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IN THE SUPERIOR COURT OF ROCKDALE COUNTY STATE

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Child Support Order Addendum, Page 1 of 5
Rockdale Judicial Circuit, 7/2020
IN THE SUPERIOR COURT OF ROCKDALE COUNTY
STATE OF GEORGIA
)
Plaintiff, ) Civil Action
)
vs. ) Case Number
)
)
Defendant. )
CHILD SUPPORT ORDER ADDENDUM
Instructions: All parts of this Addendum must be completed and it must be attached to all final
orders and judgments determining the amount of child support. However, it is not required
for orders on contempt motions.
[You must check one of the following boxes.]
( ) The parties have agreed to the terms of this order and this information has been furnished
by both parties to meet the requirements of OCGA §19-6-15. The parties agree on the
terms of the order and affirm the accuracy of the information provided, as shown by their
signatures at the end of this addendum.
or
( ) This addendum includes findings of fact and conclusions of law and fact made by the
Court, in compliance with OCGA §19-6-15.
Application of Child Support Guidelines. The statutory requirements of OCGA §19-6-15 have
been applied in reaching the amount of child support provided under the final order in this
action. The specifics are as follows:
1.
Gross Income - The Father’s gross monthly income (before taxes) is $ ;
the Mother’s gross monthly income (before taxes) is $ .
2.
Number of Children - The number of children for whom support is being provided under
this order is .
3.
Attachments - The Child Support Worksheet and Schedule E are attached and made a part
of this addendum, along with any other applicable schedules.
4.
Child Support Amount - The shall pay to the ,
for the support of the minor children, the sum of Dollars ($ )
per beginning on , 20 .
Child Support Order Addendum, Page 2 of 5
Rockdale Judicial Circuit, 7/2020
5.
Duration of Child Support
[You must check & complete only one of the following paragraphs.]
( ) (a) Beyond Age 18 for High School - The child support shall continue monthly
thereafter until (the)/(all) child(ren) reach(es) the age of eighteen, dies, marries, or
otherwise becomes emancipated; provided that if a child becomes eighteen years old
while enrolled in and attending secondary school on a fulltime basis, then the child
support shall continue for the child until the child has graduated from secondary school or
reaches twenty years of age, whichever occurs first.
( ) (b) Stops at Age 18 - The child support shall continue monthly thereafter until each child
reaches the age of eighteen, dies, marries, or otherwise becomes emancipated.
( ) (c) Until Further Order - This is not a final order, so the child support shall continue
until further order of this Court.
( ) (d) Until Specific Date - The child support shall continue monthly thereafter until
.
6.
Deviation from Presumptive Amount
[You must check & complete only one of the following paragraphs.]
( ) (a) No Deviation - It has been determined that none of the Deviations allowed under
OCGA §19-6-15 applies in this case, as shown by the attached Schedule E. The amount
of support in Paragraph 4 above is the Presumptive Amount of Child Support shown on
the attached Child Support Worksheet.
( ) (b) Deviation - It has been determined that one or more of the Deviations allowed under
OCGA §19-6-15 applies in this case, as shown by the attached Schedule E. The
Presumptive Amount of Child Support that would have been required under OCGA §19-
6-15 if the deviations had not been applied is $ per month, as shown on the
attached Child Support Worksheet. The attached Schedule E explains the reasons for the
deviation, how the application of the guidelines would be unjust or inappropriate
considering the relative ability of each parent to provide support, and how the best
interest of the children who are subject to this child support determination is served by
deviation from the presumptive amount of child support.
7.
Health, Dental & Vision Insurance for Children
[You must check & complete all parts of only one of the following paragraphs, (a) or (b).]
( ) (a) Insurance Available - The following insurance for the children involved in this
action is available at a reasonable cost to the through that parent’s
employer or the PeachCare program:
( ) Health (medical, mental health and hospitalization) ( ) Dental ( ) Vision
Child Support Order Addendum, Page 3 of 5
Rockdale Judicial Circuit, 7/2020
So long as it remains available to that parent, the shall maintain the
types of insurance checked above for the benefit of the minor children, until each child
reaches the age of eighteen, dies, marries, or otherwise becomes emancipated; except that
if a child becomes eighteen years old while enrolled in and attending secondary school on
a full-time basis, then the insurance shall be continued for the child until the child has
graduated from secondary school or reaches twenty years of age, whichever occurs first.
(1)
The parent who maintains the insurance shall provide the other parent with an
insurance identification card or such other acceptable proof of insurance coverage and
shall cooperate with the other parent in submitting claims under the policy.
(2)
All money received by one of the parties for claims processed under the insurance
policy shall be paid within five (5) days after the party receives the money, to the other
party (if that other party paid the applicable health care service provider) or to the
applicable health care provider (if the provider has not been paid by one of the parties).
( ) (b) Insurance Not Available - Insurance (other than Medicaid) is not available at this
