State of Alabama 
Unified Judicial System 
CS-16  Rev. 7/2019 
Page 1 of 2 

ORDER ESTABLISHING PATERNITY 
AND SETTING AMOUNT OF CHILD SUPPORT 

Court Case Number 

IN THE ____________      COURT OF ______________________      COUNTY, ALABAMA 
STATE OF ALABAMA,  ex rel. 
Plaintiff 

v. Defendant 

      

     

Address 

 

Address 

FINDINGS: 

This case having been heard on the __     day of _______     ,  ____   , this Court finds that it has jurisdiction over the parties and the 
subject matter. This Court further finds that the Defendant was properly served with a summons and petition by: 

 personal service; 

 certified mail. 

The following persons were present: 

 Plaintiff: 
 Defendant: 
 State’s Attorney _____________    

 Pro se 
 Pro se 
 Other ________________________________________________ 

 Plaintiff’s Attorney 
 Defendant’s Attorney       

                  
                  

This case being submitted 
the Court finds that the Defendant is the father of the minor child(ren) and is obligated to pay child support for the minor child(ren) 
named herein. 

 upon the pleadings and upon the evidence presented or 

 upon the agreement reached by the parties, 

 This Court finds that health care coverage is unavailable, unavailable at reasonable cost, or is not accessible. 

IT IS THEREFORE ORDERED BY THE COURT AS FOLLOWS: 

1. The Defendant is adjudicated to be the father of child(ren) named below:

NAME OF CHILD 

BORN TO (MOTHER) 

DATE OF 
BIRTH 

2. The Defendant is ORDERED to pay the sum of $ _______     per ______      commencing on _      for the support and

maintenance of the minor child(ren) named above.

 That the award of child support made herein was determined by application of the Child Support Guidelines established by 
Rule 32, Alabama Rules of Judicial Administration.  The Child Support Guidelines (CS-42) and the Child Support Obligation 
Income Statement/Affidavit (CS-41) forms have been filed herein and are made a part of the record in this case. 

 The Court finds that deviation is appropriate based on the Child Support Guidelines established by Rule 32, Alabama Rules 
of Judicial Administration.  The findings are noted in the Child Support Guidelines Notice of Compliance (CS-43). 

3. The child support payments shall continue until discharged as provided by law.

4. The child support payments shall be made payable to: Alabama Child Support Payment Center at P.O. Box 244015,

Montgomery, Al  36124-4015.

5.

 the Plaintiff, wherever employed, shall include the child(ren) named above on any health care

The Defendant OR 
coverage policy at his or her place of employment and shall provide proof of the coverage within thirty (30) days of the date
of this order to the other party in non-Title IV-D cases OR to the ______________      County Department  of Human
Resources in Title IV-D cases.

The Defendant OR 
she shall purchase and shall provide proof of the coverage within thirty (30) days of the date of this order to the other party in
non-Title IV-D cases OR to the _________________      County Department of Human Resources in Title IV-D cases.

 the Plaintiff shall include the child(ren) named above on any health care coverage policy which he or

COURT RECORD 

ATTORNEY 

DEFENDANT 

State of Alabama 
Unified Judicial System 
CS-16  Rev. 7/2019 
Page2 of 2 

ORDER ESTABLISHING PATERNITY 
AND SETTING AMOUNT OF CHILD SUPPORT 

Court Case Number 

 The Defendant is ordered to pay __    % and the Plaintiff is ordered to pay __    % of all unreimbursed health expenses.  
The parties must submit within 30 days any unreimbursed health expenses to the other party and payment of the expenses 
must be made within 30 days of this submission. 

 The Defendant is ordered to pay the sum of $ ______     per __      commencing on ____      for the medical support of the 
minor child(ren) named above, as health care coverage is not accessible, not available, or is not available at a reasonable 
cost. 

 Other arrangements regarding health care coverage: ______________________________________     . 

6. The Defendant shall notify

                  County Department of Human Resources as to any change of address, employment, or  

lapse orchange in health care coverage.

7.  The Defendant is ordered to pay the following:

 $_____      representing retroactive child support to be paid at the rate of $_____      per _____      commencing on ___     . 

 $_____      representing the cost of genetic testing to be paid at the rate of $ _____     per _      commencing on ______     , 
or repaid as follows________________     ._____ 

 $_____      representing previous medical expenses to be paid at the rate of $_________      per ______      commencing 
on ____________     . 

These sums are hereby reduced to a judgment for which let execution issue.  Interest will continue to accrue on this judgment 
until it has been satisfied in full as provided in Ala.Code 1975, Section 8-8-10.   

8.

If necessary, an amended certificate(s) of birth, consistent with the findings of this Court, shall be issued pursuant to the
provisions of the Ala.Code 1975, Section 26-17-636(f).

9. Costs of these proceedings are taxed as follows:

 against Plaintiff, for which let execution issue; 

 against Defendant, for which let execution issue; 

 waived. 

10. Reference is hereby made in this Order Establishing Paternity and Setting Amount of Child Support to a separate income

withholding order, the entry of which is required of this Court by law, and which is specifically incorporated herein as a part of
this Court’s Order in this case.

11.

In cases where payments are ordered paid directly to the Clerk of the Court, there shall be paid an additional $1.00
administrative fee as provided in Ala.Code 1975, Section 12-19-26, with each periodic payment.

12. Other:   _________________________________________________     .

Ordered this the _     day of ______     , ___    . 

Signature of Judge 

COURT RECORD 

ATTORNEY 

DEFENDANT