W - Ohio DR Software_ LLC

I. STATEWIDE FORMS

A. Child Support Worksheets

Child Support Worksheet – Sole/Shared Parenting

Child Support Worksheet – Split Parenting Rights



B. Uniform Domestic Relations Forms

Affidavit 1 - Affidavit of Income and Expenses

Affidavit 2 - Affidavit of Property

Affidavit 3 - Parenting Proceeding Affidavit (R.C. 3127.23(A)

Affidavit 4 - Health Insurance Affidavit

Affidavit 5 - Motion and Affidavit or Counter Affidavit for Temporary Orders without Oral Hearing



II. PLEADINGS LIBRARY



I. OFFICE FORMS IV. TEMPORARY ORDERS

Firm Information Motion for Ex Parte Temporary Orders

Fee Agreement Affidavit in Support of Motion for Ex Parte Temporary Orders

Intake Form Ex Parte Order

Complete Interview Form Motion for Relief from Ex Parte Temporary Order

Personal & Case Interview Form Includes:

Assets and Debts Interview Form Objection to Parenting

Living Expenses Interview Form Objection to Child Support

Objection to Parenting Provision

II. INITIAL PLEADINGS Objection to ―Other Provision‖

Complaint for Divorce Affidavit in Support of Motion for Relief from Ex Parte Temporary

Answer and Counterclaim for Divorce Order

Reply to Counterclaim Motion for Temporary Allocation of Parental Rights and

Complaint for Legal Separation Responsibilities

Complaint for Annulment Affidavit in Support of Motion for Temporary Order

Answer

Petition for Dissolution of Marriage V. TEMPORARY RESTRAINING ORDER AND RELATED

Complaint to Establish Parent Child Relationship and Motions MOTIONS

Instructions for Service Motion for Temporary Restraining Order

Certificate of Prior Filing Affidavit in Support of Motion for TRO

Temporary Restraining Order

III. PARENTING & CHILD SUPPORT FORMS Mutual Temporary Restraining Order

Child Support Worksheet - Sole Residential Parent or Shared Motion for Contempt of Restraining Order

Parenting (2008) Motion to Modify/Terminate Restraining Order

Child Support Worksheet - Split Parental Rights (2008)

Child Support Worksheet - Sole Residential Parent or Shared VI. IN FORMA PAUPERIS

Parenting (2003) Motion for Leave to File In Forma Pauperis

Child Support Worksheet - Split Parental Rights (2003) Motion to Appear In Forma Pauperis

Parenting Affidavit Under ORC 3127.23 Affidavit in Support of Motion to File In Forma Pauperis

Application for Registration of Out-of-State Order Poverty Affidavit

Notice to Withhold (ODJFS 4047 Rev. 8/00) Financial Disclosure/Affidavit of Indigency

Notice to Withhold (ODJFS 4047 Rev. 11/01) Entry Granting Motion to File In Forma Pauperis

Addendum Withholding Notice (ODJFS 4048 Rev. 8/00)

Addendum Withholding Notice (ODJFS 4048 Rev. 11/01 VII. SERVICE BY PUBLICATION

IV-D – Application for Child Support Services (ODHS 7076 Rev. Motion to Serve by Publication

11/92) Affidavit in Support of Motion for Service by Publication

IV-D – Application for Child Support Services (ODHS 7076 Rev. Entry Granting Motion to Serve by Publication

6/98) Notice of Service by Publication

IV-D – Application for Child Support Services (JFS 07076 Rev

9/2001) VIII. SPECIAL PROCESS SERVER

IV-D – Application for Child Support Services (JFS 07076 Rev Motion to Appoint Special Process Server

12/2001) Entry Granting Motion to Appoint Special Process Server

Affidavit of Service by Process Server Motion for In Camera Interview

Motion for Substance Abuse Assessment

IX. WAIVERS Motion to Appoint/Replace Counselor/Psychologist

Motion to/Waiver of Service of Summons Motion to Appoint/Replace Guardian ad Litem

Waiver of Venue Motion to Mediate – Parenting/parenting Provision

Waiver of Representation Motion for Counseling

Waiver of 14 day Objection Period Includes:

Parent and Child

X. SOLDIERS AND SAILOR'S ACT Parents

Military Affidavit B. Motion to Establish/Modify/Terminate Parental Rights and

Motion to Appoint Counsel Responsibilities

Affidavit in Support of Motion to Appoint Counsel Motion to Establish/Modify/Terminate Parental Rights and

Entry Granting Motion to Appoint Counsel Responsibilities

Includes:

XI. DISCOVERY AND RELATED MOTIONS, EVIDENCE Motion for Companionship Rights

ISSUES, AND PRETRIAL STATEMENT Motion for Parenting Provision

Subpoena and Notice of Issuance of a Subpoena to a Third Party Includes‖

Interrogatories Communication/Telephone Number

Request for Production of Documents (Detailed Version) Daycare

Request for Production of Documents (Short Version) Medical Expenses

Interrogatories, Request for Production of Documents, and/or Medical Insurance

Request for Admissions (Form Only) Other

Affidavit for Responses to Interrogatories School District

Motion for In Camera Review of Documents Tax Exemptions

Motion for Protective Order/Non-Disclosure Order Transportation

Motion for Release of Documents Tuition

Motion in Limine Motion for Parenting Time

Subpoena by Notary Motion to Designate Custodian

Duces Tecum (Detailed Version) Motion to Designate Residential Parent for School Purposes

Duces Tecum (Short Version) Motion to Amend Birth Certificate

Notice of/Motion for Deposition Motion to Modify/Restrict/Terminate a Parenting Provision

Notice of Filing of Deposition Includes:

Motion to Compel Communication/Telephone Number

Motion for Sanctions Daycare

Affidavit of Attorney In Support of Motion to Compel/Motion for Medical Expenses

Sanctions Medical Insurance

Motion for Failure to File Financial Affidavit/Property Statement Other

Includes: School District

Motion for Contempt Tax Exemptions

Motion to Compel Transportation

Motion for Sanctions Tuition

Motion to Examine Spouse and/or Children by Expert Parenting Time

Includes: Motion to Modify Residential Parent for School Purposes

Motion for Physical Examination Motion to Modify Supervised Parenting Time

Motion for Vocational Examination Motion to Restrict/Terminate Companionship Rights

Motion for Psychological Examination Motion to Restrict Removal of Children

Motion for Substance Abuse Assessment C. Motions Regarding Shared Parenting

Motion for Drug Testing Evaluation Motion for Shared Parenting

Objection to Motion to Examine Spouse and/or Children by Expert Motion to Terminate Shared Parenting

Motion to Admit Evidence Motion to Modify Shared Parenting

Motion to Disclose Property D. Motions to Establish or Contest Paternity

Motion to Quash Motion to Establish/Contest Paternity

Motion to Strike Includes:

Objection to Admissibility of Evidence/Document Motion for Acknowledgment of Paternity

Pretrial Statement/Affidavit Motion for DNA Testing

Notice of Subpoena to Non-Party Motion to Contest Paternity

Motion to Establish Paternity

XII. PARENTING ISSUES Objection to Genetic Testing

A. Motion for Evaluation, Interviews or Services E. Motions to Modify or Review Order or Parenting Time

Motion for Evaluation, Interviews or Services Motion to Modify Parenting Order (Custody)

Includes: Motion to Modify/Review Parenting Time (Visitation)

Motion for Drug Testing Motion to Review Parenting Provision

Motion for Home Investigation

F. Motions and Notices Regarding Relocation XV. MOTIONS TO ADOPT COURT ORDERS

Notice of Intent to Relocate Motion for Entry Nunc Pro Tunc

Motion for Hearing Pursuant to ORC 3109.051(G) (2) (Notice to Motion to Adopt Court Order

Spouse)\ Motion to Adopt Mediation Agreement

Objection to Notice of Intent to Relocate

G. Motions Regarding Mandatory Education XVI. MOTIONS TO AMEND, EXTEND OR FOR LEAVE

Motions Regarding Mandatory Education Motion for Leave to File Answer Out of Time

Includes: Motion to Amend Pleading

Motion to Accept Foreign Mandatory Education Certificate Includes:

Motion to Waive Mandatory Education Complaint

Answer

XIII. SUPPORT MOTIONS Counterclaim

A. Motions to Establish/Modify/Terminate Child Support Decree

& Related Matters Decree to Change Name

Motions to Establish/Modify/Terminate Child Support & Related Motion to Extend Time

Matters Includes:

Includes: Answer/

Motion to Establish/Increase/Reduce/Terminate Child/ Support Argument

Motion for Lump Sum Judgment Objections

Motion to Escrow Response/

Motion to Establish/Modify Child Support with Arrears Transcript

Motion to Establish Child Support with a Deviation Trial Brief

Motion to Establish/Modify Child Support with Interest on a Lump

Sum Judgment XVII. MOTIONS TO APPEAR, SUBSTITUTE, INTERVENE

Motion to Establish/Modify Child Support with a Lump Sum AND WITHDRAW

Judgment Notice of Appearance

Motion to Establish/Modify Child Support with an Overpayment Notice of Substitution/Motion to Substitute Counsel

Motion to Establish/Modify/.Terminate a Withholding Order Includes:

Motion to Modify Child Support Due to Emancipation Notice of Substitution of Counsel

Motion to Review Judgment – Child Support Motion to Substitute Counsel

Motion to Set Aside Ex Parte Child Support Order Notice of Substitution/Motion to Substitute Party

B. Motions to Establish, Modify, Terminate Spousal Support Includes:

Motions to Establish, Modify, Terminate Spousal Support Notice of Substitution of Party

Includes Motion to Substitute Party

Motion to Establish/Modify/Terminate Spousal Support Motion to Appear Pro Hoc Vice

Motion to Escrow Spousal Support Motion to Intervene

Motion to Establish/Modify Arrearage in Spousal Support Motion to Withdraw as Counsel

Motion to Establish Allocation of Debt as Spousal Support

Motion to Establish/Modify Spousal Support with Interest on a XVIII. MOTIONS TO CONTINUE, CONSOLIDATE,

Lump Sum Judgment CONVERT, EXPUNGE AND DISMISS

Motion to Establish/Modify Spousal Support with a Lump Sum Motion for Continuance

Judgment Motion to Consolidate

Motion to Establish/Modify Overpayment of Spousal Support Motion to Convert

Motion to Establish a Withholding Order Motion to Seal Record from Public/Restrict Internet

C. Motions Related to Driving Privileges Publication/Expunge

Motions Related to Driving Privileges Entry Granting Motion to Seal Record From Public/Restrict Internet

