Form FOC 10 Uniform Child Support Order - Michigan

Form FOC10 or the "Uniform Child Support Order" is a form issued by the Michigan Circuit Court.

The form was last revised in December 1, 2018 and is available for digital filing. Download an up-to-date Form FOC10 in PDF-format down below or look it up on the Michigan Circuit Court Forms website.

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If you are filing before December 31, 2018, use form
https://courts.michigan.gov/Administration/SCAO/Forms/courtforms/oldfoc10.pdf
Original - Court
2nd copy - Defendant
Approved, SCAO
1st copy - Plaintiff
3rd copy - Friend of the court
STATE OF MICHIGAN
CASE NO.
UNIFORM CHILD SUPPORT ORDER
JUDICIAL CIRCUIT
EX PARTE
TEMPORARY
COUNTY
MODIFICATION
FINAL
If you are filing before
December 31, 2018, use
Court address
Court telephone no.
form
https://courts.michigan.gov/
Plaintiff’s name, address, and telephone no.
Defendant’s name, address, and telephone no.
Administration/SCAO/Form
s/courtforms/oldfoc10.pdf
v
Plaintiff’s attorney name, bar no., address, and telephone no.
Defendant’s attorney name, bar no., address, and telephone no.
Plaintiff’s source of income name, address, and telephone no.
Defendant’s source of income name, address, and telephone no.
This order is entered
after hearing.
after statutory review.
on stipulation/consent of the parties.
The friend of the court recommends child support be ordered as follows.
If you disagree with this recommendation, you must file a written objection with
on or before
21 days from the date this order is mailed. If you do not object, this proposed order will be presented to the court for entry.
Attached are the calculations pursuant to MCL 552.505(1)(h) and MCL 552.517b.
IT IS ORDERED, unless otherwise ordered in item 12 or 13:
Standard provisions have been modified (see item 12 or 13).
1. The children who are supported under this order and the payer and payee are:
Payer:
Payee:
Children’s names, birthdates, and annual overnights with payer:
Children’s names
Date of birth
Overnights
Effective
, the payer shall pay a monthly child support obligation for the children named above.
Children supported:
1 child
2 children
3 children
4 children
5 or more children
Base Support: (includes support plus or minus premium adjustment for health-care insurance)
Support:
$
$
$
$
$
Premium adjust:
$
$
$
$
$
Subtotal:
$
$
$
$
$
Ordinary medical:
$
$
$
$
$
Child care:
$
$
$
$
$
Other:
$
$
$
$
$
Benefit credit:
$
$
$
$
$
Total:
$
$
$
$
$
Support was reduced because payer’s income was reduced.
(Continued on page 2.)
UNIFORM CHILD SUPPORT ORDER
FOC 10/52 (12/18)
MCL 552.14, MCL 552.517, MCL 552.517b(3), MCR 3.211
If you are filing before December 31, 2018, use form
https://courts.michigan.gov/Administration/SCAO/Forms/courtforms/oldfoc10.pdf
Original - Court
2nd copy - Defendant
Approved, SCAO
1st copy - Plaintiff
3rd copy - Friend of the court
STATE OF MICHIGAN
CASE NO.
UNIFORM CHILD SUPPORT ORDER
JUDICIAL CIRCUIT
EX PARTE
TEMPORARY
COUNTY
MODIFICATION
FINAL
If you are filing before
December 31, 2018, use
Court address
Court telephone no.
form
https://courts.michigan.gov/
Plaintiff’s name, address, and telephone no.
Defendant’s name, address, and telephone no.
Administration/SCAO/Form
s/courtforms/oldfoc10.pdf
v
Plaintiff’s attorney name, bar no., address, and telephone no.
Defendant’s attorney name, bar no., address, and telephone no.
Plaintiff’s source of income name, address, and telephone no.
Defendant’s source of income name, address, and telephone no.
This order is entered
after hearing.
after statutory review.
on stipulation/consent of the parties.
The friend of the court recommends child support be ordered as follows.
If you disagree with this recommendation, you must file a written objection with
on or before
21 days from the date this order is mailed. If you do not object, this proposed order will be presented to the court for entry.
Attached are the calculations pursuant to MCL 552.505(1)(h) and MCL 552.517b.
IT IS ORDERED, unless otherwise ordered in item 12 or 13:
Standard provisions have been modified (see item 12 or 13).
1. The children who are supported under this order and the payer and payee are:
Payer:
Payee:
Children’s names, birthdates, and annual overnights with payer:
Children’s names
Date of birth
Overnights
Effective
, the payer shall pay a monthly child support obligation for the children named above.
Children supported:
1 child
2 children
3 children
4 children
5 or more children
Base Support: (includes support plus or minus premium adjustment for health-care insurance)
Support:
$
$
$
$
$
Premium adjust:
$
$
$
$
$
Subtotal:
$
$
$
$
$
Ordinary medical:
$
$
$
$
$
Child care:
$
$
$
$
$
Other:
$
$
$
$
$
Benefit credit:
$
$
$
$
$
Total:
$
$
$
$
$
Support was reduced because payer’s income was reduced.
(Continued on page 2.)
UNIFORM CHILD SUPPORT ORDER
FOC 10/52 (12/18)
MCL 552.14, MCL 552.517, MCL 552.517b(3), MCR 3.211
Uniform Child Support Order (12/18) Page
of
Case No.
1. Item 1 (continued).
Uninsured Health-Care Expenses. All uninsured health-care expenses exceeding the annual ordinary medical amount will
be paid
% by the plaintiff and
% by the defendant. Uninsured expenses exceeding the annual ordinary
medical amount for the year they are incurred that are not paid within 28 days of a written payment request may be enforced
