR COURT FOR THE STATE OF ALASKAAT JUNEAU ) MERGEFIELD "P_First_Name" ?P_First_Name? MERGEFIELD "P_Last_Name" ?P_Last_Name?)Plaintiff,))vs.)) MERGEFIELD "D_First_Name" ?D_First_Name? MERGEFIELD "D_Last_Name" ?D_Last_Name?)Defendant.))Case No. MERGEFIELD "Case_Number" ?Case_Number?CUSTODY FINDINGS OF FACT AND CONCLUSIONS OF LAWThe settlement conference in this case was held on MERGEFIELD "Hearing_date" ?Hearing_date?.The plaintiff appeared in person/telephonically. The defendant appeared in person/ telephonically.The record shows that the defendant was served with the summons and complaint for custody. The parties reached a complete settlement on all issues. The court has considered testimony and examined any evidence or agreements presented. The court makes the following findings of fact and conclusions of law:FINDINGS OF FACT1.The following child(ren) was(were) born or adopted by these parties:NameDOB MERGEFIELD "Name_Child_1" ?Name_Child_1? MERGEFIELD "DOB_Child_1" ?DOB_Child_1? MERGEFIELD "Name_Child_2" ?Name_Child_2? MERGEFIELD "DOB_Child_2" ?DOB_Child_2? MERGEFIELD "Name_Child_3" ?Name_Child_3? MERGEFIELD "DOB_Child_3" ?DOB_Child_3? MERGEFIELD "Name_Child_4" ?Name_Child_4? MERGEFIELD "DOB_Child_4" ?DOB_Child_4?2.The child(ren) has(have) resided in Alaska for at least six consecutive months immediately before the complaint was filed; therefore, the court has jurisdiction over the child(ren).3.The parties have reached an agreement concerning the parenting and support for the child(ren). 4.After considering the factors listed in AS 25.24.150(c) and, if appropriate, AS 25.20.090, the court finds that the best interests of the child(ren) will be served by the parenting plan set out in the parents’ agreement, which is in a separate document incorporated by reference.5.Agreements on the child(ren)’s Alaska Permanent Fund Dividends (PFDs) and Federal taxes are set out the parents’ agreement, which is a separate document incorporated herein by reference. Child and medical support will be ordered according to Civil Rule 90.3.6.Other: Click here to enter text.CONCLUSIONS OF LAW1.This court has jurisdiction over the minor child(ren) involved in this proceeding, including subject-matter jurisdiction over the custody of the child(ren).2.The parenting plan is in the child(ren)’s best interest.3.Child and medical support shall be ordered as set forth above.4.Application for the PFD funds and claiming the child(ren) for federal tax purposes shall be done as set forth above.5.Other: Click here to enter text. DATE \@ "MMMM d, yyyy" April 6, 2016_______________________________(Date)Judge Stephanie Joannides IN THE SUPERIOR COURT FOR THE STATE OF ALASKAAT JUNEAU ) MERGEFIELD "P_First_Name" ?P_First_Name? MERGEFIELD "P_Last_Name" ?P_Last_Name?)Plaintiff,))vs.)) MERGEFIELD "D_First_Name" ?D_First_Name? MERGEFIELD "D_Last_Name" ?D_Last_Name?)Defendant.))Case No. MERGEFIELD "Case_Number" ?Case_Number?CUSTODY DECREE AND JUDGMENT IT IS HEREBY ORDERED, ADJUDGED AND DECREED as follows:1.The parenting plan referenced in the Findings of Fact and Conclusions of Law for the minor child(ren) is in their best interests. 2.Child and medical support is ordered according to the Findings of Fact and Conclusions of Law. There is a Child Support Order, Form DR-300, attached.The application for the child(ren)’s PFD funds shall be as set forth in the Findings of Fact and Conclusions of Law.The arrangement for claiming the child(ren) as a dependent(s) for federal tax purposes shall be as set forth in the Findings of Fact and Conclusions of Law.Other: Click here to enter text. DATE \@ "MMMM d, yyyy" April 6, 2016_______________________________(Date)Judge Stephanie JoannidesI certify that on DATE \@ "M/d/yy" 4/6/16a copy of the Final Findings and Conclusions of Law and the Decree and Judgment was given to:?The plaintiff in court / mailed ?The defendant in court / mailed Clerk:IN THE SUPERIOR COURT FOR THE STATE OF ALASKAAT JUNEAU) MERGEFIELD "P_First_Name" ?P_First_Name? MERGEFIELD "P_Last_Name" ?P_Last_Name?)Plaintiff,))vs.)) MERGEFIELD "D_First_Name" ?D_First_Name? MERGEFIELD "D_Last_Name" ?D_Last_Name?)Defendant.))Case No. MERGEFIELD Case_Number ?Case_Number?PARENTING AGREEMENTInterim/FinalWe have come to the following agreements which we believe are in the best interests of our child(ren). The following child(ren) is/are included in this plan:NameDate of Birth MERGEFIELD "Name_Child_1" ?Name_Child_1? MERGEFIELD "DOB_Child_1" ?DOB_Child_1? MERGEFIELD "Name_Child_2" ?Name_Child_2? MERGEFIELD "DOB_Child_2" ?DOB_Child_2? MERGEFIELD "Name_Child_3" ?Name_Child_3? MERGEFIELD "DOB_Child_3" ?DOB_Child_3?CommunicationCommunication Between Parents. We will communicate with each other to discuss the child(ren) by text messages, email, or telephone. Communication Between Parents and Children. The child(ren) shall have frequent and open telephone and text communication with both parents. FORMTEXT ?????Communication Between Parents and Children. Communication between the children and Mother/Father when not with that parent shall be follows. FORMTEXT ?????Events and Activities. We will make a good faith effort at keeping the other parent informed about events and activities in the children’s lives such as school programs, scouts, concerts, award ceremonies, plays, sports events. We also recognize that it is our individual responsibility to make sure that organizations have our contact information and that we are receiving notifications from them. Children as Messengers. We agree to not use the child(ren) as messengers between the parents to give or get information, ask questions or request schedule changes. We will communicate about the children as set out above. We will not question the child(ren) about the other parent.Parent Remarks and Behavior. We agree that our child(ren) have the right to be free of bad comments and behavior by one parent about the other. We agree that we will not badmouth, criticize, roll our eyes, be sarcastic or otherwise disrespectful to the other parent in our children’s presence. We will not let others do this either. Decision MakingMajor Decisions: We can communicate and make joint decisions in the child(ren)’s best interests regarding the child(ren)’s education, healthcare, religious training, and other major decisions.Optional to include:When Mother/Father/either parent is unavailable due to FORMTEXT ?????, the other parent may make major decisions independently.When Mother/Father/either parent doesn’t respond within FORMTEXT ????? hours/days, the other parent may make major decisions independently.When we can’t reach agreement after a good faith effort to discuss and communicate with each other, then Mother/Father may make major decisions independently.Major Decisions: It is difficult for us to make joint decisions regarding our child(ren), therefore we agree that Mother/Father will make decisions regarding the child(ren)’s education, healthcare, religious training, and other major decisions. The decision-making parent must keep the other parent informed about major decisions affecting the child(ren). Neither parent can move out of state with the child(ren) without written permission from the other parent or a court order.Day to Day Decisions: Each parent may make decisions regarding the day-to-day care of the children while they are with that parent. Either parent may make emergency decisions affecting the children’s health and safety and notify the other parent as soon as possible.Access to Information. Both parents must be listed on and have access to all educational and medical records.Living ArrangementsRegular Schedule: FORMTEXT ?????. Optional also to include: First Option. Each parent shall call the other parent and give them first option to care for the child(ren) when they need care for more than FORMTEXT ????? hours or overnight. Special days (holidays, birthdays and special occasions)We may agree to celebrate holidays and birthdays together or make other agreements regarding special days. If we cannot reach agreement, the following schedule will apply:Spring vacation: The child(ren) will be with Mother in even years and with Father in odd years.Summer vacation: The regular schedule will apply, except that each parent may select up to 2 weeks of uninterrupted time with the child(ren). Each parent will notify the other parent of the proposed dates by May 1. If both parents have selected the same period and cannot reach agreement, Mother’s proposed schedule will apply in even years and Father’s in odd years.Halloween: The child(ren) will be with Father in odd years and with Mother in even yearsThanksgiving: The child(ren) will be with Mother in odd years and with Father in even years.Winter vacation: The regular schedule will apply until at least one child is in school. When the child(ren) reach school age the first half of break will be with Mother in even years and with Father in odd years.Christmas: The child(ren) will spend Christmas Day with Mother/Father in even years and with the other parent in odd years. The parent who is not with the child(ren) for Christmas Day shall have time with them on Christmas Eve from X to X Mother’s Day and mother’s birthday: With Mother.Father’s Day and father’s birthday: With Father.Child(ren)’s Birthdays: We will celebrate the child(ren)’s birthdays during our regularly scheduled parenting times. Other Special Days: FORMTEXT ?????Exchanging the Child(ren)Parents Living in the Same CommunityPlace for exchanges of the child(ren) between parents. Exchanges will take place at FORMTEXT ?????Transportation for transfer between parents. The parent receiving the child(ren) is responsible for transportation.Transportation for transfer between parents. Mother/Father/Both parents/Other will be responsible for transporting the child(ren) for exchanges.Third party