Request For The Termination Of A Child Support Order Form - Ohio
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1REQUEST FOR THE TERMINATION OF A CHILD SUPPORT ORDER
Ohio Revised Code Sections 3119.87 – 3119.93
SETS Number: _________________________
Order Number:________________________
__________________________ and/or _______________________ hereby request that the child support order
Obligee(person who receives support)
Obligor(person who pays support)
for ____________________________________________________be terminated for one of the following reasons:
list child(ren)’s names
The child turned 18 and is no longer attending an accredited high school on a full-time basis. Child turned 18 on
_________
and the child graduated or withdrew from ____________________
on __________
(date)
(name of school)
(date).
The child turned 19 on ____________
The child passed away on ___________
(date)
(date)
The child was married on ___________
The child was deported on __________
(date)
(date)
The child enlisted in the military on ___________
(date)
The child emancipated on __________
for the following reason: ______________________________________
(date)
The parties reconciled and are living together with the child(ren) as of ______________
(date)
Change of legal custody of the child (parties must provide documentation/court order verifying that a legal change
of custody has occurred)
**************************************************************************************************
CHECK ONE
Further, I, ____________________, knowingly and voluntarily state that, if the current child support obligation is
Obligee
terminated, I wish to waive the arrearage (back due child support) owed to me by Obligor, and to reduce the balance
due to me to zero. NOTE: If this option is chosen, the obligee’s signature must be notarized.
OR
Further, I, ____________________, do not wish to waive the arrearage (back due child support) and request that the
Obligee
CSEA continue to collect the arrearage (back due child support) if the current child support obligation is terminated.
Any arrearage owed to the State of Ohio must be repaid by Obligor.
**************************************************************************************************
_____________________________________________
____________________________________________
Obligee’s (person who receives support) signature
Obligor’s (person who pays support) signature
_____________________________________________
____________________________________________
Obligee’s name
Obligor’s name
_____________________________________________
____________________________________________
Address
Address
_____________________________________________
____________________________________________
City, State, Zip Code
City, State, Zip Code
_____________________________________________
____________________________________________
Phone Number
Phone Number
Sworn to before me and subscribed in my presence
this _______ day of __________________, 20____.
_________________________________________
Notary Public
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