Fillable Dissolution Agreement (Page 2 of 2) in pdf

Dissolution Agreement Page 2

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6. As to Child Care Costs that qualify under the Guidelines:

This amount follows the Guidelines.

This amount is different from the Guidelines (deviation). Give reason for deviation from the Guidelines (see

Guidelines for reason that applies):

7. As to post-majority educational support ("x" one):

Both of the parties have made a knowing and intelligent waiver of their right to request a post-majority educational

support order; or

The parties ask the Court to reserve jurisdiction to determine whether a post-majority educational support order

should issue and the terms of the order; or

The parties ask the Court to find that it is more likely than not that the parents would have provided post-majority

educational support, and for the Court to reserve jurisdiction to determine whether to enter an educational support

order and the terms of the order; or

The parties ask the Court to enter a post-majority education support as follows (Attach additional sheets if

necessary):

8. As to alimony:

9. As to income withholding, we understand that the support orders are by immediate income withholding unless for cause

or we both agree to it being contingent: We agree to a(n)

income withholding.

Immediate

Contingent

10. As to division of property:

As to real property

As to personal property

11. As to division of debts:

12. As to the change of name:

Plaintiff's name is restored to the

birthname of

former name of

Defendant's name is restored to the

birthname of

former name of

13. Other:

We certify that the above statements are our agreement.

Plaintiff (Print name)

Date signed

Plaintiff's signature

Date signed

Defendant (Print name)

Defendant's signature

JD-FM-172 (Back) Rev. 7-10

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Dissolution Agreement Page 2

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