help with exchanges between parents. We do not need help with the transfer.Third party help with exchanges between parents. We agree to have FORMTEXT ????? do exchanges or supervise exchanges.Parents Living in Different CommunitiesAccompanying Parent. The parent receiving the child(ren) is responsible for accompanying the child(ren) during travel.Mother/Father/Third Party ( FORMTEXT ?????) will accompany the child(ren) during all travel.The child(ren) is/are old enough to travel independently.Cost of exchanges.The parent receiving the child is responsible for arranging and paying for plane tickets and transportation.Mother/Father is responsible for arranging and paying for all plane tickets and transportation and the other parent will reimburse FORMTEXT ????? % of the total cost.Move by ParentNeither of us plans to move from FORMTEXT ????? in the foreseeable future.? We agree to give the other parent at least 120 days notice of any intent to move. After receiving notice of a move, we will review our parenting agreement to try to reach a modified parenting agreement that is in the best interest of our child. If we cannot agree on a modified schedule, we will continue the schedule listed in this parenting agreement for as long as both parents remain in the same community.? If one parent moves away, the child will remain with the non-moving parent until the court makes a decision.? TravelOut-of-State Travel The children may travel out of state with either parent as long as an itinerary, contact telephone number and copy of return tickets are provided at least 30 days in advance of the travel, unless the parents agree on a shortened timeline.Out-of-State Travel Father/Mother may travel out-of-state with our child(ren) during his or her custody or visitation time without restrictions/with the following restrictions: FORMTEXT ?????International Travel (includes travel to/thru Canada). The children may travel out of the country with either parent as long as an itinerary, contact telephone number and copy of return tickets are provided at least 30 days in advance of the travel, unless the parents agree on a shortened timeline. We will cooperate to obtain passports and necessary travel authorizations.International Travel (includes travel to/thru Canada). Father/Mother may travel out of the country with our child(ren) during his or her custody or visitation time without restrictions/with the following restrictions: FORMTEXT ?????Safety ConcernsWe do not have concerns about the safety of the child(ren) with either parent. We agree to the following restrictions: FORMTEXT ?????Permanent Fund DividendsMother/Father should timely apply for the child(ren)’s Alaska Permanent Fund Dividend (PFD) each year while they are minors. The parent who claims the federal tax exemption for any child(ren) agrees to pay the taxes on the child(ren)’s PFD. We agree that the child(ren)’s PFD funds may be spent for the child(ren)’s health, education and welfare. should be saved in an interest-bearing account in both parent’s names and both parents should have access to all statements from the account.will be split between the parents as follows: We want the judge to make the decision on the child(ren)’s PFD.ANCSA DividendsMother/Father is designated as the custodian of the child(ren)’s ANCSA stock. Dividendsmay be spent for the child(ren)’s health, education and welfare. should be saved in an interest-bearing account in both parent’s names and both parents should have access to all statements from the account. will be split between the parents as follows: Any taxes owing on any Native Corporation dividends paid on behalf of the child(ren) will be paid by Mother/Father.We want the judge to make the decision on the child(ren)’s ANCSA dividends.Federal TaxesFederal Tax Exemptions and Tax Credits. We agree that Mother/Father will claim the child(ren) every year. Every year, mother will claim FORMTEXT ????? and father will claim FORMTEXT ?????. The parents will claim the child(ren) in alternating years with Mother/Father claiming the child(ren) for odd-numbered tax years such as 2015 and 2017, and the other parent claiming them for even-numbered tax years such as 2014 and 2016.We want the judge to make the decision on who can claim the child(ren) on federal taxes.This agreement regarding the child(ren)’s exemption(s) may be modified without a court order if both parties agree in writing. As required by AS 25.24.232, we also agree that the parent who has physical custody of the child(ren) for a period less than the other parent may not claim the exemption in any tax year if on December 31 of that year the parent was behind in child support payments in an amount more than four times the monthly child support obligation.Other Federal Tax Considerations. We understand the parent who has physical custody of a child for the greater part of the year, whether or not that parent claims the