Petition For Dissolution Of Marriage Form Page 9
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15V.
VISITATION AGREEMENT
A. Visitation Rights of Parents.
We agree
will have the following specific visitation rights:
summer vacation:
holidays:
weekends:
other:
[If you want child support reduced, you must specify dates as explained in section V, page
11, of the Instructions.]
Our agreement concerning visitation is contained in the attached Model Parenting
Agreement (form DR-475)
B. Visitation Rights of Other Persons (grandparents, etc.)
Names of Other Persons:
Describe visitation agreement:
VI. CHILD SUPPORT (Civil Rule 90.3)
A. Child Support Calculation
Husband
Wife
1.a. Adjusted Annual Income (from II.D. on page 4)
$
$
b. If line 1.a. is more than $120,000, write
$120,000 here. Otherwise, repeat amount
on line 1.a.:
2.
Multiply line 1.b. by:
.20 for one child;
.27 for two children;
x
x
.33 for three children; and
.03 for each additional child
TOTAL
ANNUAL CHILD SUPPORT
$
$
(amount from “TOTAL” line above or $600, whichever is larger.)
Husband’s Signature
Wife’s Signature
Page 9 of 15
DR-105 FBKS (10/14)(cs)
AS 25.24.200-.260
PETITION FOR DISSOLUTION OF MARRIAGE (WITH CHILDREN)
Civil Rule 90.1(a)
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