Uniform Support Order
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THE STATE OF NEW HAMPSHIRE
JUDICIAL BRANCH
Court Name:
Case Name:
Case Number:
UNIFORM SUPPORT ORDER
Name, Residence and Mailing Address of Person
Name, Residence and Mailing Address of
Ordered to Pay Support (Obligor)
Person Receiving Support (Obligee)
D.O.B.
Telephone
D.O.B.
Telephone
E-mail Address
E-mail Address
Name of Employer:
Name of Employer:
Address of Employer:
Address of Employer:
Child(ren) to whom this order applies:
Full Name
Date of Birth
Full Name
Date of Birth
The following parties appeared:
Obligor
Obligee
Division of Child Support Services
Other
NOTE: SECTIONS PRECEDED BY
ARE ONLY PART OF THIS ORDER IF MARKED.
1. This order is entered:
2.
This order is a:
after hearing
temporary order
upon approval of agreement
final order
upon default
3. This order modifies a final support obligation in accordance with:
a three-year review (RSA 458-C:7) OR
substantial change in circumstances, as
follows:
4. Obligor is ORDERED to PAY THE FOLLOWING AMOUNTS (See Standing Orders 4A-4G):
4.1 CHILD SUPPORT: $
per
(week, month, etc.)
4.2 Arrearage of $
as of
,
payable $
per
(week, month, etc.)
NHJB-2066-FS (07/01/2013)
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