Stipulation To Terminate An Income Withholding Order

Petitioner's Name: Mailing Address: City, State, Zip: Phone Number: Representing Self Respondent's Name: Mailing Address: City, State, Zip: Phone Number: Representing Self SUPERIOR COURT OF ARIZONA, COUNTY OF COCONINO Petitioner's Name on the Petition that started this case: Case Number: DO STIPULATION TO TERMINATE AN INCOME WITHHOLDING ORDER Respondent's Name: ATLAS Number: We ask the court to terminate the Income Withholding Order dated because the following is true or will be true by 90 days after we file this Stipulation: [] [] [] All past-due court-ordered amounts have been paid. All past-due court-ordered amounts have been waived. The court-ordered child support obligation has ended for all the children because: Is at least 18 and Child's Name not in high school Is married Has been adopted Is deceased [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] [] Other: Current Child Support Order Date: Monthly Amount: $ [] The court-ordered spousal maintenance obligation has ended because: [] The receiving party is [ ] remarried or [ ] deceased. [] Other: Page 1 of 2 Revised January 2013 American LegalNet, Inc. www.FormsWorkFlow.com Coconino County Law Library and Self-Help Center Forms [] Other: Paying Party's Employer or Other Payor's Name: Address: Sign in front of a notary, or in front of the Court Clerk when you file. The person signing must bring photo ID. Notaries are at most banks or listed in the Yellow Pages. Notaries usually charge a fee. Petitioner's Signature: State of Arizona County of Subscribed and sworn before me this date: Seal: ) ) ) by: Notary Public: Notary Expiration Date: Respondent's Signature: State of Arizona County of Subscribed and sworn before me this date: Seal: ) ) ) by: Notary Public: Notary Expiration Date: Attorney General's Office's Signature (If either parent receives Title IV-D services from DCSE) Printed Name: State of Arizona County of Subscribed and sworn before me this date: Seal: ) ) ) by: Notary Public: Notary Expiration Date: American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2 Revised January 2013 Coconino County Law Library and Self-Help Center Forms