Includes Publication/Expunge

Motion to Restore Driving Privileges Motion to Dismiss

Motion to Suspend Driving Privileges

D. Motions to Review XIX. CONTEMPT, BOND, SENTENCING AND DOMESTIC

Motion for Review – CSEA Case VIOLENCE MOTIONS

Includes: A. Contempt Matters

Motion for CSEA Review Motion for Contempt

Motion for Judicial Mistake of Fact Hearing Includes:

Motion to Review – Non CSEA Case Failure to Submit/Sign

Includes:

XIV. ADDITION OF THIRD PARTY Motion to Show Cause Agreed Entry

Motion to Add Party Motion to Show Cause Decree

Includes: Motion to Show Cause – QDRO

Motion to Add Defendant Non-Payment of Child Support

Motion to Add Third Party Defendant Includes:

Affidavit in Support of Motion to Add Defendant Non Payment of Child Support – Arrears

Entry Granting Motion to Add Defendant Non Payment of Child Support – Final Order

Non Payment of Child Support – Temporary Order Other

Non Payment of Fees Removal of

Includes Related to Business

Non-Payment of Attorney Fees/Court Costs Includes:

Non-Payment of DNA Testing Fees Provide Access

Non-Payment of Guardian ad Litem Fees Provide Accounting

Non-Payment of Psychological Evaluation Fees Related to Assets

Non-Payment of Drug Testing Fees Includes:

Non-Payment of Spousal Support Non-Payment/Termination of Life Insurance

Includes: Related to Bank Accounts/Negotiable Instruments

Non Payment of Spousal Support – Arrears Related to Retirement Accounts/Assets

Non-Payment of Spousal Support – Final Order Related to Tax Refunds

Non-Payment of Spousal Support – Temporary Order Related to Debts

Violation of Court Order Includes:

Includes: Failure to Hold Harmless

Failure to Appear Failure to Pay Household Bills or Expenses

Failure to Obtain DNA Testing Failure to Pay Insurance Premiums

Failure to Obtain Drug Test Failure to Pay Marital Debt

Failure to Pay Equity Interest Failure to Pay Medical Bills

Other Failure to Pay Pursuant to Decree

Violation of Restraining Order Motion to Show Cause

Includes: Affidavit/Citation in Support of Motion for Contempt

Canceling Insurance/Utilities B. Motions Related to Bond

Disposing of Property Motion for Return of Bond

Encumbering Property Motion for Review of Bond

Harassment Motion to Set Bond

Interference C. Motions Related to Contempt Findings and Sanctions

Violation of Companionship Rights, Parenting Time or a Parenting Motion for Additional Time to Purge Contempt

Provision Motion for Capias

Includes: Motion for Early Release

Violation of Companionship Rights Motion to Credit Time Served

Communication Motion to Deem Contempt Purged

Daycare Motion to Impose Jail Term/Sanctions

Medical Expenses Motion to Impose Sanctions

Medical Insurance Motion to Review Sentence

Other D. Motions Related to Domestic Violence

Shared Parenting Plan Motion for Contempt of CPO – Ex Parte

Tax Exemptions Motion for Contempt of CPO – Final

Transportation Motion for Return of Weapons

Tuition Motion to Amend CPO

Parenting Time Includes:

Violation of Discovery Orders Motion to Amend CPO – Consent Provision

Includes: Motion to Amend CPO – Ex Parte Provision

Failure to Provide Financial Affidavit/Property Statement Motion to Amend CPO – Final Provision

Failure to Provide Discovery/Answers

Motion for Sanctions XX. MOTIONS TO DISQUALIFY OR REASSIGN

Related to Real Estate Motion to Disqualify Counsel Due to Conflict

Includes: Motion to Disqualify Guardian ad Litem

Non-Payment of Mortgage Motion to Disqualify Hearing Officer

Exclusive Use of Real Estate Motion to Reassign Case

Other

Refinance Provision XXI. MOTIONS FOR EMERGENCY HEARINGS

Sale Provision Motion for Emergency Hearing:

Taxes Includes:

Related to Vehicles Child Support

Includes: Early Release

Failure to Provide Vehicle Payment of Expenses/Debts

Non-Payment of Vehicle Parenting Time

Non-Payment of Vehicle Insurance Property

Use of Vehicle Spousal Support

Related to Personal Property Affidavit in Support of Motion for Emergency Hearing

Includes:

Failure to Divide

XXII. MOTIONS FOR FEES AND COSTS Property Rights

Motion for Attorney Fees/Costs Motion for Mediation - other

Affidavit of Attorney (For Fees/Costs)

Motion for Fees/Costs XXVIII. MOTIONS FOR REPORTS, SERVICES OR

Includes: TRANSCRIPTS

Testing/costs Motion for Court Reporter

Discovery Expenses/Costs Motion for Interpreter

Drug Testing Costs Motion for Transcript

Guardian Ad Litem fees Motion to Release Reports

Psychological Evaluation Costs Motion to Transport Prisoner/Juvenile

Advance Costs/Legal Fees

Determine Attorney Fees/Costs XXIX. PROPERTY MOTIONS

Review Guardian Ad Litem Fees A. Motions to Appoint

Motion to Appoint Appraiser

XXIII. MOTIONS FOR HEARINGS AND REVIEWS Motion to Appoint Listing Agent

Motion for Pre-Trial Motion to Appoint Receiver

Motion for Scheduling Conference B. Motions Related to Assets

Motion for Teleconference Motion for Accounting of Bank Accounts

Motion to Review Order Motion for Accounting of Retirement Benefits

Motion for Accounting of Other Item(s)

XIV. MOTIONS RELATED TO DECISIONS OR DECREES Motion for Accounting of Income

Motion for Clarification Motion for Valuation of Retirement Account

Request for Findings of Fact and/or Conclusions of Law Motion to Liquidate Marital Asset

Motion for Leave to File Objections C. Motions Related to Bonds for Property

Motion for New Trial Motion to Post Bond for Property

Motion for Stay Motion to Release Bond for Property

Motion for Stay of Execution D. Motions Related to Businesses

Motion to Correct Motions for Business Accounting

Motion to Remand Includes:

Motion for Relief from Judgment Motion for Accounting of Business Assets

Objection to Magistrate’s Decision Motion for Accounting of Business Debts

Response to Objection to Magistrate’s Decision Motion for Accounting of Business Income

Motion to Set Aside Magistrate’s Order Motion for Exclusive Use of Business

Notice of Appeal Motion for Valuation of Business

E. Motions Related to Date of Valuation

XXV. MOTIONS RELATED TO JUDGMENTS AND Motion for Alternative Valuation Date

ENFORCEMENT OF JUDGMENTS Motion to Determine Date of De Facto Termination of Marriage

Motion for Declaratory Judgment F. Motions Related to Debts

Motion for Default Judgment Motion for Accounting of Debt

Motion for Journalization Motion to Assign Payment of Debt:

Motion to Enforce Separation Agreement Includes:

Motion to Review Judgment Consumer

Mortgages

XXVI. MOTIONS RELATED TO JURISDICTION Taxes

Motion for Conciliation Vehicle

Motion/Notice of Suggestion of Death G. Motions Related to Escrow

Motion to Relinquish Jurisdiction Motion to Escrow

Affidavit in Support of Motion to Relinquish Jurisdiction Motion to Escrow Sale Proceeds

Entry Granting Motion to Relinquish Jurisdiction Motion to Release Escrowed Funds

Motion to Accept Jurisdiction Motion to Release Escrowed Proceeds

Affidavit in Support of Motion to Accept Jurisdiction H. Motions Related to Personal Property/Household

Entry Granting Motion to Accept Jurisdiction Goods/Furnishings

Motion to Change Venue Motion for Inventory of Personal Property

Objection to Motion to Accept Jurisdiction Motion for Accounting of Disposed/Damaged Personal Property

Motion to Register Decree Motion for Appraisal of Personal Property

Motion to Stay Proceedings for Reconciliation Motion to Divide Personal Property

Notice of Appeal Motion to Verify Inventory of Personal Property

Notice of Bankruptcy I. Motions Related to Pets and Domestic Animals

Motion to Appraise Pet/Domestic Animal

XXVII. MOTIONS FOR MEDIATION Motion to Care for Pet or Domestic Animal

Motion to Mediate Motion to Remove Pet or Domestic Animal

Includes: Motion to Retain Pet or Domestic Animal

Parenting Rights

J. Motions Related to Property Judgments Division of Property Order (State Pension)

Motion for Interest on Judgment (Property Judgment) Motion to Order Release of Information Pursuant to ORC 3105.87

Motion for Lump Sum Judgment (Property Judgment) Order to Release Information Pursuant to ORC 3105.87

Motion to Review Property Judgment

K. Motions Related to Real Estate XXXIV. DOMESTIC VIOLENCE FORMS

Motion for Exclusive Use of Marital Residence General Information about Domestic Violence Protection Orders

Motion for Access to Real Estate (Form 10.01-A)

Motion to Appraise Real Estate How to Obtain a Domestic Violence Civil Protection Order (Form

Motion to Force Sale of Real Estate 10.01-B)

Motion to Inspect Real Estate How to Complete a Petition for a Domestic Violence Civil

Motion to List Real Estate for Sale Protection Order (Form 10.01-C)

L. Motions Related to Transfers of Property Petition for Domestic Violence Civil Protection Order (Form 10.01-

Motion to File QDRO D)

Motion to File Quitclaim Deed How to Complete the Information for Parenting Proceeding

Motion to Transfer Title of Vehicle Affidavit (Form 10.01-E)

Information for Parenting Proceeding Affidavit (Form 10.01-F)

M. Motions Related to Vehicles Warning Concerning the Attached Domestic Violence Civil

Motion for Appraisal (Vehicle/Trailer) Protection Order (Form 10.01-G)

Motion for Use of Vehicle Domestic Violence Civil Protection Order (CPO) Ex Parte (Form

Motion to Sell Vehicle 10.01-H)

Motion to Transfer Title of Vehicle Domestic Violence Civil Protection Order (CPO) Full Hearing

(Form 10.01-I)

N. Motions to Mediate Consent Agreement and Domestic Violence Civil Protection Order

Motion to Mediate (Form 10.01-J)

Includes: Motion to Modify or Terminate Domestic Violence Civil Protection

Parenting Rights Order or Consent Agreement (Form 10.01-K)

Property Rights Judgment Entry on Motion to Modify or Terminate Domestic

Violence Civil Protection Order or Consent Agreement (Form

XXX. MISCELLANEOUS OTHER DOCUMENTS 10.01-L)

Notice of Hearing (Generic) Modified Domestic Violence Civil Protection Order (Form 10.01-M)

Entry (Generic) How to Complete a Motion for Contempt for Violating a Domestic

Notice of Dismissal Violence Civil Protection Order (Form 10.01-N)

