APPENDIX 4


Non-residential parent shall be entitled to parenting time per Local R. 8.021, except as modified below. As long as one of the parties resides outside the State of Ohio, paragraphs C, D, and F of Loc. R. 8.021 are amended. The non-residential parent shall be entitled to:

A) Six (6) weeks visitation during the children's summer vacation from school.
C) Extended visitation at Christmas time, in the first year from the day after the last day of school through December 26, in the second year from December 27 to the day before school commences again and alternating in the same sequence thereafter.

D) Visitation - Whenever non-residential parent is in the state in which the residential parent resides, and after at least 24 hours notice, for a reasonable period of time considering the circumstances.

E) Visitation - Whenever residential parent is in the state in which non-residential parent resides he/she shall notify non-residential parent that he/she may visit with the children for a reasonable period of time considering the circumstances.

F) In all events, a reasonable period of time shall beat least those periods established in Local R. 8.021.

G) Whenever possible the children shall spend Father's Day and Mother's Day with the appropriate person.

H) Each parent shall have access personally or telephonically to the child on that child's birthday.

I) Non-residential parent shall be permitted to telephone the children at 6:00 P.M. Eastern time on alternate Sundays commencing the first week after the order and thereafter and residential parent shall make sure that the children are available to receive the calls.

J) The parties shall exchange all pertinent addresses, phone numbers and other necessary information to implement these orders.

K) Costs of transportation shall be borne by the party that has chosen to relocate outside of the State of Ohio subject to the discretion of the Court in light of the financial circumstances of the parties.
APPENDIX 5

SUPPORT ORDERS

IT IS FURTHER ORDERED that (Name of Obligor), SSN: ____________, born , living at _________________________, shall pay $ per month, plus two percent administrative fee commencing __________________ . (Name of Obligor) is currently employed by ___________________ All payments shall be made through Ohio Child Support Central, P.O. Box 182372, Columbus, Ohio 43218. Questions can be addressed to Miami County CSEA, 2040 N. Co. Road 25A, Troy, Ohio 45373, telephone number (937) 339-2919. (Name of Obligor) shall make the payments to Ohio Child Support Central until appropriate withholdings are issued and deductions begin.

All child support under this order shall be withheld or deducted from the wages or assets of the Obligor pursuant to a withholding or deduction notice or appropriate court order issued and forwarded to the Obligee in accordance with O.R.C. Sections 3121.01 et seq.

The Obligor is restrained from making payments directly to the Obligee and the Obligee is restrained from accepting direct payments from the Obligor. Any payments not made through the Miami County CSEA shall be deemed a gift.

The Obligor shall notify the Miami County CSEA in writing of any change in employment. This is an ongoing duty and failure to provide said notification may make the Obligor liable for retroactive support that would have been ordered.

The Obligee shall notify the Miami County CSEA of any change in the child’s status, which would terminate the duty of support.

If the Obligor is in default under this support order and has a claim against a third party of more than One Thousand Dollars, the Obligor shall notify the CSEA of the claim, including the nature of the claim and the name of the person or entity against whom the claim exists.

EACH PARTY TO THIS SUPPORT ORDER MUST NOTIFY THE CHILD SUPPORT ENFORCEMENT AGENCY IN WRITING OF HIS OR HER CURRENT MAILING ADDRESS, CURRENT RESIDENCE ADDRESS, CURRENT RESIDENCE TELEPHONE NUMBER, CURRENT DRIVER’S LICENSE NUMBER, AND OF ANY CHANGES IN THAT INFORMATION. EACH PARTY MUST NOTIFY THE AGENCY OF ALL CHANGES UNTIL FURTHER NOTICE FROM THE COURT.

IF YOU ARE THE OBLIGOR UNDER A CHILD SUPPORT ORDER AND YOU FAIL TO MAKE THE REQUIRED NOTIFICATIONS YOU MAY BE FINED UP TO $50 FOR A FIRST OFFENSE, AND $500 FOR EACH SUBSEQUENT OFFENSE. IF YOU ARE AN OBLIGOR OR OBLIGEE UNDER ANY SUPPORT ORDER AND YOU WILLFULLY FAIL TO MAKE THE REQUIRED NOTIFICATIONS YOU MAY BE FOUND IN CONTEMPT OF COURT AND MAY BE SUBJECTED TO FINES UP TO $1000 AND IMPRISONMENT FOR NOT MORE THAN 90 DAYS.

IT IS FURTHER ORDERED that the parties shall provide for (Name of Child)’s_ health care needs in accordance with the Standard Order of Health Care Needs for Dependent Children and Additional Order of Health Care Needs for Dependent Children attached hereto.
APPENDIX 6

STANDARD ORDER OF HEALTH CARE NEEDS FOR DEPENDENT CHILDREN

The parties shall comply with the Court’s Standard Order of Health Care Needs for Dependent Children and the parents shall be responsible for payment of the medical expenses pursuant to
Option __________ of the following schedule:

(1) HEALTH INSURANCE PROVIDED BY OBLIGOR’S GROUP INSURANCE

IT IS THEREFORE ORDERED that Obligor shall provide group health insurance coverage if available at a reasonable cost for the dependent children pursuant to the Dependent Health Care Order filed herewith.

IT IS THEREFORE ORDERED that Obligor and Obligee shall take notice of the Additional Order of Health Care Needs for Dependent children attached hereto and incorporated herein by reference.

Obligee shall be responsible for the first $100.00 incurred per child per calendar year of uninsured medical, dental and optical expenses.

