STATE OF MICHIGAN

CASE NO. and JUDGE

JUDICIAL CIRCUIT
COUNTY 

UNIFORM SPOUSAL SUPPORT ORDER 
 TEMPORARY    
 FINAL

 EX PARTE                                
  MODIFICATION                        

     
    

Court address

Court telephone no.

Plaintiff’s name, address, and telephone no.

Defendant’s name, address, and telephone no.

v

Plaintiff’s attorney, bar no., address, and telephone no.

Defendant’s attorney, bar no., address, and telephone no.

Plaintiff’s source of income name, address, and telephone no.

Defendant’s source of income name, address, and telephone no.

1. Spousal Support. Spousal support shall be paid monthly through the Michigan State Disbursement Unit as follows:

Payer:

Payee:

Effective date:

Amount:
$

2. Income withholding takes immediate effect for those items payable through the Michigan State Disbursement Unit.

3. This order continues until the death of the payee or until the earliest of the following events:

 4. This order modifies a spousal support order entered on or before December 31, 2018. For tax purposes, the payments 
    will be deductible to the payer and included in the income of the payee.

 Date: 
 

           

 $ 
 

 is paid.

 Remarriage of the payee.            

 Death of the payer.

 Other (specify all other events): 
 

   

 

   

   

   

 

 

This order is entered 

 

 after hearing. 

 

 on stipulation/consent of the parties.

IT IS ORDERED, UNLESS OTHERWISE ORDERED IN ITEM 11:

 Standard provisions have been modified (see item 11).

Approved, SCAOForm FOC 10b, Rev. 7/22MCL 552.13, MCR 3.211Page 1 of 2Distribute form to: Court PlaintiffDefendant Friend of the courtUniform Spousal Support Order 
Page 2 of 2

(7/22) 

Case No. 
 

 5. Payments that must be paid directly to the third party (not to the payee) are listed below. (Payments to be made  
    directly to a third party are not payable through the Michigan State Disbursement Unit or friend of the court.)

 

 

Type

Amount Per Month Start Date

Pay to

End Date

$ $ $ $

6. Retroactive Modification, Surcharge for Past-Due Support, and Liens for Unpaid Support. Support is a judgment  
 
the date it is due and is not retroactively modifiable. A surcharge may be added to past-due support. Unpaid support is   
  a lien by operation of law and the payer’s property can be encumbered or seized if an arrearage accrues for more than  
 

the periodic support payments payable for two months under the payer’s support order.

7. Address, Employment Status, Health Insurance. Both parties shall notify the friend of the court in writing of: a) their 
 
  mailing and residential addresses and telephone numbers; b) the names, addresses, and telephone numbers of  
 
their sources of income; c) their health-maintenance or insurance companies, insurance coverage, persons insured, or  
  contract numbers; d) their occupational or driver’s licenses; and e) their social security numbers unless exempt by law   
  pursuant to MCL 552.603. Both parties shall notify the friend of the court in writing within 21 days of any change in this   
 

information. Failure to do so may result in a fee being imposed.

8. Fees. The payer of support shall pay statutory and service fees as required by law.

9. Prior Orders. This order supersedes all prior spousal support orders. Past-due amounts owed under any prior
  support order are preserved.

10.  Property Settlement. All property settlement (alimony in gross) payment obligations that are set forth in the    
 

  judgment are not part of this order.

 

11.  Other: (Attach separate sheets as needed.)

Plaintiff (if consent/stipulation)                                                              Date

Defendant (if consent/stipulation)                                                             Date

Plaintiff’s attorney                                                                                  Date

Defendant’s attorney                                                                                 Date

 

 

Judge signature and date

CERTIFICATE OF MAILING

 

Date

I served a copy of this order on the parties or their attorneys by first-class mail addressed to their last-known addresses as 
defined by MCR 3.203. I declare under the penalties of perjury that this certificate of mailing has been examined by me and 
that its contents are true to the best of my information, knowledge, and belief.

 

Signature