Motion To Modify Child Support Forms Package Page 15
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3614. Payment of Extraordinary Child-Rearing Costs of the Children
a. Extraordinary Child-Rearing Costs INCLUDED on Form 14
Extraordinary Child-Rearing Costs Paid by
Amount of Expense
Father INCLUDED on Form 14
Form 14
$___________ per month
_______________________________________________________
$___________ per month
_______________________________________________________
$___________ per month
_______________________________________________________
The total cost of these extraordinary child-rearing costs of the children is $___________ per month.
This amount HAS been included in the child support calculation pursuant to Form 14. (You must include
this amount on Form 14 - Line 6e)
Extraordinary Child-Rearing Costs Paid by
Amount of Expense
Mother INCLUDED on Form 14
$___________ per month
_______________________________________________________
$___________ per month
_______________________________________________________
$___________ per month
_______________________________________________________
The total cost of these extraordinary child-rearing costs of the children is $___________ per month.
This amount HAS been included in the child support calculation pursuant to Form 14. (You must include
this amount on Form 14 - Line 6e)
b. Extraordinary Child-Rearing Costs NOT INCLUDED on Form 14
Extraordinary Child-Rearing Costs Paid by
Percentage to be Paid by
Father NOT INCLUDED on Form 14
Mother to Father
_______________________________________________________
_______%
_______________________________________________________
_______%
_______________________________________________________
_______%
Mother will reimburse Father for the percentage amount of each of these extraordinary child-rearing costs
of the children so long as they are actually paid by Father. No reimbursement of extraordinary child-
rearing costs of the children will be allowed unless Father submits proof of such expense to Mother in
writing within 120 days of the date said expenses were incurred. Except for good cause, no legal
proceedings seeking reimbursement will be allowed unless instituted within 360 days of the date said
expenses were incurred.
Extraordinary Child-Rearing Costs Paid by
Percentage to be Paid by
Mother NOT INCLUDED on Form 14
Father to Mother
_______________________________________________________
_______%
_______________________________________________________
_______%
_______________________________________________________
_______%
Father will reimburse Mother for the percentage amount of each of these extraordinary child-rearing costs
of the children so long as they are actually paid by Mother. No reimbursement of extraordinary child-
rearing costs of the children will be allowed unless Mother submits proof of such expense to Father in
writing within 120 days of the date said expenses were incurred. Except for good cause, no legal
proceedings seeking reimbursement will be allowed unless instituted within 360 days of the date said
expenses were incurred.
Parenting Plan Part B - Support – Page 7
Form CAFC501-08/29/2009
This form is available for free at
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