Affidavit of Witness (Corroborating Merits Testimony) Motion for Contempt of a Domestic Violence Civil Protection Order

Calculation of Arrearage of Support (Form 10.01-O)

Motion to Set Aside Antenuptial Agreement Protection Order Notice to NCIC (Form 10-A)

Power of Attorney to Grandparent How to Complete a Protection Notice to NCIC (Form 10-B)

Caretaker Authorization Affidavit by Grandparent Notice Concerning Possession or Purchase of Firearms (Form 10.04-

Determination of Paternity (HEA 3029) A)

Quitclaim Deed

Divorce Settlement Memorandum XXXV. CIVIL AND CRIMINAL STALKING OR SEXUALLY

ORIENTED OFFENSE FORMS

XXI. AGREEMENTS Motion for Criminal Protection Order (CRPO) (Form 10.03-A)

Separation Agreement Criminal Protection Order (CRPO) (Form 10.03-B)

Shared Parenting Plan Petition for Civil Stalking or Sexually Oriented Offense Protection

Shared Parenting Plan #2 Order (Form 10.03-D)

Antenuptial Agreement Civil Stalking or Sexually Oriented Offense Protection Order Ex

Parte (Form 10.03-E)

XXXII. DECREES Civil Stalking or Sexually Oriented Offense Protection Order Full

Decree of Divorce Hearing (Form 10.03-F)

Decree of Annulment Instructions for Obtaining a Civil Stalking or Sexually Oriented

Decree of Legal Separation Offense Protection Order (Form 10.03-G)

Decree of Dissolution Warning Concerning Attached Protection Order (Form 10.03-H)

Decree of Shared Parenting Protection Order Notice to NCIC (Form 10-A)

Entry Restoring Former Name How to Complete a Protection Notice to NCIC (Form 10-B)

Notice Concerning Possession or Purchase of Firearms (Form 10.04-

XXXIII. SAMPLE QDRO'S A)

Qualified Domestic Relations Order #1 (General)

Qualified Domestic Relations Order #2 (Stock Plan)

III. COUNTY LIBRARIES

First Appellate District Summons (Form 13.2)

A. Hamilton County Waiver Counsel (Form 13.3)

Clerk of Court Forms Waiver Counsel (Form 13.3A) Contempt Proceeding

Classification Form Motion for Exemption Parent Education Class (Form 14.11)

Directions for Sheriff List of Exhibits and Description (Form 20.0)

Notice to Clerk 3105.88 Parenting Services Information (Form 22.1)

Notification Form Entry Ordering Mediation (Form 22.2)

Written Request for Service Petition for Conciliation (Form 42.9)

Personal Identifier Reference List Entry Allocating Costs (Form 70)

Notice to Withhold (HCDHS Form 4047)

Court Forms Notice to Withhold-Addendum (HCDHS Form 4048)

Questionnaire (Form 1.1) Support Account Data Form (HCDHS 4905)

Medical Expense Sheet (Form 1.25) ODHS 7076 (IV-D)

Mandatory Disclosure Order (Form 1.26)

Parenting Proceeding Affidavit (Form 2.1) Second Appellate District

Shared Parenting Plan (Form 2.2) A. Clark County

Final Decree of Shared Parenting (Form 2.3) No county required forms. Any other county’s forms, Uniform

Request for Services (Form 2.4) Domestic Relations Forms, and Worksheets accepted.

Entry Ordering Parenting Investigation (Form 2.5)

Standard Parenting Order (Form 2.7) B. Dark County

Notice of Intent to Relocate (Form 2.8) Affidavit 1--Affidavit of Income and Expenses

Motion for Hearing Pursuant to ORC 3109.051(G)(2) (Form 2.8a) Affidavit 2 – Affidavit of Property

Entry Certifying Case to Juvenile Court (Form 2.11) Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A)

Waiver Shared Parenting (Form 2.15) Affidavit 4 – Health Insurance Affidavit

Agreed Entry Change Residential Parent (Form 2.16) Affidavit 5 – Motion and Affidavit or Counter Affidavit for

Entry-Blank (Form 3.0) Temporary Order

Motion and Affidavit for Issuance of Temporary Orders (75(N)) Confidential Information for Identification of the Parties

(Form 3.2) Domestic Questionnaire

Notice of Service (Form 3.4) Affidavit of Income, Expenses and Financial Disclosure

Request for Oral Hearing (Form 3.7) Application for Services (IV-D) (Form ODHS 7076)

Property Statement (Form 4.1) Standard Schedule for Parenting Time

Stipulations (Form 4.3) Motion for Temporary Restraining Order and Affidavit in Support

Agreed Entry-Property (Form 4.4A) Entry for Temporary Restraining Orders

Waiver Property (Form 4.5) Child Support Worksheet – Sole/Shared Parenting

Waiver Financial Disclosure (Form 7.1) Child Support Worksheet – Split Parenting Rights

Financial Disclosure Affidavit (Form 7.2)

Financial Affidavit (Form 7.3) C. Greene County

Child Support Worksheet - Sole Residential Parent or Shared Affidavit 1--Affidavit of Income and Expenses

Parenting (Form 7.5A) Affidavit 2 – Affidavit of Property

Child Support Worksheet - Split Parental Rights (Form 7.6A) Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A)

Unemployment Notice Order (Form 7.10) Affidavit 4 – Health Insurance Affidavit

Entry Terminating Deduction Order (Form 7.12) Affidavit 5 – Motion and Affidavit or Counter Affidavit for

Agreed Entry-Support-Parenting & Support (Form 7.14) Temporary Orders Without Oral Hearing

Agreed Entry-Support-Shared Parenting (Form 7.15) Divorce & Dissolution Questionnaire (DR 8)

Group Health Insurance Affidavit (Form 7.16) Information for Parenting Proceeding Affidavit (DR 9)

Qualified Medical Support Order (Form 7.17) Affidavit of Financial Disclosure (DR 10)

Shared Medical Order (No Ins Avail) (Form 7.20) Instructions for Service

Health Care Verification (Form 7.21) Praecipe and Summons for Witness

Cash Medical Support Order (Form 7.24) Order Requiring Attendance at Seminar

Magistrate's Order for Continuance (Form 8.1) Obligor Information Sheet

Judge's Order for Continuance (Form 8.1A) Obligee Information Sheet

Motion Requesting Documents Not Be Displayed on Internet (Form Notice of Intent to Relocate

8.21) Parenting Time Guidelines

Request for Transcription (Form 8.30) Appendix C

Agreed Entry-Misc (Form 8.5) Poverty Affidavit

Interim Order (Form 8.7) Entry Approving Poverty Affidavit

Request for Merits Setting Entry (Form 9.1) Request for Transcript

Waiver of Representation (Form 9.2) Suggested Support Withholding Language

Waiver of Service (Form 9.3) Suggested Health Care Language

Request for Interview-GAL (Form 10.2) Child Support Worksheet – Sole/Shared Parenting

Agreed Entry-Appointing Appraiser (Form 11.1) Child Support Worksheet – Split Parenting Rights

Affidavit for Citation (Form 13.1)

D. Miami County Third Appellate District

Affidavit 1--Affidavit of Income and Expenses A. Allen County

Affidavit 2 – Affidavit of Property Affidavit 1--Affidavit of Income and Expenses

Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A) Affidavit 2 – Affidavit of Property

Affidavit 4 – Health Insurance Affidavit Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A)

Affidavit 5 – Motion and Affidavit or Counter Affidavit for Affidavit 4 – Health Insurance Affidavit

Temporary Order Affidavit 5 – Motion and Affidavit or Counter Affidavit for

IV-D Application for Services (ODHS 7076 Rev. 11/92) Temporary Order

DR-1 Personal History of Parties IV D Application for Services

DR-2 Information for Parenting Proceeding DR-3 Waiver of Counsel

DR-4 Waiver of Counsel DR-4 Child Health Care Information

DR-9 Affidavit of Income, Expenses & Financial Disclosure Qualified Medical Support/Health Care Order

DR-11 Child Support Worksheet—Sole or Shared Parenting Waiver of magistrate’s Decision

DR-12 Child Support Worksheet—Split Parental Rights Waiver of Service of Summons

DR-16 Support Order and Standard/Additional Order of Health Care Notice of Intent to Relocate (3109.051(G))

Needs Standing Orders

DR-17 Dependant Health Care Order (Obligor) Parenting Time Allocation

DR-18 Dependant Health Care Order (Obligee) Child Support Worksheet – Sole/Shared Parenting

DR-19 Motion for Continuance Child Support Worksheet – Split Parenting Rights

DR-20 Entry of Continuance

DR-21 Parenting Seminar Order B. Auglaize County

DR-22 Agreement to Mediate Affidavit 1--Affidavit of Income and Expenses

DR-23A Obligee’s Rights and Remedies for Enforcement of Support Affidavit 2 – Affidavit of Property

Acknowledgment & Dissolution Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A)

Acknowledgment & Divorce Affidavit 4 – Health Insurance Affidavit

Standard Parenting Time Schedule Affidavit 5 – Motion and Affidavit or Counter Affidavit for

Motion for Temporary Restraining Orders and Affidavit in Support Temporary Orders Without Oral Hearing

Entry for Temporary Restraining Orders Marital History Information Sheet

Waiver Magistrate Decision Dissolution Personal Identifiers

Waiver Magistrate Decision Divorce DR-FD - Orders of Financial Disclosure

DR-SO – Standing Orders

E. Montgomery County Standard Visitation and Companionship

Divorce and Dissolution Questionnaire (DR 8) IV-D Application for Child Support Services

Parenting Proceeding Affidavit (DR 9) Child Support Worksheet – Sole/Shared Parenting

Affidavit of Financial Disclosure (DR 10) Child Support Worksheet – Split Parenting Rights

Montgomery County SEA New Case Number Worksheet (DR 16)

IV-D Application (DR 17) C. Crawford County

Instructions for Service (DR-18) Affidavit 1--Affidavit of Income and Expenses

Obligee's Rights and Remedies for the Enforcement of Support (DR Affidavit 2 – Affidavit of Property

20) Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A)

Standard Parenting Schedule (DR 21) Affidavit 4 – Health Insurance Affidavit

Standard Order of Health Care Needs (DR-32) Affidavit 5 – Motion and Affidavit or Counter Affidavit for

Entry Restoring Former Name (DR-76) Temporary Orders Without Oral Hearing

Request to Record Proceedings (DR 98) Affidavit in Support of Temporary Order

Entry of Permission to Record Proceedings (DR 99) Counter Affidavit

Parent Questionnaire and Information Sheet Rule 25 - Standard Visitation Schedule