time to either party at a reasonable cost. If health insurance for the children later becomes
available to the parent who is required to pay child support for these children, then that
parent must obtain the following types of insurance, unless it is then being provided by
the other parent:
( ) Health (medical, mental health and hospitalization) ( ) Dental ( ) Vision.
When insurance has been obtained by either party, Paragraphs 7 (a)(1) and (2) shall
apply.
8.
Uninsured Health Care Expenses - The shall pay % and
the shall pay % of all expenses incurred for the
children’s health care (including medical, dental, mental health, hospital and vision care)
that are not covered by insurance. The party who incurs a health care expense for one of
the children shall provide verification of the amount to the other party. That other party
shall reimburse the incurring party (or pay the health care provider directly) for the
appropriate percentage of the expense, within fifteen (15) days after receiving the
verification of a particular health care expense.
9.
Parenting Time Amounts - The approximate number of days of parenting time per year
according to the visitation order is days for the Father and days for the
Mother.
10.
Social Security Benefits
[You must check & complete only one of the following paragraphs.]
( ) (a) Not Received - The children do not receive Title II Social Security benefits under the
account of the parent ordered to pay child support.
Child Support Order Addendum, Page 4 of 5
Rockdale Judicial Circuit, 7/2020
( ) (b) Received - The children receive Title II Social Security benefits under the account of
the parent ordered to pay child support. The benefits received by the children shall be
counted as child support payments, and shall be applied against the final child support
order to be paid by that parent.
(1)
If the amount of benefits received is less than the amount of support ordered,
the obligor shall pay the amount exceeding the Social Security benefit.
(2)
If the amount of benefits received is equal to or more than the amount of
support ordered, the obligor’s responsibility is met and no further support shall be
paid.
(3)
Any Title II benefits received for the children’s benefit shall be retained by the
custodial parent or nonparent custodian for the children’s benefit, and it shall not
be used as a reason for decreasing the final child support order or reducing
arrearages.
11.
Modification [You must check & complete only one of the following paragraphs.]
( ) (a) Not Modification Action - This is an initial determination of child support, not a
modification action.
( ) (b) Support Not Modified - This action is a modification action, but the order does not
modify the amount of child support that was previously ordered for these children The
date of the initial support order concerning this child support case was:
.
( ) (c) Support Amount Modified - The order modifies the amount of child support that
was previously ordered for these children. The basis for the modification is:
( ) (1) Substantial change in the income and financial status of the Father;
( ) (2) Substantial change in the income and financial status of the Mother;
( ) (3) Substantial change in the needs of the Children;
( ) (4) The noncustodial parent failed to exercise visitation provided under the prior
order;
( ) (5) The noncustodial parent has exercised more visitation than was provided in the
prior order.
The date of the initial support order concerning this child support case was:
.
12.
Continuing Garnishment for Child Support - Whenever, in violation of the terms of
the order, there shall have been a failure to make the support payments, so that the
amount unpaid is equal to or greater than the amount payable for one month, the
payments required to be made may also be collected by the process of continuing
garnishment for support.
13.
Income Deduction Order
[You must check & complete only one of the following paragraphs: (a), (b) or (c).]
Child Support Order Addendum, Page 5 of 5
Rockdale Judicial Circuit, 7/2020
( ) (a) An Income Deduction Order shall be entered by the Court, under OCGA § 19-6-32, for
payment of the child support and alimony (if any) provided. The Income Deduction
Order shall take effect:
[To finish (a), you must check either (1) or (2). Do not check both.]
( ) (1) immediately upon entry by the Court.
( ) (2) upon accrual of a delinquency equal to one month’s support. The Income
Deduction Order may be enforced by serving a “Notice of Delinquency,” as provided
in OCGA §19-6-32 (f).
( ) (b) The parties agree that an Income Deduction Order is not immediately necessary.
( ) (c) The Court finds that there is good cause not to require income deduction, having
determined that income deduction will not serve the children’s best interests and that there
has been sufficient proof of timely payment of any previously ordered support.
( ) Parties’ Consent - We knowingly and voluntarily agree on the terms of this order. Each of
us affirms that the information we have provided in this Addendum is true and correct.
Father’s Signature Mother’s Signature
Third Party Custodian
or
( ) Contested Hearing.
ORDER
( ) The Court has reviewed the foregoing Child Support Order Addendum, and it is hereby
made the order of this Court.
or
( ) After a hearing in the above styled case, the Court hereby makes the finding of facts as
shown on this Child Support Order Addendum.
This Order entered on the day of , 20
JUDGE, ROCKDALE] SUPERIOR COURT
Rockdale Judicial Circuit
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IN THE SUPERIOR COURT OF ROCKDALE COUNTY STATE

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Completed 11 April 2022

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