Costs of the remaining medical, dental, optical and all psychological expenses shall be shared equal unless otherwise agreed as follows: ________________________________


(2) HEALTH INSURANCE PROVIDED BY OBLIGEE’S GROUP INSURANCE

IT IS THEREORE ORDERED that Obligee shall provide group health insurance coverage if available at a reasonable cost for the dependent children pursuant to the Dependent Health Care Order filed herewith.

IT IS FURTHER ORDERED that Obligee shall take notice of the Additional Order of Health Care Needs for Dependent Children attached hereto and incorporated herein by reference.

Obligee shall be responsible for the first *100.00 incurred per child per calendar year of uninsured medical, dental, and optical expenses.

Costs of the remaining medical, dental, optical and all psychological expenses shall be shared, equally unless otherwise agreed as follows: ______________________

(3) IN THE EVENT BOTH OBLIGOR AND OBLIGEE HAVE GROUP HEALTH INSURANCE AVAILABLE

IT IS THEREFORE ORDERED that Obligor and Obligee shall provide group health insurance coverage if available, at a reasonable cost, for the dependent children pursuant to the Dependent Health Car. Orders filed herewith.

IT IS FURTHER ORDERED that Obligor and Obligee shall take notice of the Additional Order of Health Care Needs for Dependent Children attached hereto and incorporated herein by reference.

Obligee shall be responsible for the first $100.00 incurred per child per calendar year of uninsured medical, dental and optical expenses.

Costs of the remaining medical, dental, optical and all psychological expenses shall be shared equally, unless otherwise agreed as follows ___________________________________________

(4) IN THE EVENT NEITHER OBLIGOR NOR OBLIGEE HAS GROUP HEALTH INSURANCE AVAILABLE AT A REASONABLE COST.

IT IS THEREFORE ORDERED since no health Insurance for dependent children is available at a reasonable cost. Obligee shall be responsible for the first * 100.00 Incurred per child par calendar year of uninsured medical, dental and optical expense.

Cost of the remaining medical, dental, optical and al psychological expense shall be shared equally, unless otherwise agreed as follows ___________________________________________

IT IS FURTHER ORDERED that Obligor and Obligee shall take notice of the Additional Order of Health Care Needs for Dependent Children attached hereto and Incorporated herein by reference.

IT IS FURTHER ORDERED that if after the Issuance of this order a group health insurance becomes available for the dependant children at a reasonable cost through a plan offered by the Obligor’s or Obligee’s employer or through any other group health insurance plan, available to Obligor or Obligee said party shall immediately notify the Miami County Child Support Enforcement Agency, 2040 N. County Road 25.A.Troy. OH 45373 in writing of the available Insurance company name and address and policy number.



ADDITIONAL ORDER OF HEALTH CARE NEEDS FOR DEPENDENT CIIILDREN


. Pursuant to R.C. 3113.217 (C) obligor and obligee slid take notice that all children subject of a child support order (hereinafter “children”) must have health insurance coverage provided as set out below. The parties may reach agreement accordingly, or the court will determine based on testimony. Once the health insurance coverage for children becomes an order, the parties have thirty (301 days to comply with all provisions.

1. Health insurance coverage shall be provided through a group insurance policy (i) offered by the employer of the obligor, (ii) through another group health insurance plan when available to the obligor, (iii) offered by the employer of the obligee or (iv) through another group health insurance plan available to the obligee. whichever group policy is available for the most reasonable cost.

2. When the obligor is providing the health insurance coverage, obligor shall supply obligee with (i) insurance forms necessary to receive payment reimbursement, or other benefits. (ii) with necessary insurance cards, and (iii) obligor shall notify the insurance company that all reimbursement for expense covered under the policy and paid for by the obligee on behalf of insured children. shall be paid to obligee upon filing of necessary insurance or claim forms.

3. Obligor and Obligee shall designate the children as covered dependents on any health insurance plan for which they contract.

4. Obligor and obligee shall share the costs of any uninsured extraordinary medical, dental, optical or psychological expenses including co-payments and/or deductibles under the health insurance plan(s) that cover the children in equal amounts. Obligee shall be responsible for uninsured ordinary medical, dental and optical expenses including co-payments and/or deductibles. Ordinary medical expense shall be defined as the first $100.00 incurred per child per calendar yea of uninsured medical, dental and optical expenses including co-payments and/or deductible costs of the remaining extraordinary medical, dental optical and all psychological expense (extraordinary expenses are defined as those expenses in excess of $100.00 per child per calendar year.

5. When health insurance coverage for the children is not available to either obligor or obligee through employment or through another group health insurance plan at a reasonable cost, then obligor and obligee shall share liability for the cost of extraordinary medical, dental, optical or psychological expenses in equal amounts. Obligee shall be responsible for ordinary medical, dental and optical expenses. Thereafter, when any group health insurance plan becomes available to either obligor or obligee said party shall immediately notify the Miami County Child Support Enforcement Agency.

6. If obligor is ordered (i) to provide health insurance coverage and (ii) to assure access to insurance forms, cards and reimbursement to obligee and fails to comply, the court shall order obligor’s employer to enroll the obligor and children in available group health insurance and to deduct from obligor’s earnings, the amount necessary to pay for the coverage.

7. While a medical insurance order is in effect, obligor’s employer shall comply with R.C. 3113.217(C) and with court orders and shall release to obligee or the Miami County Child Support Enforcement Agency information on health insurance coverage, including, but not limited to, the name and address of the insurance company and policy number.

8. Any insurance company providing group health insurance to obligor and obligee must comply with R.C. 3113.217 and court orders.