Child Support Guidelines Worksheet Rule 26 Provisions for Medical Support

Determination of Paternity (HEA 3029) IV-D Application for Services (ODHS 7076)

Entry and Order of Custody Upon Death of Party Proposal for Temporary Orders

Health Care Reimbursement Claim Form Waiver of Temporary Orders

Financial Disclosure/Affidavit of Indigency Certification of Counsel

Poverty Affidavit Pre-Trial Statement

Petition for Conciliation Child Support Worksheet – Sole/Shared Parenting

Order to Show Cause Child Support Worksheet – Shared Parenting Rights

Notice

Division of Property Order D. Defiance County

Motion for Temporary Restraining Order DR 1, DR-1A, DR-1B and DR-1C Financial Disclosure Form

Entry Granting Temporary Restraining Order DR-1D Affidavit and Notice of Filing and Duty to Amend

Child Support Worksheet – Sole/Shared Parenting DR 2 Parenting Affidavit under O.R.C. 3127.23

Child Support Worksheet – Split Parenting Rights DR-3-Health Insurance Disclosure Affidavit (HIDA)

Schedule A – Parenting Time Guidelines for Travel Distances under

150 Miles

Schedule B – Long Distance Time Guidelines (Over 150 Miles One G. Henry County

Way) DR 1, DR-1A, DR-1B and DR-1C Financial Disclosure Form

Schedule C – Maintenance of Insurance and Payment of DR-1D Affidavit and Notice of Filing and Duty to Amend

Extraordinary Expenses for Minor Children DR 2 Parenting Affidavit under O.R.C. 3127.23

Schedule D – Provision of Health Insurance for Minor Children DR-3-Health Insurance Disclosure Affidavit (HIDA)

Schedule E – IV-D Application for Services Schedule A – Parenting Time Guidelines for Travel Distances under

Court Order #1 – Preliminary Injunctions 150 Miles

Court Order #2 – Order Appointing Guardian ad Litem Schedule B – Long Distance Time Guidelines (Over 150 Miles One

Court Order #3 – Qualified Medical Support Order Way)

Court Order #4 – Order to Attend Parenting Class Schedule C – Maintenance of Insurance and Payment of

Court Order #5 – Order for Investigation (Home Study) Extraordinary Expenses for Minor Children

Court Order #6 – Order for Evaluation Schedule D – Provision of Health Insurance for Minor Children

Court Order #7 – Motion to Review Family File Schedule E – IV-D Application for Services

Court Order #8 – Order Requiring Mediation Services Court Order #1 – Preliminary Injunctions

Child Support Worksheet – Sole/Shared Parenting Court Order #2 – Order Appointing Guardian ad Litem

Child Support Worksheet – Split Parenting Rights Court Order #3 – Qualified Medical Support Order

Court Order #4 – Order to Attend Parenting Class

E. Hancock County Court Order #5 – Order for Investigation (Home Study)

Case Designation Sheet Court Order #6 – Order for Evaluation

Personal Identifiers Court Order #7 – Motion to Review Family File

Personal History and Financial Affidavit Court Order #8 – Order Requiring Mediation Services

Documents to be Disclosed without Formal Discovery Requests Child Support Worksheet – Sole/Shared Parenting

Parenting Affidavit Under O.R.C. 3127.23 Child Support Worksheet – Split Parenting Rights

IV-D Form

Motion for Temporary Allocation of Parenting Rights and H. Logan County

Responsibilities of the Minor Children Affidavit 1--Affidavit of Income and Expenses

Orders for Health Insurance Coverage for Minor Children Affidavit 2 – Affidavit of Property

Order to Employer Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A)

Parenting Plan and Companionship Schedule (App. J) Affidavit 4 – Health Insurance Affidavit

Long Distance Parenting Plan and Companionship Calendar (App. Affidavit 5 – Motion and Affidavit or Counter Affidavit for

K) Temporary Orders Without Oral Hearing

Certification of Receipt of Appendix J/K DR 01 Guidelines on Parenting Time

Motion for Mutual Restraining Order under Local Rule 2.09 Judgment entry/Child Support and Medical Support

Judgment Entry Granting Mutual Restraining Orders DR 11 Property Distribution/Balance Sheet

Request for Service DR 12 Health Insurance Coverage Contempt Form

Motion to File Without Payment of Costs DR 18 CSEA IV-D Application

Poverty Affidavit Mutual Temporary Restraining Order

Order for Filing Child Support Worksheet – Sole/Shared Parenting

Request for Transcript Child Support Worksheet – Split Parenting Rights

Notice of Intent to Relocate

Order to Appear and Show Cause I. Marion County

Waivers of Service of Summons Affidavit of Income and Expenses - Form A

Notice of Hearing Affidavit of Property - Form B

Child Support Worksheet – Sole/Shared Parenting Parenting Proceeding Affidavit – Form C

Child Support Worksheet – Split Parenting Rights Health Insurance Affidavit – Form D

Motion and Affidavit or Counter Affidavit for Temporary Orders –

F. Hardin County Form E

Affidavit 1--Affidavit of Income and Expenses Case Designation Form - Form F

Affidavit 2 – Affidavit of Property Duty to Keep Court Advised of Address – Form G

Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A) Request to Issue Wage Assignment – Form H

Affidavit 4 – Health Insurance Affidavit Notice to Responding Party (P.E.A.C.E. Notice) – Form I

Affidavit 5 – Motion and Affidavit or Counter Affidavit for Restraining Orders – Form J

Temporary Orders Without Oral Hearing Addendum – Form K

Designation Form (Appendix A) Notice of Intent to Relocate – Form L

Domestic Relations Admonishment (Appendix H) Companionship Schedule 2011

Documents to be Exchanged without Formal Discovery (Appendix I) Child Support Worksheet – Sole/Shared Parenting

Standard Order of Parenting Time (Rule 26) Child Support Worksheet – Split Parenting Rights

Exhibit A

Pre-Trial Statement (not official form) J. Mercer County

Child Support Worksheet – Sole/Shared Parenting DR-1 – Financial Disclosure Affidavit

Child Support Worksheet – Split Parenting Rights DR-2 – Parenting Affidavit Declaration under UCCJEA

DR-3 - Child Support Worksheet – Sole/Shared Parenting

DR-4 - Child Support Worksheet – Split Parenting Rights

DR-5 – Waiver of Magistrate’s Decision O. Union County

DR-6 – Notice of Intent to Relocate Affidavit 1--Affidavit of Income and Expenses

DR-7 – HCCWD Notice/Registration 2009 Affidavit 2 – Affidavit of Property

DR-8 – Medical Healthcare Information Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A)

SO 1 – DR Restraint Orders Affidavit 4 – Health Insurance Affidavit

SO 2 – Standard Visitation Schedule/Parenting Time Allocation Affidavit 5 – Motion and Affidavit or Counter Affidavit for

SO 3 – Addendum Withholding Notice (ODJFS 4048) Temporary Orders Without Oral Hearing

SO 4 - Notice to Income Provider (ODJFS Form 4047) Classification Form

IV-D Form – Application for Child Support Services Standard Visitation Guidelines

Financial Disclosure/Affidavit of Indigency IV-Application (ODHS 7076)

Restraining Order

K. Paulding County Notice to Relocate

DR-1 Affidavit for Costs Child Support Worksheet – Sole/Shared Parenting

DR-2 Parenting Affidavit Child Support Worksheet – Split Parenting Rights

DR-3 Affidavit

DR-4 Pre-Trial Financial Form P. Van Wert County

DR-5 Questionnaire Affidavit 1--Affidavit of Income and Expenses

Standard Rules for Non-Residential Parent Visitation and Rights Affidavit 2 – Affidavit of Property

Child Support Worksheet – Sole/Shared Parenting Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A)

Child Support Worksheet – Split Parenting Rights Affidavit 4 – Health Insurance Affidavit

Affidavit 5 – Motion and Affidavit or Counter Affidavit for

L. Putnam County Temporary Orders Without Oral Hearing

Parenting Affidavit DR-2 - IV-D Affidavit

Form DR-1 DR-5 – Support Order

Form DR-3 Waiver of Counsel DR-6 – Health Insurance Order

Personal Identifiers DR-10 – Waiver of Objections to Magistrate’s Report

Standard Order DR-14 – Standing Orders

Parenting Schedule Standard Rules for Residential and Non-Residential Parents

Child Support Worksheet – Sole/Shared Parenting Child Support Worksheet – Sole/Shared Parenting

Child Support Worksheet – Split Parenting Rights Child Support Worksheet – Split Parenting Rights



M. Seneca County Q. Wyandot County

Affidavit 1--Affidavit of Income and Expenses Affidavit 1--Affidavit of Income and Expenses

Affidavit 2 – Affidavit of Property Affidavit 2 – Affidavit of Property

Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A) Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A)

Affidavit 4 – Health Insurance Affidavit Affidavit 4 – Health Insurance Affidavit

Affidavit 5 – Motion and Affidavit or Counter Affidavit for Affidavit 5 – Motion and Affidavit or Counter Affidavit for

Temporary Orders Without Oral Hearing Temporary Orders Without Oral Hearing

Form 7 - Proposal for Temporary Orders Standard Order of Parenting Time

Praecipe for Service Exhibit ―A‖

IV-D Application for Services Child Support Worksheet – Sole/Shared Parenting

Child Support Worksheet – Sole/Shared Parenting Child Support Worksheet – Split Parenting Rights

Child Support Worksheet – Split Parenting Rights

Fourth Appellate District

N. Shelby County A. Athens County

Affidavit 1--Affidavit of Income and Expenses Affidavit 1--Affidavit of Income and Expenses

Affidavit 2 – Affidavit of Property Affidavit 2 – Affidavit of Property

Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A) Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A)

Affidavit 4 – Health Insurance Affidavit Affidavit 4 – Health Insurance Affidavit

Affidavit 5 – Motion and Affidavit or Counter Affidavit for Affidavit 5 – Motion and Affidavit or Counter Affidavit for

Temporary Orders Without Oral Hearing Temporary Orders Without Oral Hearing

DR-6 IV-D Application for Services Designation Form

DR-7 Obligee’s Rights and Remedies for Enforcement of Support DR 1 Affidavit of Income and Expenses

DR-8 Personal Identifier/Sensitive Information Sheet DR 2 Financial Disclosure

Local Rule 16 – Required Language for Health and Medical DR 3 Application for Waiver of Deposit

Insurance Orders DR 4 Health Insurance Affidavit

Local Rule 17 – Medical Expense Defined/Court Formula/Uninsured Pretrial Statement

Health Expenses Parenting Affidavit

Local Rule 22 – Guidelines for Visitation Visitation/Parenting Time Guidelines

Child Support Worksheet – Sole/Shared Parenting Child Support Worksheet – Sole/Shared Parenting