by the friend of the court. The annual ordinary medical amount is
.
Obligation Ends. Except for child care, or as otherwise ordered, support obligations for each child end on the last day of the
month the child turns age 18.
Post-majority Support: The following children will be attending high school on a full-time basis after turning 18 years
of age. Therefore, the support obligation for each specific child ends on the last day of the month as follows, except in
no case may it extend beyond the time the child reaches 19 years and 6 months of age:
(Specify name of child and date obligation ends.)
Child Care. The parties must notify each other of changes in child-care expenses and must additionally notify the friend of
the court if the changes end those expenses. The child-care obligation for each child ends on August 31 following the child’s
12th birthday, at which time the total child care obligation reduces by that child’s pro rata share unless specified differently in
this order.
2. Insurance. For the benefit of the children, the
plaintiff
defendant shall maintain health-care coverage through an
insurer
that includes payment for hospital, dental, optical, and other health-care expenses when
(as defined in MCL 552.602)
that coverage is available at a reasonable cost, including coverage available as a benefit of employment or under an
individual policy
up to a maximum of $
for plaintiff.
up to a maximum of $
for defendant.
not to exceed 6% of the plaintiff's/defendant's gross income.
3. Income Withholding. Income withholding takes immediate effect. Payments shall be made through the Michigan State
Disbursement Unit unless otherwise ordered in item 13.
4. Qualified Medical Support Order. This order is a qualified medical support order with immediate effect pursuant to 29
USC 1169. To qualify this order, the friend of the court shall issue a notice to enroll pursuant to MCL 552.626b. A parent may
contest the notice by requesting a review or hearing concerning availability of health care at a reasonable cost.
5. Retroactive Modification, Surcharge for Past-Due Support, and Liens for Unpaid Support. Except as provided by MCL
552.603, support is a judgment the date it is due and is not modifiable retroactively. A surcharge may be added to past-due
support. Unpaid support is a lien by operation of law and the payer's property can be encumbered or seized if an arrearage
accrues in an amount greater than the periodic support payments payable for two months under the payer's support order.
6. Address, Employment Status, Health Insurance. Both parties shall notify the friend of the court in writing of: a) their
mailing and residential addresses and telephone numbers; b) the names, addresses, and telephone numbers of their sources
of income; c) their health-maintenance or insurance companies, insurance coverage, persons insured, or contract numbers;
d) their occupational or drivers' licenses; and e) their social security numbers unless exempt by law pursuant to MCL
552.603. Both parties shall notify the friend of the court in writing within 21 days of any change in this information. Failure to
do so may result in a fee being imposed.
7. Foster-Care Assignment. When a child is placed in foster care, that child's support is assigned to the Department of Health
and Human Services while under the state's jurisdiction and to the funding county while placed in a county-funded program.
8. Redirection and Abatement. Subject to statutory procedures, the friend of the court: 1) may redirect support paid for a child
to the person who is providing the actual care, support, and maintenance of that child, or 2) shall abate support charges for
a child who resides on a full-time basis with the payer of support.
9. Fees. The payer of support shall pay statutory and service fees as required by law.
(Continued on page 3.)
Uniform Child Support Order (12/18) Page
of
Case No.
10. Review. Each party to a support order may submit a written request to have the friend of the court review the order. The
friend of the court is not required to act on more than one request received from a party each 36 months. A party may also
file a motion to modify this support order.
11. Prior Orders. This order supersedes all prior child support orders and all continuing provisions are restated in this
order. Past-due amounts owed under any prior support order in this case are preserved and paid at the rate calculated
using the arrearage guideline in the Michigan Child Support Formula.
12. Michigan Child Support Formula Deviation. The support provisions ordered do not follow the Michigan Child Support
Formula. The attached deviation addendum (FOC 10d) provides the basis for deviation and the required findings by the
court.
13. Other: (Attach separate sheets as needed.)
Plaintiff (if consent/stipulation)
Date
Defendant (if consent/stipulation)
Date
Plaintiff’s attorney
Date
Defendant’s attorney
Date
Prepared by:
Name (type or print)
Date
Judge
Bar no.
CERTIFICATE OF MAILING
I certify that on this date I served a copy of this order on the parties or their attorneys by first-class mail addressed to their last-
known addresses as defined in MCR 3.203.
I certify that I also served the Deviation Addendum (FOC 10d) with this order.
Date
Signature
COURT USE ONLY

Download Form FOC 10 Uniform Child Support Order - Michigan

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