exemption for the child, may be able to claim other tax benefits such as the Earned Income Credit, Head of Household filing status, and Credit for Dependent (Child) Care Expenses.Child SupportFather’s adjusted annual income for child support purposes is: FORMTEXT ?????.Mother’s adjusted annual income for child support purposes is: FORMTEXT ?????.We do not have an existing child support order through CSSD and understand that the court is required to order child and medical support in accordance with Civil Rule 90.3.We have an existing support order through CSSD that should remain in effect.Father/Mother/Neither parent is receiving public benefits for the children. Medical CoverageAvailable Coverage. The children are eligible for medical services through Indian Health Service/Military/Denali Kid Care and these services are available in the area where the children live.Health insurance is available at a reasonable cost to Mother/Father/both parents. We agree that Mother/Father will purchase insurance and child support will be adjusted to reflect the additional cost of insuring the child(ren).Health insurance is not available to either parent at a reasonable cost. We understand that we are required to provide coverage for the children if health insurance becomes available to either parent at a reasonable cost. Uncovered Medical Expenses. The parents will each pay one-half of the first $5,000 in health care expenses not covered by insurance.Mother will pay FORMTEXT ?????% and Father will pay FORMTEXT ?????% of the first $5,000 in health care expenses not covered by insurance.Changing or Modifying the AgreementWe understand that we can change this agreement to adjust the children’s schedule when we agree. However, when we do not agree to change something, this agreement is in effect as written. Legal Advice Our volunteer attorneys helped us prepare this agreement. We understand that our attorneys provided unbundled services and advice based on the information we provided to them in a limited amount of time. We understand we have the right to hire a full representation attorney to review this agreement before we sign it.Our mediator helped us prepare this agreement, which is based on our agreements. The mediator advised us of our right to have an attorney review the agreement before we sign it.Other FORMTEXT ????? MERGEFIELD "Hearing_date" ?Hearing_date?___________________________DateFather MERGEFIELD "Hearing_date" ?Hearing_date?DateMotherORDERReviewed and approved by me on MERGEFIELD "Hearing_date" ?Hearing_date? and incorporated into the FORMCHECKBOX Final FORMCHECKBOX Interim Order. IT IS SO ORDERED. MERGEFIELD "Hearing_date" ?Hearing_date?_______________________________(Date)Judge Stephanie Joannides FORMTEXT ?????I certify that on MERGEFIELD "Hearing_date" ?Hearing_date? a copy of this agreementand order was delivered to plaintiff and defendant. FORMTEXT ?????Deputy Clerk/JAIN THE SUPERIOR COURT FOR THE STATE OF ALASKAAT JUNEAU) MERGEFIELD "P_First_Name" ?P_First_Name? MERGEFIELD "P_Last_Name" ?P_Last_Name?,)Plaintiff,))vs.))Case No. MERGEFIELD "Case_Number" ?Case_Number? MERGEFIELD "D_First_Name" ?D_First_Name? MERGEFIELD "D_Last_Name" ?D_Last_Name?,)Defendant.)CHILD SUPPORT ORDER)? Interim ? FinalChildren. Custody and support are ordered for the following minor child(ren):Full Names of ChildrenBirth Dates MERGEFIELD "Name_Child_1" ?Name_Child_1? MERGEFIELD "DOB_Child_1" ?DOB_Child_1? MERGEFIELD "Name_Child_2" ?Name_Child_2? MERGEFIELD "DOB_Child_2" ?DOB_Child_2? MERGEFIELD "Name_Child_3" ?Name_Child_3? MERGEFIELD "DOB_Child_3" ?DOB_Child_3? MERGEFIELD "Name_Child_4" ?Name_Child_4? MERGEFIELD "DOB_Child_4" ?DOB_Child_4?2.Parent A.Full Name: FORMTEXT ?????DOB: MERGEFIELD "His_DOB" ?His_DOB?Mailing Address: MERGEFIELD "His_Address" ?His_Address?Residence Address (if different): FORMTEXT ?????Most Recent Employer: MERGEFIELD "His_Employer" ?His_Employer?Employer's Address: FORMTEXT ?????Parent B.Full Name: FORMTEXT ?????DOB: MERGEFIELD "Her_DOB" ?Her_DOB?Mailing Address: MERGEFIELD "Her_Address" ?Her_Address?Residence Address (if different): FORMTEXT ?????Most Recent Employer: MERGEFIELD "Her_Employer" ?Her_Employer?Employer's Address: FORMTEXT ?????Custodian (if not a parent)Full Name: FORMTEXT ?????DOB: FORMTEXT ?????Mailing Address: FORMTEXT ?????Residence Address (if different): FORMTEXT ?????3.Legal custody of the child(ren) named above is awarded to: FORMTEXT ?????4.Physical Custody.Type of Custody Ordered: ? Primary ? Shared ? Divided ? Hybrid(For divided custody, fill in both a and b. For hybrid custody, fill in a, b, and c.) Primary Custody (child lives with this parent more than 70% of the year)a.Parent A, FORMTEXT ?????, will have primary physical custody ofthe following child(ren): FORMTEXT ?????b.Parent B, FORMTEXT ?????, will have primary physical custody ofthe following child(ren): FORMTEXT ?????Shared Custody (child lives with each parent at least 30% of the year)The parents will share physical custody of the following child(ren): FORMTEXT ?????The child(ren) will reside with FORMTEXT ????? during the followingperiods: FORMTEXT ?????which equals FORMTEXT ?????