Child Support Worksheet – Split Parenting Rights Child Support Worksheet – Split Parenting Rights

Decision of Magistrate

B. Gallia County Response to Motion for Temporary Custody

Affidavit 1--Affidavit of Income and Expenses Judgment Entry/Restraining Order

Affidavit 2 – Affidavit of Property Companionship and Visitation Schedule

Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A) Long Distance Companionship Schedule

Affidavit 4 – Health Insurance Affidavit Notice to Withhold (ODJFS 4047)

Affidavit 5 – Motion and Affidavit or Counter Affidavit for Health Care Order

Temporary Orders Without Oral Hearing Financial Disclosure/Affidavit of Indigency

Group Health Insurance Affidavit Child Support Worksheet – Sole/Shared Parenting

Declaration under Uniform Child Custody Jurisdiction Act Child Support Worksheet – Split Parenting Rights

(UCCJEA)

Personal Identifiers H. Ross County

Standard Order of Visitation/Parenting Time - Local Affidavit 1--Affidavit of Income and Expenses

Standard Order of Visitation/Parenting Time – Long Distance Affidavit 2 – Affidavit of Property

Child Support Worksheet – Sole/Shared Parenting Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A)

Child Support Worksheet – Split Parenting Rights Affidavit 4 – Health Insurance Affidavit

Affidavit 5 – Motion and Affidavit or Counter Affidavit for

C. Highland County Temporary Orders Without Oral Hearing

Classification Form Child Support Worksheet – Sole/Shared Parenting

Affidavit of Income, Expenses and Financial Disclosure Child Support Worksheet – Split Parenting Rights

Mutual Restraining Order

Temporary Custody Order I. Scioto County

Parenting Affidavit Affidavit 1--Affidavit of Income and Expenses

Mandatory Language for Child Support Orders Affidavit 2 – Affidavit of Property

Standard Parenting Schedule Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A)

IV-D Application for Child Support Services Affidavit 4 – Health Insurance Affidavit

Child Support Worksheet – Sole/Shared Parenting Affidavit 5 – Motion and Affidavit or Counter Affidavit for

Child Support Worksheet – Split Parenting Rights Temporary Orders Without Oral Hearing

DR Form 1 – Notice of Hearing

D. Hocking County DR Form 2 – Information for Parenting Proceeding Affidavit

Affidavit 1--Affidavit of Income and Expenses DR Form 4 – IV-D Application for Services (ODHS 7076)

Affidavit 2 – Affidavit of Property DR Form 5 – Financial Disclosure Affidavit

Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A) DR Form 6 – Mutual Restraining Order

Affidavit 4 – Health Insurance Affidavit DR Form 7 – Payment Explanation of Medical Expenses

Affidavit 5 – Motion and Affidavit or Counter Affidavit for DR Form 8 - Notice

Temporary Orders Without Oral Hearing DR Form 9 – Order to Show Cause

Child Support Worksheet – Sole/Shared Parenting DR Form 12 – Poverty Affidavit

Child Support Worksheet – Split Parenting Rights Rule 6.0 Standard Parenting Time Order

Child Support Worksheet – Sole/Shared Parenting

E. Jackson County Child Support Worksheet – Split Parenting Rights

D.R. Form 1 - Affidavit of Income and Expenses and Property

D.R. Form 2 – Personal History of Parties J. Washington County

D.R. Form 3 - Health Insurance Disclosure Affidavit (HIDA) Affidavit of Income, Expenses, and Financial Disclosure

D.R. Form 4 – Information for Parenting Proceeding Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A)

Praecipe for Transcript Affidavit 4 – Health Insurance Affidavit

D.R. Form 6 – Affidavit of Income and Expenses Information Sheet/Notice to Divorce Investigator/WCCSEA Notice

D.R. Form 7 – Affidavit for Temporary Spousal Support Request for Service (Parties in Caption)

Standard Parenting Schedule Request for Service (Children in Caption)

Child Support Worksheet – Sole/Shared Parenting Motion to Mediate With Attached Entry (Parties in Caption)

Child Support Worksheet – Split Parenting Rights Motion to Mediate With Attached Entry (Children in Caption)

Visitation Mediation Referral

F. Meigs County Parenting Schedule

Affidavit 1--Affidavit of Income and Expenses Poverty Affidavit

Affidavit 2 – Affidavit of Property Child Support Worksheet – Sole/Shared Parenting

Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A) Child Support Worksheet – Split Parenting Rights

Affidavit 4 – Health Insurance Affidavit

Affidavit 5 – Motion and Affidavit or Counter Affidavit for Fifth Appellate District

Temporary Orders Without Oral Hearing A. Ashland County

Child Support Worksheet – Sole/Shared Parenting Affidavit 1--Affidavit of Income and Expenses

Child Support Worksheet – Split Parenting Rights Affidavit 2 – Affidavit of Property

Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A)

G. Pickaway County Affidavit 4 – Health Insurance Affidavit

Parenting Affidavit Affidavit 5 – Motion and Affidavit or Counter Affidavit for

Motion for Temporary Custody Temporary Orders Without Oral Hearing

Form 1:00 Affidavit of Indigency for Court Costs D. Fairfield County

Form 2:00 Case Designation Sheet - Domestic Case Designation Form

Form 3:00 DRH Form Declaration Under UCCJEA (Parenting Affidavit)

Form 4:00 Judgment Entry of Injunctions Financial Affidavit/Motion for Temporary Orders

Form 5:00 Waiver of Paternity Testing and Legal Rights Private Health Insurance Affidavit

Form 6:00 Order Appointing Guardian ad Litem Health Insurance Order

Form 7:00 Order for Genetic Testing IV-D Application for Services

Form 8:00 Health Care Expense Worksheet Judgment Entry Restraining Order

Form 9:00 Summons and Order to Appear on Contempt Standard Parenting Time Order

Form 10:00 Pretrial Statement and Settlement Proposal Notice to Obligors and Obligees

Form 11:00 Notice of Intent to Relocate Divorce Settlement Memorandum

Form 11:10 Waivger of Receipt and Hearing on Notice of Intent to Child Support Worksheet – Sole/Shared Parenting

Relocate Child Support Worksheet – Split Parenting Rights

11:20 Judgment Entry Permitting Service of Notice of Intent to

Relocate E. Guernsey County

11:30 Judgment Entry Prohibiting Service of Notice of Intent to Financial Affidavit Original Actions (Form DR-1)

Relocate Information for Child Custody Proceeding (DR-3)

Form 12:00 Waiver of Magistrate's Decision, Time Limits and Application for Title IV-D Services

Objections Standard Order of Visitation

Form 13:00 Suggested Language for Child Support Orders Child Support Worksheet – Sole/Shared Parenting

Form 14:00 Required Language for Deviations for Child Support Child Support Worksheet – Split Parenting Rights

Purposes

Form 15:00 Mediation Order F. Holmes County

Form 16:00 Suggested Language for Dependent Health Care Child Affidavit 1--Affidavit of Income and Expenses

Support Order Provisions Affidavit 2 – Affidavit of Property

Form 18:00 Omitted or Redacted Personal Identifiers Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A)

Form 20:00 Standard Parenting Time Order Affidavit 4 – Health Insurance Affidavit

Child Support Worksheet – Sole/Shared Parenting Affidavit 5 – Motion and Affidavit or Counter Affidavit for

Child Support Worksheet – Split Parenting Rights Temporary Orders Without Oral Hearing

New Case Designation Form

B. Coshocton County Instructions for Service

Dependent Health Care Order (Obligor) Financial Affidavit for Computation of Child Support and Medical

Dependent Health Care Order (Obligee) Support

Pretrial Financial Statement and Affidavit Parenting Time/Companionship/Visitation Schedules

Pretrial Proposal for Marital Property Division and for Separate IV-D Application for Services

Property Division Child Support Worksheet – Sole/Shared Parenting

Child Support Worksheet – Sole/Shared Parenting Child Support Worksheet – Split Parenting Rights

Child Support Worksheet – Split Parenting Rights

G. Knox County

C. Delaware County Health Insurance Disclosure Affidavit (HIDA)

Affidavit 1--Affidavit of Income and Expenses Private Health Insurance Questionnaire

Affidavit 2 – Affidavit of Property Declaration under UCCJEA (Parenting Affidavit)

Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A) IV-D Application for Child Support Services

Affidavit 4 – Health Insurance Affidavit Parenting Schedule

Affidavit 5 – Motion and Affidavit or Counter Affidavit for CSEA Information Sheet – Residential Parent

Temporary Orders Without Oral Hearing CSEA Information Sheet – Non-Residential Parent

Form 1 - Affidavit in Support or Temporary Orders, Pre-trial Pretrial Statement

Statement (Minor Children) Child Support Worksheet – Sole/Shared Parenting

Form 2 - Affidavit in Support or Temporary Orders (No Minor Child Support Worksheet – Split Parenting Rights

Children)

Form 3 - Affidavit in Support of Agreed Support Orders H. Licking County

Form 4 - Affidavit in Support of or in Opposition to Motion to Affidavit 1--Affidavit of Income and Expenses

Modify Support Orders Affidavit 2 – Affidavit of Property

Assets & Liabilities Disclosure Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A)

Custody Affidavit/R.C.3127.23 Affidavit 4 – Health Insurance Affidavit

Health Insurance Affidavit Affidavit 5 – Motion and Affidavit or Counter Affidavit for

Instructions for Ordinary Mail Service (Single) Temporary Orders Without Oral Hearing

Instructions for Ordinary Mail Service (Multiple) Information for Parenting Proceeding Affidavit

Instructions for Service Affidavit of Income, Expenses and Financial Disclosure

Classification Form Health Insurance Disclosure Affidavit (HIDA)

Standard Visitation Schedule Notice of Temporary Custody Order

Child Support Worksheet – Sole/Shared Parenting Notice of Temporary Visitation Order

Child Support Worksheet – Split Parenting Rights Health Care Order

Rule 19 Parenting Time Order Form 13.20 - Judgment Entry Permitting Service of Notice of Intent

Judgment Entry - ORC 3105.87 to Relocate

Motion for Temporary Orders Form 13.30 – Judgment Entry Prohibiting Notice of Intent to

Affidavit in Support of Motion for Temporary Orders Relocate

Judgment Entry/Magistrate’s Order-Temporary Orders Form 14.00 – Order for Paternity Testing

Instructions for Service Form 15.00 – Waiver of Paternity Testing and Legal Rights

Request for Service (All matters) Form 16.00 – Paternity Testing Information Form

Child Support Worksheet – Sole/Shared Parenting Form 17.00 – Mandatory Language for Child Support Orders

