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Back to Forms for 'Husband and Wife'.





____________________________________ (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)


As of ___________ (month & day), _________ (year), Husband is presently in arrears in child support payments in an amount totaling ________________________ Dollars ($ __________).  The present payment for such child support equals ______________ Dollars ($ ___________) paid ___________ (weekly/monthly).


The parties agree that the arrears shall be repaid as follows:


The payment shall be changed to _______________ Dollars ($___________), without interest, to be paid _______________ (weekly/monthly) until the amount in arrears is paid in full,.


In addition, Husband shall also pay attorney fees in the amount of ________________ Dollars ($______________).  Such payment shall be made by Husband no later than _____________________ (month & day), __________ (year).


So long as payments are made as provided for herein, Husband shall take no further action in regards to the arrears.


In the event that Husband fails to pay as agreed, the repayment of the entire amount of arrears shall be due immediately.


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



_________________________                                           ____________________

(Signature of Husband)                                                          (Date)


_________________________                                           ____________________

(Signature of Wife)                                                                (Date)


_________________________                                           ____________________

(Witness for Husband)                                                           (Date)


_________________________                                           ____________________

(Witness for Wife)                                                                 (Date)



________________________                                 My commission expires on:

(Notary Public)




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