% of the year, and with FORMTEXT ????? during thefollowing periods: FORMTEXT ?????which equals FORMTEXT ?????% of the year.Failure to take physical custody of the child(ren) at least 30% of the year is grounds for modification of this support order. However, denial of visitation by the custodial parent is not cause to increase child support. Civil Rule 90.3(b)(1)(E)5.Child Support.The obligor, FORMTEXT ?????, shall pay child support as follows:(Put the current number of children on the first line. Subtract one number on each subsequent line and do the calculations for each line.)Number ofBasic MonthlyHealth InsuranceTotal MonthlyChildrenAmount OwedAdjustment (? 9)Amount Owed FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Except as provided below, as each child reaches the age of 18, is otherwise legally emancipated or dies, the amount of support will change to the next lower amount. Support must continue while each child is 18 years old if the child is (1) unmarried, (2) actively pursuing a high school diploma or equivalent level of technical or vocational training, and (3) living as a dependent with the obligee parent or guardian or a designee of the parent or guardian, unless the following box is checked:? Child support will end when each child reaches age 18.The first payment is due no later than FORMTEXT ?????. Subsequent payments are due no later than the 1st day of each month thereafter. The parties agree, and the court finds that it is in the best interests of the child(ren), that child support arrears will be set at $0 as between the parties, effective between the date of the parties’ separation and the date of this order.6.Extended Visitation Credit (available only in primary custody situations).Primary physical custody of the children listed in paragraph 4.a or 4.b has been given to the non-obligor parent. However, the obligor parent shall have physical custody of these child(ren) for the following periods of over 27 consecutive days: FORMTEXT ?????If this visitation is exercised, child support is reduced for the above period(s) as follows: FORMTEXT ?????(This reduction may not exceed 75% of the amount owed for the period.)If this visitation is not exercised, child support is not reduced. [Civil Rule 90.3(a)(3)]Seasonal Income.? The court finds thatobligor’s income is seasonal, andobligee agrees that, as long as the total annual amount remains the same, the obligor can make higher payments during high income months and lower payments during low income months as set forth below, andthe burden of budgeting for periods of unequal income should be placed on the obligee rather than the obligor.The annual support amount is: $ FORMTEXT ?????The average monthly support amount is: $ FORMTEXT ?????Therefore, it is ordered that the monthly support amount in paragraph 5 will be varied as follows:High Income Months. Obligor must pay $ FORMTEXT ????? per month in the following months: FORMTEXT ?????Low Income Months. Obligor must pay $ FORMTEXT ????? per month in the following months: FORMTEXT ?????If this support order takes effect in a low income month, the obligor must pay the “average monthly amount” each month until a high income month is reached, at which time the unequal monthly payment schedule will begin.This order varying the monthly support amount applies only to the support amount for the number of children listed on the first line in paragraph 5. When support is no longer owed for the first child, the seasonal variation in monthly support amounts? must be recalculated. ? will be as follows FORMTEXT ?????8.Application of Civil Rule 90.3 Formula.The amount of child support in paragraph 5 was determined pursuant to:a. ? The formula in Civil Rule 90.3(a) or (b).b. ? 90.3(c)(2). Obligor’s adjusted annual income is over $120,000.c. ? 90.3(c)(3). Obligor’s calculated amount of support is less than $600 per year so the $600 minimum was ordered. Obligor’s income is low because obligor is:? incarcerated.? unable to work because FORMTEXT ?????? other: FORMTEXT ?????d. ? 