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THE COURT FINDS:

1. Paragraph(s)

in the preceding pages of the uniform order deviate from the Michigan Child

(Specify paragraph number.)

Support Formula and are warranted to avoid an unjust or inappropriate result.

2. Pursuant to MCL 552.605(2), it has been determined from the facts of this case that:

a. The child support obligation that would be ordered by applying the Michigan Child Support Formula is:

Payer:

Payee:

Children’s names and annual overnights with payer:

Children’s names

Overnights

1 child

2 children

3 children

Children supported
4 children
Base Support: (includes support plus or minus premium adjustment for health-care insurance)
Support:
$
Premium adjust. $
Subtotal:
$
Ordinary medical: $
$
Child care:
$
Other:
$
Benefit credit:
$
Total:

$
$
$
$
$
$
$
$

Support was reduced because payer’s income was reduced.

$
$
$
$
$
$
$
$

5 or more children

Uninsured Health-Care Expenses. All uninsured health-care expenses exceeding the annual ordinary medical
% by the defendant. Uninsured expenses exceeding
amount will be paid

the annual ordinary medical amount for the year they are incurred that are not paid within 28 days of a written payment
.
request may be enforced by the friend of the court. The annual ordinary medical amount is

% by the plaintiff and

STATE OF MICHIGANJUDICIAL CIRCUITCOUNTYUNIFORM CHILD SUPPORT ORDERDEVIATION ADDENDUMCASE NO. and JUDGECourt addressCourt telephone no.Plaintiff’s namevDefendant’s nameApproved, SCAOForm FOC 10d, Rev. 7/20MCL 552.517, MCL 552.517b(3), MCL 552.605, MCR 3.211Page 1 of 2Distribute form to: Court PlaintiffDefendant Friend of the courtUniform Child Support Order Deviation Addendum
Page 2 of 2

(7/20)

Case No.

(Item 2 continued.)

Health-Care Coverage. For the benefit of the children, the
coverage (as defined in MCL 552.602) that includes payment for hospital, dental, optical, and other health-care expenses when
that coverage is accessible to the child and available at a reasonable cost. The reasonable cost is the parent’s net cost of
adding the children to the parent’s coverage

defendant shall maintain health-care

for defendant.

plaintiff

up to a maximum of $

not to exceed 6% of the plaintiff’s/defendant’s gross income.

for plaintiff.

up to a maximum of $

b. Applying the Michigan Child Support Formula is unjust or inappropriate because: (Specify the deviation factors relied on.)

c. The child support order deviates from the Michigan Child Support Formula as follows:

(Specify which provisions of the child support formula create an unjust or inappropriate result and explain how this order deviates from the
provisions.)

d. The value of property or other support awarded instead of the payment of child support: (If not applicable, put none.)

Plaintiff (if consent/stipulation)

Date

Defendant (if consent/stipulation)

Date

Plaintiff’s attorney

Date

Defendant’s attorney

Date

Prepared by:

Name (type or print)

NOTE: When deviating, this form must be completed, attached, and served along with the rest of the Uniform Child Support Order. The proof of service on
the Uniform Child Support Order must indicate this form was included.

FOC 10d, Uniform Child Support Order, Deviation Addendum

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the Michigan state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from www.courts.michigan.gov/Domestic-Relations (2023-03)
Page(s): 2
Fields(s): 87
Average fields per page: 43
Reading Level: Grade 13
LIST Grouping(s): MO-00-00-00-00, HE-00-00-00-00.

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Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

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plaintiffs_name was Plaintiffs name (0.45 conf)
defendants_name was Defendants name (0.40 conf)
specify_paragraph_number was Specify paragraph number (0.37 conf)
payer was Payer (0.40 conf)
payee was Payee (0.40 conf)
annual_payer_row__1 was Childrens names and annual overnights with payer Childrens names OvernightsRow1 (0.35 conf)
annual_payer_row__2 was Childrens names and annual overnights with payer Childrens names OvernightsRow1_2 (0.38 conf)
annual_payer_row__3 was Childrens names and annual overnights with payer Childrens names OvernightsRow2 (0.35 conf)
annual_payer_row__4 was Childrens names and annual overnights with payer Childrens names OvernightsRow2_2 (0.38 conf)
annual_payer_row__5 was Childrens names and annual overnights with payer Childrens names OvernightsRow3 (0.35 conf)
annual_payer_row__6 was Childrens names and annual overnights with payer Childrens names OvernightsRow3_2 (0.38 conf)
annual_payer_row__7 was Childrens names and annual overnights with payer Childrens names OvernightsRow4 (0.35 conf)
annual_payer_row__8 was Childrens names and annual overnights with payer Childrens names OvernightsRow4_2 (0.38 conf)
annual_payer_row__9 was Childrens names and annual overnights with payer Childrens names OvernightsRow5 (0.35 conf)
annual_payer_row__10 was Childrens names and annual overnights with payer Childrens names OvernightsRow5_2 (0.38 conf)
annual_payer_row__11 was Childrens names and annual overnights with payer Childrens names OvernightsRow6 (0.35 conf)
annual_payer_row__12 was Childrens names and annual overnights with payer Childrens names OvernightsRow6_2 (0.38 conf)
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annual_payer_row__14 was Childrens names and annual overnights with payer Childrens names OvernightsRow7_2 (0.38 conf)
undefined__1 was undefined (0.38 conf)
amount_incurred_paid_payment was the annual ordinary medical amount for the year they are incurred that are not paid within 28 days of a written payment (0.37 conf)
uninsured_expenses_exceeding was by the defendant Uninsured expenses exceeding (0.45 conf)
undefined__2 was undefined_2 (0.39 conf)
text__1 was Text1 (0.35 conf)
judge was Judge (0.39 conf)
text__2 was Text3 (0.35 conf)
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plaintiff was plaintiff (1.00 conf)
defendant__1 was defendant (1.00 conf)
maximum__1 was up to a maximum of (0.38 conf)
undefined__3 was undefined_3 (0.39 conf)
maximum__2 was up to a maximum of_2 (0.36 conf)
defendant__2 was for defendant (0.38 conf)
exceed_gross_income was not to exceed 6 of the plaintiffsdefendants gross income (0.40 conf)
plaintiff_consentstipulation was Plaintiff if consentstipulation (0.57 conf)
signature_date__1 was Date (1.00 conf)
defendant_consentstipulation was Defendant if consentstipulation (0.48 conf)
signature_date__2 was Date_2 (1.00 conf)
plaintiffs_attorney was Plaintiffs attorney (0.45 conf)
signature_date__3 was Date_3 (1.00 conf)
defendants_attorney was Defendants attorney (0.45 conf)
signature_date__4 was Date_4 (1.00 conf)
name_type_print was Name type or print (0.45 conf)
text__4 was Text5 (0.35 conf)
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text__6 was Text6d (0.35 conf)

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

FOC 10d, Uniform Child Support Order, Deviation Addendum

About This Form:

Identified Data Fields:

Create an Interactive Version of this Form:

The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02