Child Support Worksheet – Split Parenting Rights Form 18.00 - Required Language for Deviations for Child Support

Purposes

I. Morgan County Form 19.00 - Mediation Order

Affidavit 1--Affidavit of Income and Expenses Form 21.00 – Personal Identifiers

Affidavit 2 – Affidavit of Property Rule 24 - Standard Parenting Time Order

Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A) IV-D Request for Services

Affidavit 4 – Health Insurance Affidavit Child Support Worksheet – Sole/Shared Parenting

Affidavit 5 – Motion and Affidavit or Counter Affidavit for Child Support Worksheet – Split Parenting Rights

Temporary Orders Without Oral Hearing

Child Support Worksheet – Sole/Shared Parenting N. Stark County

Child Support Worksheet – Split Parenting Rights Standard Parenting Schedule (Local) Exhibit ―A‖

Standard Parenting Schedule (Long Distance) Exhibit ―B‖

J. Morrow County Health Care Order Exhibit ―C‖

Parenting Proceeding Affidavit Addendum Notice

Affidavit of Assets and Liabilities Restraining Order (Under Same Roof) Exhibit ―D‖

Health Insurance Disclosure Affidavit (HIDA) Restraining Order

Affidavit of Income and Expenses Financial Affidavit

Child Support Worksheet – Sole Custody/Shared Parenting Declaration under UCCJEA (Parenting Affidavit)

Child Support Worksheet – Split Custody Application for Registration of Out-of-State Order

Pretrial Statement/Settlement Proposal (not currently used)

K. Muskingum County Shared Parenting Plan

Affidavit 1--Affidavit of Income and Expenses IV-D Application for Child Support Services

Affidavit 2 – Affidavit of Property Power of Attorney to Grandparent

Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A) Caretaker Authorization Affidavit by Grandparent

Affidavit 4 – Health Insurance Affidavit Child Support Worksheet – Sole/Shared Parenting

Affidavit 5 – Motion and Affidavit or Counter Affidavit for Child Support Worksheet – Split Parenting Rights

Temporary Orders Without Oral Hearing

Entry Converting Divorce to Action for Dissolution O. Tuscarawas County

Entry Converting Dissolution to Action for Divorce Domestic Case Designation Form

Standard Parenting Time Order Disclosure of Personal Identifier Information

IV-D Application for Child Support Services (ODHS 7076) Affidavit 1--Affidavit of Income and Expenses

Child Support Worksheet – Sole/Shared Parenting Affidavit 2 – Affidavit of Property

Child Support Worksheet – Split Parenting Rights Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A)

Private Health Insurance Questionnaire

L. Perry County IV-D Application for Services

Affidavit of Income, Expenses and Financial Disclosure Standard Parenting Orders and Incidental Rules

Child Support Worksheet – Sole/Shared Parenting Long Distance Companionship Schedule

Child Support Worksheet – Split Parenting Rights Affidavit Application for Registration of Out-of State Order

Health and Medical Expenses and Tax Exemptions

M. Richland County Child Support Worksheet – Sole/Shared Parenting

Form 1.00 – Affidavit of Indigency for Court Costs Child Support Worksheet – Split Parenting Rights

Form 2.00 – Request for Appointment of Counsel

Form 3.00 – Judgment Entry of Injunctions Sixth Appellate District

Form 4.00 – Request for Temporary Orders A. Erie County

Form 5.00 – Financial Affidavit 1.00 Affidavit of Indigency for Court Costs

Form 6.00 – Parenting Proceeding Affidavit (ORC 3127.23) 1.10 D.R. Information

Form 7.00 – Pretrial Statement and Settlement Proposal 3.00 Judgment Entry of Injunctions

Form 8.00 – Summons and Order to Appear 4.00 Request for Temporary Orders

Form 9.00 – Request for Home Investigation 5.00 Affidavit of Income, Expenses and Property

Form 10.00 – Order Appointing Guardian ad Litem 6.00 Child Custody Affidavit (ORC 3109.27)

Form 11.00 – Dependant Health Care Child Support Order 7.00 Pretrial Statement and Settlement Proposal

Form 12.00 – Health Care Expense Worksheet 7.10 Case Management Conference Order

Form 13.00 – Notice of Intent to Relocate 8.00 Motion and Affidavit to Show Cause

Form 13.10 – Waiver of Receipt and Hearing on Notice of Intent to 8.00 Order to Appear and Show Cause

Relocate 8.10 Motion and Affidavit to Modify

8.10 Hearing Notice Court Form 6 – Pension Information Sheet

9.00 Request for Home Investigation Court Form 8 – Notice of Filing Exhibit

10.00 Notice of Filing Child Support Worksheet – Sole/Shared Parenting

10.10 Request for Copy of Recording of Proceedings Child Support Worksheet – Split Parenting

10.20 Judgment Entry for Recording of Proceedings

10.30 Waiver of Objections to Magistrate’s Decision D. Lucas County

12.00 Health Care Expense Worksheet Schedule I - Affidavit of Income

13.00 Notice of Intent to Relocate Schedule II - Parenting Affidavit

13.10 Waiver of Receipt and Hearing on Notice of Intent to Schedule III - Affidavit of Monthly Expenses

Relocate Schedule IV - Affidavit of Property Division and Spousal Support

13.20 Judgment Entry Permitting Service of Notice of Intent to Schedule V - Modification of Prior Support Order

Relocate Application for Child Support Services (IV-D Notice) (Form JFS

13.30 Judgment Entry Prohibiting Service of Notice of Intent to 07076)

Relocate Order/Notice to Withhold Income

14.00 Order for Paternity Testing Medical Order Information Sheet

15.00 Waiver of Paternity Testing and Legal Rights Affidavit/Counter Affidavit in Support of Request for Temporary

16.00 Paternity Testing Information Orders

17.00 Suggested Language for Child Support Orders Standard Local Parenting Time Schedule

18.00 Required language for Deviations for Child Support Standard Long Distance Parenting Time Schedule

Purposes Child Support Worksheet – Sole/Shared Parenting

20.00 Motion to Modify Civil Protection Order Child Support Worksheet – Split Parenting Rights

20.01 Notice of Hearing

20.02 Judgment Entry to Modify Civil Protection Order E. Ottawa County

20.03 Motion to Dismiss CPO Case Designation Sheet

20.04 Judgment Entry to Dismiss CPO DR 1 Information for Parenting Proceeding (R.C. 3127.23(A)

Standard Parenting Time Order (Rule 24) DR 2 Affidavit of General Information, Income, Monthly Expenses

Child Support Worksheet – Sole/Shared Parenting and Financial Disclosure

Child Support Worksheet – Split Parenting Rights DR 3 Companionship Schedule (Eff. 12/16/2010)

DR 4 Long Distance Companionship Schedule (Eff. 12/16/2010)

B. Fulton County DR-5 Payment of Extraordinary Health Care Expenses for Minor

DR 1, DR-1A, DR-1B and DR-1C Financial Disclosure Form Children

DR-1D Affidavit and Notice of Filing and Duty to Amend DR-6 Standard Health Care and Cash Medical Orders for Minor

DR 2 Parenting Affidavit under O.R.C. 3127.23 Children

DR-3-Health Insurance Disclosure Affidavit (HIDA) DR-7 Standard Child Support Order

Schedule A – Parenting Time Guidelines for Travel Distances under DR-8 Mutual Restraining Order

150 Miles DR-9 Mandatory Statutory Notices

Schedule B – Long Distance Time Guidelines (Over 150 Miles One Child Support Worksheet – Sole/Shared Parenting

Way) Child Support Worksheet – Split Parenting Rights

Schedule C – Maintenance of Insurance and Payment of

Extraordinary Expenses for Minor Children F. Sandusky County

Schedule D – Provision of Health Insurance for Minor Children Affidavit 1--Affidavit of Income and Expenses

Schedule E – IV-D Application for Services Affidavit 2 – Affidavit of Property

Court Order #1 – Preliminary Injunctions Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A)

Court Order #2 – Order Appointing Guardian ad Litem Affidavit 4 – Health Insurance Affidavit

Court Order #3 – Qualified Medical Support Order Affidavit 5 – Motion and Affidavit or Counter Affidavit for

Court Order #4 – Order to Attend Parenting Class Temporary Orders Without Oral Hearing

Court Order #5 – Order for Investigation (Home Study) Form B – Case Designation Sheet – Domestic Relations

Court Order #6 – Order for Evaluation Form D – Standard Order – Parenting Time

Court Order #7 – Motion to Review Family File Form E – Standard Order – Health Care Expenses

Court Order #8 – Order Requiring Mediation Services Form F – CSEA Information Sheet

Child Support Worksheet – Sole/Shared Parenting Affidavit of Assets and Liabilities

Child Support Worksheet – Split Parenting Rights Affidavit of Income and Expenses (Court Form 4)

Parenting Affidavit (Court Form 6)

C. Huron County Child Support Worksheet – Sole/Shared Parenting

Designation Form Child Support Worksheet – Split Parenting Rights

Appendix A – Standard Health Care Orders for Minor Children

Appendix B – Parenting Guidelines G. Williams County

Appendix C – Parenting Guidelines – Long Distance Affidavit 1--Affidavit of Income and Expenses

Appendix F – Support Obligation Notice Affidavit 2 – Affidavit of Property

Appendix G – Notice of Bankruptcy Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A)

Court Form 2 – Affidavit of Income, Expenses and Property Affidavit 4 – Health Insurance Affidavit

Court Form 3 – Proposal for Temporary Orders Affidavit 5 – Motion and Affidavit or Counter Affidavit for

Court Form 4 – Information for Parenting Proceeding Affidavit Temporary Orders Without Oral Hearing

Form DR-1 Financial Disclosure Information Financial Affidavit

Form DR-1A Affidavit and Notice of Filing and Duty to Amend Declaration under UCCJEA (Parenting Affidavit)

Form DR-2 Parenting Affidavit ORC §3127.23 Affidavit Application for Registration of an Out-of-State Order

Parenting Schedule - Local Application for Child Support Services – ODHS 7076 (IV-D)

Parenting Schedule – Long Distance Guideline Parenting Schedule

Schedule C Maintenance of Insurance and Payment of Uniform Long Distance Companionship Plan

Extraordinary Expenses for Minor Children Transitional Schedule for Companionship

Appendix A – Personal Identifiers Notice of Intent to Relocate (Local)

Child Support Worksheet – Sole/Shared Parenting Notice of Intent to Relocate (Long Distance)

Child Support Worksheet – Split Parenting Rights Explanation of Medical Bills

Child Support Worksheet – Sole/Shared Parenting

H. Wood County Child Support Worksheet – Split Parenting Rights

Affidavit 1--Affidavit of Income and Expenses

Affidavit 2 – Affidavit of Property D. Harrison County

Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A) Affidavit 1--Affidavit of Income and Expenses