90.1(c)(1). The court finds good cause upon clear and convincing evidence that manifest injustice would result if the support award were not varied. Reason(s) for the variation: FORMTEXT ?????The amount of support which would have been required but for this 90.3(c)(1) variation is $ FORMTEXT ????? for FORMTEXT ????? children per month to be paid by the ? Parent A ? Parent B. The estimated value of any property conveyed instead of support calculated under 90.3 is $ FORMTEXT ?????.9.Medical Support Order. AS 25.27.060(c) and Civil Rule 90.3(d)(1). This order concerns health insurance for the child(ren) covered by this child support order. It does not concern health insurance for any other children or for the parents.a.Current Coverage.? The? obligor? obligee must purchase health insurance for the child(ren) because such insurance is available at reasonable cost through his/her employer, union or otherwise. Name and address of employer/union through which insurance will be purchased: FORMTEXT ?????The insurance cost (currently $ FORMTEXT ????? per month) will be divided between the parties equally unless a different division of the cost is ordered. The child support calculation in paragraph 5 includes:? a credit of $ FORMTEXT ????? per month (50% of the cost to the obligor) for health insurance purchased for the child(ren) by the obligor. If the obligor fails to purchase the insurance, the monthly child support obligation will increase by this amount, without further order of the court, until the obligor purchases the insurance and provides proof of the purchase to the other parent and to the Child Support Services Division (CSSD) if CSSD is handling collections.? an extra $ FORMTEXT ????? per month (50% of the cost to the obligee) for health insurance purchased for the child(ren) by the obligee. If the obligee fails to purchase the insurance, the monthly child support obligation will decrease by this amount, without further order of the court, until the obligee purchases the insurance and provides proof of the purchase to the other parent and to the Child Support Services Division (CSSD) if CSSD is handling collections.If the cost of the insurance changes, the amount of the child support obligation will be adjusted accordingly, without further order of the court. The parent purchasing the insurance shall provide documentation of the change to the other parent and to the Child Support Services Division (CSSD) if CSSD is handling collections. If either parent believes the cost of the insurance has become unreasonable, that parent may file a motion asking the court to suspend the requirement that insurance be purchased.? The children are eligible for services through? the Indian Health Service? military medical benefitsbut these services are not available in the area where the children live. Therefore, insurance must be purchased as stated above until these services become available.? The children are eligible for services through? the Indian Health Service? military medical benefitsand these services are available to the children. Therefore, no additional insurance is required while these services are available.? Health insurance for the child(ren) is not now available at reasonable cost or its availability is unknown.b.Future Coverage. If there is no health care coverage for the child(ren) and insurance becomes available to a parent at a reasonable cost, that parent must purchase the insurance after giving notice to the other parent. The cost of the insurance must be divided between the parents equally unless a different division of the cost is ordered. Without further order of the court, the monthly child support obligation will increase by 50% of the cost of the insurance if the obligee purchases it and decrease by 50% of the cost of the insurance if the obligor purchases it, unless otherwise ordered. If the parents disagree about whether the cost of insurance is reasonable or about which insurance policy should be purchased, either parent may file a motion asking the court to resolve the dispute.rmation for Other Parent. The parent purchasing the insurance must notify the insurance company that the other parent can apply for benefits on behalf of the child(ren) and should be reimbursed directly. The purchaser must also provide coverage information to the other parent and all forms and instructions necessary to apply for benefits. The parent with insurance who receives statements or Explanations of Benefits from the insurance company regarding any of the children must send a copy to the other parent upon request.10.Uncovered Health Care Expenses (including medical, dental, vision and mental health counseling expenses). Civil Rule 90.3(d)(2) and (f)(5).The cost of the child(ren)'s reasonable health care expenses not covered by insurance must be paid as follows, unless the expenses exceed $5,000 in a calendar year:? Obligor will pay half and obligee will pay half.? Obligor will pay FORMTEXT ????? and obligee will pay FORMTEXT ?????because FORMTEXT ?????A party shall reimburse the other party for his or her share of the uncovered expenses within 30 days after receiving the health care bill, proof of payment and, if applicable, a health insurance statement showing what part of the cost is uncovered. The bill and other materials should be sent within a reasonable time. If the uncovered expenses exceed $5,000 in a calendar year, the expenses must be allocated based on the parties’ relative financial circumstances when the expenses occur.11.Travel Expenses. Civil Rule 90.3(g)Travel