____________________________________ (name), referred to as Husband, located at  ___________________________________________ (address) and _______________ (name), referred to as Wife, located at ______________________________________ (address), agree:


Husband is obligated to pay child support to Wife for the care of _______ (number) children who are listed as follows:


1).  _________________________  _________  _________________

      (Name)                                         (Age)           (Date of Birth)


2).  _________________________  _________  _________________

      (Name)                                         (Age)           (Date of Birth)


3).  _________________________  _________  _________________

      (Name)                                         (Age)           (Date of Birth)


4).  _________________________  _________  _________________

      (Name)                                         (Age)           (Date of Birth)


The present payment for such child support equals ______________ Dollars ($_________) paid every ________________ (week, month, etc.). Due to

_________________________________________________ (Reason for Suspension)

the parties agree that payment of support shall be suspended beginning on __________ (month & day), _____ (year), and ending on ____________________ (month & day), __________ (year).


No future repayment of the amount of child support not paid shall be required.

This agreement may be entered at the discretion of either party before the ___________

_____________________________________________ (name and location of court)

in case number _______________.


This is the entire agreement between the parties and may only be modified in writing executed by the parties hereto.


Dated: ___________________




(Signature of Wife)



(Signature of Husband)



Appropriate acknowledgment by Notary Public