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Saskatchewan Agreement as to Child Support Form


Saskatchewan Agreement as to Child Support Form
Saskatchewan Agreement as to Child Support Form
Form 15-28B
(Subrule 15-28(2))
AGREEMENT AS TO CHILD SUPPORT
THE PARTIES AGREE AS FOLLOWS:
1 The income of the payor __________________________________________ is $ ________________.
(name)
2 The payor currently resides in _________________________________________________________.
(province or, if resident outside of Canada, country)
3 The income of the recipient ________________________________________ is $ ________________.
(name)
4 The recipient currently resides in _______________________________________________________.
(province or, if resident outside of Canada, country)
(Paragraphs 3 and 4 must be included if special or extraordinary expenses are to be shared or if the
amount agreed to differs from the table amount set out in the Federal Child Support Guidelines.)
5 Child support is to be provided for (state names and dates of birth of children for whom child
support is to be provided)
Name of Child
Date of Birth
and according to the applicable child support table set out in the Federal Child Support Guidelines, the
amount of child support payable for that number of children (the “child support table amount”)
is $ _____________________________.
6 The payor will pay to the recipient, ______________________________________________________,
(name)
child support of $ ______________________________ per month for the children referred to in section 5.
COURT FILE NUMBER
_______________________________________
Clerk's Stamp
COURT OF QUEEN’S BENCH FOR SASKATCHEWAN
(FAMILY LAW DIVISION)
JUDICIAL CENTRE
_______________________________________
PETITIONER(S)/
CO-PETITIONER(S)
_______________________________________
RESPONDENT(S)
_______________________________________
Saskatchewan Agreement as to Child Support Form
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