expenses which are necessary to exercise visitation will be allocated between the parties as follows: FORMTEXT ?????12.INCOME WITHHOLDING ORDER. Unless one of the following boxes is checked (or CSSD later authorizes an exemption for one of these reasons), the obligor, any employer of the obligor and any person, political subdivision, department of the State, or other entity possessing property of the obligor shall immediately withhold from the obligor's income and any other money due the obligor the amount of child support due pursuant to AS 25.27.062 and shall pay this amount to the Child Support Services Division.? The parties have agreed on the alternative arrangement described in the attached document signed by both parties.? The court finds good cause not to require immediate income withholding because it would not be in the best interests of the child(ren) for the following reason: NOTEREF _Ref394120366 \h \* MERGEFORMAT FORMTEXT ?????? The obligor is receiving social security or other disability compensation that includes regular payments to the child(ren) at least equal to the support owed each month. To the extent these payments to the child(ren) do not satisfy the monthly amount owed, the remaining amount due shall be withheld from the obligor's income pursuant to AS 25.27.062.Even if one of the above boxes is checked, exempting the obligor from immediate income withholding, such withholding may be initiated under AS 25.27.062(c) through the court or through CSSD.13.CSSD Services. All child support payments must be made to the Child Support Services Division (CSSD) if one of the parties applies for the services of CSSD. In addition, if the above income withholding order is served on the obligor’s employer or anyone holding money belonging to the obligor, the money withheld pursuant to the order must be paid to CSSD.? An application for CSSD services has been made.? No application for CSSD services has been made at the time of this order.When payments are made through CSSD:Payments must include the case number and names of both parties and must be made payable to the CHILD SUPPORT SERVICES DIVISION, PO Box 100380, Anchorage, Alaska 99510-0380. CSSD shall disburse the payments as required by law after deducting any fee required by law.CSSD shall maintain a record of support payments.c.Interest will be imposed in accordance with AS 25.27.020 on payments which are 10 or more days overdue or if payment is made by a check backed by insufficient funds. No interest will be charged, except on arrearages more than 30 days past due, if payments are made under an income withholding order.d.The parties shall notify CSSD, in writing, of any change in their mailing or residence addresses within 5 days after any such change.e.The obligor shall keep CSSD informed of the name and address of his or her current employer. Whenever employment changes, the obligor must notify CSSD in writing within 20 days. This employment information must be given to the obligee instead of CSSD if CSSD is not enforcing the order.f.The party ordered to provide insurance shall provide to CSSD proof of medical insurance coverage for the children within 20 days of this order. If insurance becomes unavailable, that party shall notify CSSD within 20 days. When insurance again becomes available, that party must, within 20 days, give CSSD proof that the children are insured. The above proof and notice of insurance must be given to the other party instead of CSSD if CSSD is not enforcing the order.g.If a party applies for CSSD services:CSSD shall take whatever enforcement action is deemed legally proper, including recommending contempt proceedings against the party ordered to pay support. Failure to pay support as ordered may result in execution against the property of the obligor or arrest of the obligor.(2)Either party may ask CSSD to review the amount of child support. CSSD may require that the request be made in writing on a form specified by CSSD. The parties shall provide income information requested by CSSD in connection with a review of the amount of child support within 20 days after the date the request is mailed.(3)Unless the box below is checked, CSSD may issue a withholding order, pursuant to AS 25.27.062 or AS 25.27.250, to attach funds owed to the obligor by any corporation created by the Alaska Native Claims Settlement Act (ANCSA) or any settlement trusts established pursuant to section 39 of ANCSA, codified at 43 USC 1629e. Upon service of such an order, the obligor's dividends, distributions and/or other periodic monetary benefits of ANCSA stock or benefits paid by a settlement trust shall be transferred to the child support obligee pursuant to the terms of the withholding order. The ANCSA corporation or settlement trust shall pay the funds so transferred to CSSD for distribution to the child support obligee. The obligor is prohibited from transferring, selling or