Affidavit 4 – Health Insurance Affidavit Affidavit 2 – Affidavit of Property

Affidavit 5 – Motion and Affidavit or Counter Affidavit for Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A)

Temporary Orders Without Oral Hearing Affidavit 4 – Health Insurance Affidavit

Affidavit of Income and Expenses (Schedule A) Affidavit 5 – Motion and Affidavit or Counter Affidavit for

Affidavit of Assets (Schedule B) Temporary Orders Without Oral Hearing

Affidavit of Income and Expenses (Schedule C) Child Support Worksheet – Sole/Shared Parenting

Declaration Under UCCJEA (Parenting Affidavit) Child Support Worksheet – Split Parenting Rights

Orders for Medical Care

Separate Order for Health Insurance Coverage E. Jefferson County

Case Designation Form Affidavit of Income and Expenses

Local Parenting Time Schedule Affidavit of Property

Long Distance Parenting Schedule Health Insurance Disclosure Affidavit (HIDA)

Seminar for Divorcing Adults Information for Parenting Proceeding (ORC 3109.27)

Explanation of Medical Expense Payments Application for Child Support Services – OHHS 7076 (IV-D)

Temporary Restraining Order Parenting Schedule

Child Support Worksheet – Sole/Shared Parenting Child Support Worksheet – Sole/Shared Parenting

Child Support Worksheet – Split Parenting Rights Child Support Worksheet – Split Parenting Rights



Seventh Appellate District F. Mahoning County

A. Belmont County 1. Divorce-Dissolution Filing Forms

DR Form 101 Mutual Restraining Order Family Information Sheet

DR Form 102 Affidavit Child Custody Information Mandatory Discovery Order

DR Form 103 Property Appraisal Form Mutual Restraining Order

DR Form 104 Response to Property Appraisal Form IV-D Application for Services

DR Form 105 Financial Affidavit Declaration under UCCJEA (Parenting Affidavit)

Standard Parenting Schedule Affidavit Application for Registration of Out-of-State Order

Child Support Worksheet – Sole/Shared Parenting Affidavit of Income, Expenses and Financial Disclosure

Child Support Worksheet – Split Parenting Rights Request for Affidavit Order Pursuant to Rule 75(N)

Pre-Trial Statement

B. Carroll County Affidavit 1--Affidavit of Income and Expenses

Affidavit 1--Affidavit of Income and Expenses Affidavit 2 – Affidavit of Property

Affidavit 2 – Affidavit of Property Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A)

Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A) Affidavit 4 – Health Insurance Affidavit

Affidavit 4 – Health Insurance Affidavit Affidavit 5 – Motion and Affidavit or Counter Affidavit for

Affidavit 5 – Motion and Affidavit or Counter Affidavit for Temporary Orders Without Oral Hearing

Temporary Orders Without Oral Hearing Notice of Hearing on Dissolution of Marriage

DR-6 IV-D Application for Services Mandatory Language for Orders Regarding Child Support, Spousal

Child Support Worksheet – Sole/Shared Parenting Support and Health Insurance

Child Support Worksheet – Split Parenting Rights 2. Wage Withholding Forms

Notice to Employer to Withhold Income (Form ODHS 4047)

C. Columbiana County Notice to Employer Addendum (Form ODHS 4048)

Affidavit 1--Affidavit of Income and Expenses Notice to Employer to Enroll Employee in Health Plan (Form OHHS

Affidavit 2 – Affidavit of Property 4040)

Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A) Notice to Employee to Provide Health Insurance

Affidavit 5 – Motion and Affidavit or Counter Affidavit for 3. Parenting Time Forms

Temporary Orders Without Oral Hearing Standard Parenting Time Schedule (Local)

Rule 9(g) Form Standard Parenting Time Schedule (Long Distance)

Personal Identifiers Transitional Parenting Time Schedule

Notice of Intent to Relocate (Local) Child Support Worksheet – Split Parenting Rights

Notice of Intent to Relocate (Long Distance)

4. Miscellaneous Forms Ninth Appellate District

Summons and Order to Appear A. Lorain County

Explanation of Medical Bills Affidavit 1--Affidavit of Income and Expenses

Entry Converting Dissolution to Divorce Action Affidavit 2 – Affidavit of Property

Entry Converting Divorce to Dissolution Action Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A)

Division of Property Order (State Pension) Affidavit 4 – Health Insurance Affidavit

Application for Appointment as Standing Special Process Server Case Management Order

Explanation of Medical Bills Case Management Conference Notice

Notice of Registration of Foreign Support Order Judgment Entry Restraining Order

Judgment Entry Confirming Registration of Foreign Support Order Notice of Hearing

Notice of Registration of Foreign Custody Order Notice of Seminar for Separating Parents

Poverty Affidavit and Order Standard Parenting Order

Request, Affidavit and Order for Service by Publication or Posting Application for Child Support Services (IV-D) ODHS 7076

Legal Notice Posting Monthly Income and Expense Form

Legal Notice Publication Health Insurance Order

Child Support Worksheet – Sole/Shared Parenting Order Approving Filing with Poverty Affidavit

Child Support Worksheet – Split Parenting Rights Request for Service

Child Support Worksheet – Sole/Shared Parenting

G Monroe County Child Support Worksheet – Split Parenting Rights

Affidavit 1--Affidavit of Income and Expenses

Affidavit 2 – Affidavit of Property B. Medina County

Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A) Affidavit 1--Affidavit of Income and Expenses

Affidavit 4 – Health Insurance Affidavit Affidavit 2 – Affidavit of Property

Affidavit 5 – Motion and Affidavit or Counter Affidavit for Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A)

Temporary Orders Without Oral Hearing Affidavit 4 – Health Insurance Affidavit

Application for Child Support Services – (IV-D) Affidavit 5 – Motion and Affidavit or Counter Affidavit for

Parenting Schedule Temporary Orders Without Oral Hearing

Child Support Worksheet – Sole/Shared Parenting Instructions for Service

Child Support Worksheet – Split Parenting Rights Motion for Temporary Orders (Form 4.01A)

IV-D Application for Child Support Services (Form 4.01.B)

H. Noble County UCCJEA Affidavit (Child Custody Affidavit

Affidavit 1--Affidavit of Income and Expenses Income & Expense Form (Form 4.01D)

Affidavit 2 – Affidavit of Property Response to Motion for Temporary Orders (Form 4.01E)

Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A) Mutual Restraining Order (Form 4.02)

Affidavit 4 – Health Insurance Affidavit Trial Brief (Form 5.07)

Affidavit 5 – Motion and Affidavit or Counter Affidavit for Guardian Ad Litem Questionnaire (Form 6.01A)

Temporary Orders Without Oral Hearing Standard Parenting Schedule (Local) Form 6.04A)

Information Sheet Standard Long Distance Parenting Schedule (Form 6.04B)

Standard Orders of Visitation Change of Address Form

Child Support Worksheet – Sole/Shared Parenting Mediation Request

Child Support Worksheet – Split Parenting Rights Suggested Provisions for Health Insurance Coverage

Summons and Order to Appear

Eighth Appellate District Waiver of Counsel

Cuyahoga County Waiver of Service

Case Designation Form Child Support Worksheet – Sole/Shared Parenting

Parenting Proceeding Affidavit (ORC 3127.23) Child Support Worksheet – Split Parenting Rights

IV-D Application for Child Support Services

Motion for Support Pendente Lite with Affidavit and Notice C. Summit County

Answer with Affidavit to Motion for Support Pendente Lite with Clerk of Courts Forms

Affidavit and Notice New Case Designation Form

Income and Expense Statement with Affidavit (Post Decree) Service Request

Private Health Insurance Questionnaire Service Request Child Support

Standard Parenting Guidelines Subpoena

Pretrial Statement Civil Rule 58 Service Request

Motion to Continue Court Forms

Entry Granting Continuance Affidavit 1--Affidavit of Income and Expenses

Motion to Correct Arrearage Affidavit 2 – Affidavit of Property

Entry Correcting Arrearage Dissolution Affidavit of Property and Income

Notice of Intent to Relocate Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A)

Decree with Children Affidavit 4 – Health Insurance Affidavit

Child Support Worksheet – Sole/Shared Parenting Mutual Restraining Order and Case Management Plan

Agreed Entry Findings of Fact Regarding Assets and Liabilities and Affidavit of

Informal Family Court Services Proceeding Assets and Liabilities

Parenting Time Schedule Confidential Disclosure of Personal Identifiers

Complaint to Establish Parent Child Relationship and Motions Child Support Worksheet – Sole/Shared Parenting

Order to Appear and Show Cause Child Support Worksheet – Split Parenting Rights

Explanation of Medical Bills Form

Motion for Continuance Eleventh Appellate District

Order for Continuance A. Ashtabula County

Client Affidavit for Attorney Fees and Litigation Costs Filing Designation

Motion to Modify, Extend or Dismiss Civil Protection Order Confidential Disclosure of Personal Identifiers

Praecipe to Court Reporter Order to Attend Parenting Education and Mediation

Notice of Intent to Relocate Child Support Worksheet – Sole Custody/Shared Parenting

IV-D Application for Services (JFS07076 Rev. 5/01) Child Support Worksheet – Split Custody

CSEA Information Sheet Standard Companionship Order

Authorization for Facsimile Filing IV-D Application for Services

Objection to Administrative Child Support Order Notice to Payor to Withhold Obligor Income/Assets

Child Support Worksheet – Sole/Shared Parenting Health Insurance and Expense Orders

Child Support Worksheet – Split Parenting Rights

B. Geauga County

D. Wayne County Domestic Designation Form

Affidavit 1--Affidavit of Income and Expenses IV-D Application for Child Support Services (ODHS 7076 Rev.

