Child Support Modification Agreement Template

This Child Support Modification Agreement (the “Agreement”) is made as of [Effective Date] by and between:

Parent A: [Full Name], address: [Address]

Parent B: [Full Name], address: [Address]

Child(ren): [Names/DOBs]

Existing Order/Agreement: [Court/County], Case No. [__], dated [Date] (the “Existing Order”).

1. Purpose and Court Approval

1.1 The Parents agree to modify child support terms as described below.

1.2 This Agreement is intended to be: ☐ effective upon signature ☐ subject to court approval (if required).

2. Reason for Modification

2.1 Reason(s) for modification (brief):

☐ change in income

☐ change in parenting time/custody schedule

☐ change in childcare/medical costs

☐ other: [Explain]

3. Modified Child Support Payment

3.1 New Support Amount: $[Amount] per ☐ week ☐ biweekly ☐ month.

3.2 Payor: ☐ Parent A ☐ Parent B.

3.3 Recipient: ☐ Parent A ☐ Parent B (or “through state agency,” if applicable).

3.4 Due Date: [Day/date].

3.5 Payment Method: ☐ state payment registry ☐ bank transfer ☐ wage withholding ☐ other: [__].

3.6 Effective Date of New Amount: [Date].

4. Arrears (If Any)

4.1 Existing arrears as of [Date]: $[Amount] (if known).

4.2 Arrears will be handled as follows: [Payment plan / remain per existing order / other].

4.3 This Agreement does not waive child support arrears unless allowed by law and approved by the court.

5. Health Insurance and Medical Expenses

5.1 Health insurance for the child(ren) will be provided by: ☐ Parent A ☐ Parent B ☐ both.

5.2 Uninsured medical/dental/vision expenses will be split: ☐ 50/50 ☐ []% / []%

5.3 Reimbursement timing: within [__] days after receipt of proof of payment.

6. Childcare and Other Shared Expenses

6.1 Childcare costs will be paid: ☐ by Payor ☐ shared [split].

6.2 Extracurricular/school expenses: ☐ shared [split] ☐ pre-approval required over $[__].

6.3 Tax credits/exemptions (optional): [Allocation, if allowed].

7. Continuing Terms

7.1 Except as modified by this Agreement, all other terms of the Existing Order remain in effect.

7.2 If court approval is required and not obtained, the Existing Order remains controlling.

8. Dispute Resolution and Notices (Optional)

8.1 Disputes: ☐ negotiation ☐ mediation ☐ court.

8.2 Notice address/email updates: [Process].

Signatures

Parent A: [Full Name]

Date: [Date]

Signature: ___________________________

Parent B: [Full Name]

Date: [Date]

Signature: ___________________________