otherwise alienating his/her ANCSA stock or trust benefits after CSSD issues a withholding order based on an arrearage.? CSSD is not authorized to issue the withholding order described above because FORMTEXT ?????But, CSSD may issue a withholding order if obligor accrues arrears more than two times the monthly support obligation under this order.14.Effect of Assignment of Right to Child Support to State. This order does not bind the Child Support Services Division of Alaska or of any other state to the child support herein ordered if the person receiving child support is receiving or has currently applied for welfare benefits and assigns his or her rights to child support to the state. AS 25.27.120 - .130. If child support rights are assigned to the state, any alternative arrangement for immediate income withholding will not be allowed unless approved by CSSD.15.Application For Permanent Fund Dividend (PFD) Required. AS 22.10.025(b)Unless the following box is checked, the party ordered to pay support is ordered to apply for an Alaska Permanent Fund Dividend (PFD) if he or she is an Alaska resident and is more than two months in arrears as of December 31 of the previous year. The party shall submit a complete and accurate PFD application to the Permanent Fund Dividend Division by January 15 and shall timely submit any supplemental information or documentation requested by the Permanent Fund Dividend Division. If the party is not eligible for a dividend, the party must file proof of non-eligibility with CSSD if CSSD is enforcing this support order. ? The party ordered to pay support is not required to apply for an Alaska Permanent Fund Divided because: FORMTEXT ?????16.Notice to Party Ordered to Pay Support (Obligor).a.You must pay the amount of support stated in this order. You cannot give gifts, clothes, food, or other things instead of paying this money.b.You must pay support on time. You are not excused from paying even if the other party denies you visitation with the child(ren). If you are denied visitation, you can file a motion to enforce visitation with the court, but you must still pay the child support.c.You must pay child support before your other bills and debts. Child support payments have priority over most other debts.d.If you get married or take on an obligation to support someone else, you will still be expected to make all the payments ordered in this order. If you fail to do so and a case is brought against you to enforce payment, your new obligations will not excuse your failure to pay.17.Notice to Both Parties: If your situation changes, ask the court to change this order right away. This child support order is based on:your current income, andyour current custody and visitation arrangement.If either changes significantly (for example, if a child starts living with a different parent), you can ask the court to change the custody order or child support order. The court has forms to help you do this (the DR-700 Packet).It is very important to ask the court as soon as a change occurs because child support cannot be changed retroactively (that is, a new order cannot cancel the amount ordered to be paid in the past).Past due amounts continue to remain due even if the person owed support does not ask for payment (except in the special situation described in Civil Rule 90.3(h)(3)). With interest added, these past due amounts can grow into a substantial debt.Once a year, either party can ask the other party to provide documents such as tax returns and pay stubs showing the party’s income for the prior calendar year. The request must be in writing and the party making it must attach copies of his or her tax return and pay stubs to the request. The other party must respond with documentation of his or her income within 30 days.18.Other: None. FORMTEXT ?????Superior Court JudgeDateType or Print Judge's Name-17335512890500I certify that on FORMTEXT ????? I sent a copy of this order to:? CSSD with:? DR-314 Confidential Info Sheet (REQUIRED for all cases)? The DR-315 Application for CSSD Services (if filed) ? Both Parties (list): FORMTEXT ?????? Attorneys (list): FORMTEXT ?????? If 8.d on page 4 is checked, I also sent a copy to the Administrative Director of the CourtSystem by email to ordersthatdeviate@akcourts.us? If 9.a on page 4 is checked, I also sent a copy of this order & the DR-330 Notice** to: FORMTEXT ????? Employer(s) of:? Obligor? ObligeeClerk/Judicial Assistant: FORMTEXT ????? A copy of the order and the DR-330 Notice to Employer Re: Children’s Medical Insurance must be sent to the employer of the party ordered to purchase insurance for the children if that party is eligible for family health care coverage through his/her employer. AS 25.27.063(b).CourtView Instructions: Enter this order and disposition (interim, final) into CourtView’s petitionscreen. ................
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