Affidavit 2 – Affidavit of Property 11/92)

Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A) Child Custody Affidavit

Affidavit 4 – Health Insurance Affidavit Sensitive Information Sheet

Affidavit 5 – Motion and Affidavit or Counter Affidavit for Health Insurance Order

Temporary Orders Without Oral Hearing Guidelines Worksheet Addendum

Parenting Time/Companionship/Visitation Schedule Husband/Wife Guidelines Worksheet

Child Support Worksheet – Sole/Shared Parenting Standard Parenting Time Guidelines

Child Support Worksheet – Split Parenting Rights Child Support Worksheet – Sole/Shared Parenting

Child Support Worksheet – Split Parenting Rights

Tenth Appellate District

Franklin County C. Lake County

Affidavit 1--Affidavit of Income and Expenses Case Designation Sheet

Affidavit 2 – Affidavit of Property Affidavit Regarding Parenting Proceeding

Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A) IV-D Application for Child Support Services

Affidavit 4 – Health Insurance Affidavit Affidavit of Income, Expenses and Property

Affidavit 5 – Motion and Affidavit or Counter Affidavit for Answer Affidavit

Temporary Orders Without Oral Hearing Change of Address Form

Affidavit of Indigency Child Support Worksheet – Sole/Shared Parenting

Model Parenting Time Schedule Child Support Worksheet – Split Parenting Rights

Instructions for Ordinary Mail Service (2 parties) Deviation Language (Exhibit 2)

Request for Service Entry Restoring Former Name

Instructions for Service Health Care Determinations

Instructions for Ordinary Mail Service Health Insurance and Expense Orders

Magistrate's Order/Notices to Obligor, Obligee, Payor and Insurer Motion for Continuance

(Form 1) Motion for Temporary Orders

Order to Seek Employment Mutual Restraining Order

Order Terminating Withholding (Form 24) Order for Collection of Child Support (Exhibit 1)

Notice to Withhold (ODJFS 4047) Order to Appear and Show Cause

Addendum Withholding Notice (ODHS 4048) Order to Post Bond

Instructions for Ordinary Mail Service of Final Entry Order to Report

Notice of Hearing ORC 3109.051 Order

Rule 11 Certificate Pretrial Orders

Summons and Order to Appear Instructions for Service (Motion)

Motion for Continuance Instructions for Service (Order)

Support Modification Affidavit Order to Terminate Withholding

Notice Certificate Standard Parenting Schedule

Pretrial Statement

Certification D. Portage County

IV-D Application for Services Affidavit 1--Affidavit of Income and Expenses

Civil Protection Order Information Sheet Affidavit 2 – Affidavit of Property

Addendum to DC Petition Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A)

Affidavit 4 – Health Insurance Affidavit

Affidavit 5 – Motion and Affidavit or Counter Affidavit for DR 708 Health Insurance Provisions of Support Order (Order to

Temporary Orders Without Oral Hearing Provide Insurance)

Child Support Worksheet – Sole/Shared Parenting DR 713 Motion to Modify

Child Support Worksheet – Split Parenting Rights DR 714 Motion for Contempt; Violation of Order

Affidavit of Indigency DR 715 Agreed Entry- Final Appealable Order (Hearing Required)

Temporary Order Information Sheet (Appendix B) DR 716 Agreed Entry- Final Appealable Order (No Hearing

CSEA Registration Form (Appendix C) Required)

Standard Parenting Time Schedule (Appendix D) DR 729 Family Information Sheet

Standard Out of State or Extended Distance Parenting Time DR 803 Guidelines for Parents Living in Different Homes

Schedule (Appendix E) DR 821 Summons in Contempt; Order to Appear

Standard Grandparent/Relation Parenting Time Schedule (Schedule C 13 Notice of Intent to Relocate Within Butler County

F) C 13A Notice of Intent to Relocate Outside Butler County

Guardian Ad Litem Report (Appendix G) C-14 Objection to Decision of Magistrate

Praecipe to Court Reporter (Appendix H) C 15 Mandatory Support Language (Blank form with caption)

Explanation of Medical Bills (Appendix I) C 15 Mandatory Support Language (Automated form)

Motion to Continue, Affidavit and Order C 16 Notice to Case Management

Change of Name C 17 Notice to Parents

Request for Service and Instructions C 18 Waiver of Magistrate Findings of Fact and Time Period for

Filing Objections

E. Trumbull County C 19 Waiver of Notice of Intent to Relocate

Affidavit of Income and Expenses C 20 Supplemental Affidavit

Child/Spousal Support Information Sheet C 33 Explanation of Medical Bills

Ex Parte Custody Court Inquiry DV 001 Personal Description of Petitioner and Respondent in a

Declaration under UCCJEA (Parenting Affidavit) Domestic Violence Order

Affidavit Application for Registration of an Out-of-State Order PLEADINGS AND ADDITIONAL DOCUMENTS

Pre-Trial Statement Complaint for Divorce

Standard Parenting Rules Ex Parte Temporary Order

Child Support Worksheet – Sole/Shared Parenting Separation Agreement

Child Support Worksheet – Split Parenting Rights Shared Parenting Plan

Decree of Divorce

Twelfth Appellate District Decree of Dissolution

A. Butler County Decree of Legal Separation

Appendix A – Child Support Language Pre-Trial Statement

Appendix B – Affidavit of Available Health Care Coverage Certificate of Mailing

Appendix C – Health Insurance Language Motion for Contempt

DR-04 Military Affidavit

DR 18 Waiver of Magistrate Findings of Fact and Time Period for B. Clermont County

Filing Objections 101 - Certificate of Readiness

DR 106 Request to Review Court Costs 102 - Service Information for Civil Restraining Order

DR 142 Household Goods and Furnishings 103 - Objection to Magistrate's Decision

DR 201 Withholding Order/Qualified Medical Child Support Order 104-B - Agreed Entry & 14 Day Waiver

Information Sheet 105-A - Poverty Affidavit

DR 215 Itemized Evidence Inventory 105-B – Financial Disclosure/Affidavit of Indigency

DR 602A Affidavit of Income 106 - Motion for Continuance

DR 602B Affidavit of Property 107 - Entry of Continuance

DR 602C Affidavit of Expenses 109 - Petition for Conciliation

DR 610 Guidelines for Parenting Time 110 – Praecipe/Praecipe for Transcript

DR 616 Information for Parenting Proceeding Affidavit 111 - Entry Converting Divorce to Action for Dissolution

DR 617 Health Insurance Information Form 112 - Entry Converting Dissolution to Action for Divorce

DR 624 Child Support Worksheet – Sole/Shared Parenting 113 - Motion Requesting Documents Not to be Displayed on the

DR 625 Child Support Worksheet – Split Parenting Internet

DR 627 Request for Interpreter 114 - Order to Remove from Internet

DR 628 Order to Attend Parenting Class 115 - Classification Form

DR 629 Motion & Order for Continuance 116 - Notification Form

DR 630 Support Order Information Sheet 117 - Facsimile Filing Cover Page

DR 634 Addendum to Separation Agreement – Division of Personal 118 - Application Requesting Permission to Broadcast, Televise,

Property Photograph, Record Courtroom Proceedings

DR 700 Notice and Entry to Dismiss or Withdraw Motions 121 – Blank Motion and Affidavit

DR 705 Health Insurance Provisions of Support Order (Obligor 124-A – Motion to Proceed in Forma Pauperis

and/or Obligee to Provide Insurance) 201 – Notice of Service

DR 707 Health Insurance Provisions of Support Order (No Group 202 – Motion and Affidavit or Counter Affidavit for Temporary

Health Insurance) Orders without Oral Hearing

301 – Post Decree Motion and Affidavit

302 – Post Decree Motion for Contempt and Affidavit Affidavit 1--Affidavit of Income and Expenses

304-F – Explanation of Medical Bills Form – Father Affidavit 2 – Affidavit of Property

304-M – Explanation of Medical Bills Form –Mother Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A)

407 – Child Support with Private Medical Insurance Affidavit 4 – Health Insurance Affidavit

408 - Child Support without Private Medical Insurance Affidavit 5 – Motion and Affidavit or Counter Affidavit for

409 - Health Insurance Affidavit Temporary Orders Without Oral Hearing

501 - Affidavit of Income and Expenses Child Support Worksheet – Sole/Shared Parenting

502 – Affidavit of Property Child Support Worksheet – Split Parenting Rights

509-4 – CSEA Account Information

601 – Final Decree of Shared Parenting E. Madison County

602 – Shared Parenting Plan Parenting Schedule

604 – Parenting proceeding Affidavit Child Support Worksheet – Sole/Shared Parenting

605 – Parenting times Schedule Child Support Worksheet – Split Parenting Rights

605B – Guidelines for Parents living in Different Homes

606 – Parental Questionnaire and Information Sheet F. Preble County

607 – Parental Investigation and Information Sheet Affidavit 1--Affidavit of Income and Expenses

614 – Caretaker Authorization Affidavit 2 – Affidavit of Property

615 – Power of Attorney (Grandparent) Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A)

616 – Entry and Order of Custody upon Death of a Party Affidavit 4 – Health Insurance Affidavit

622 – 2011 Ohio DFS USDA Cash Medical Support Schedule Affidavit 5 – Motion and Affidavit or Counter Affidavit for

623 – 2011 US HHS Poverty Guidelines Temporary Orders Without Oral Hearing

626 - Child Support Worksheet Information Instructions for Service

701 – Appearance and Waiver of Summons Personal Identifier Reference List

702 – Waiver of Counsel Guidelines for Visitation

703 – Waiver of Affidavit of Income and Expenses Judgment Entry/Child Support and Medical Support

704 – Waiver of Affidavit of Property Application for Services (IV-D) (Form ODHS 7076)

705 – Waiver of 14 Day Objection Period Child Support Worksheet – Sole/Shared Parenting

706 – Waiver of Venue Child Support Worksheet – Split Parenting Rights

801 – Motion for Hearing on Notice to Relocate

802 – Notice of Intent to Relocate within Clermont County G. Warren County

803 – Notice of Intent to Relocate outside of Clermont County Form 1 - Affidavit of Income and Expenses and Property

804 – Supplemental Affidavit Form 2 - Personal History of Parties

7076 – IV-D Application for Services Form 4 - Information for Parenting Proceeding

4047 – Order/Notice to Withhold Income for Child Support Form 5 - Request for Transcript

4048 – Addendum to Withholding Notice Form 7 – Mutual Restraining Order

Confidential Disclosure of Personal Identifiers Form 8 – Notice of Intent to Relocate

Form 9 – Notice of Presentation of Entry

C. Clinton County Form 10 - Health Insurance Information Form

Affidavit 1--Affidavit of Income and Expenses Form 11 – Information Sheet for Notice to Income Provider

Affidavit 2 – Affidavit of Property Form 12 – IV-D Application (OHHS 7076)

Affidavit 3 – Parenting Proceeding Affidavit (ORC 3127.23(A) Praecipe for Service

Affidavit 4 – Health Insurance Affidavit Basic Parenting Schedule

Affidavit 5 – Motion and Affidavit or Counter Affidavit for Child Support Worksheet – Sole/Shared Parenting

Temporary Orders Without Oral Hearing Child Support Worksheet – Split Parenting Rights

IV-D Application for Services Notifications

Child Support Worksheet – Sole/Shared Parenting Child Support Language with Cash Medical Support

Child Support Worksheet – Split Parenting Rights Motion, Order and Affidavit of Indigency



D. Fayette County