Rachael Yadira Rivera, OLMSTED COUNTY DEPT (2024)

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`55-FA-20-7368
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`Summons in this action.
`* Rachael Yadira Rivera was personally served in Minnesota with the
`Summons in this action.
`Joseph Lawrence_McShan was personally served the Summons and Complaint
`on 05/21/2022.
`* More than tWenty—One (2 ) days have elapsed from the original service
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`'of the Summons and Complaint and Joseph Lawrence McShan did not
`respond.
`Rachael Xadira Rivera was served the Summons and Complaint on
`09/01/2022.
`* More than twenty-one (21) days have elapsed from the original service
`of the Summons and Complaint and Rachael Yadira Rivera did not
`.respond.
`Joseph Lawrence McShan is not an active member of the Armed Services of
`the United States.
`Rachael Yadira Rivera is not an active member of the Armed Services of
`the United States.
`Joseph Lawrence McShan and Rachael Yadira Rivera are the parents of the
`following joint child(ren):
`Jadalynn A. Mcshan.
`DOB 07/02/2013
`"'0 The joint child(ren"),
`.r'e,si»de,ig(f'=s} wifith- Racha'el. Eadira River.a.~
`lms:e1 County had previously initiated a
`legal action in Court
`to establish child support for Jadalynn. This act;on "
`dism;ssed by the court on 02/0l/202l as
`the parties were
`together-
`ll" Rachael Xadira Rivera submitted.an application'for medical assistanCe
`on December 2, 2021.and an application.for cash assistance on January
`20, 2022. She did not list Joseph Lawrence McShan as part of her
`household- It is unknown when they separated. Rachel Yadira Rivera has
`not returned any documents'to the child.support office.
`Joseph Lawrence McShan and Rachael Yadira Rivera signed a Recognition
`of Parentage for the following_301nt child(ren):
`Jadalynn A..Mcshan
`Signed by Rachael Yadira Rivera on 12/27/2013
`Signed by Joseph Lawrence McShan On.l2/27/20l3
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`(A
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`IV~D Case No: 001443770502
`Doc ID? 109C5005000000194Z
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`E000300020
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`55-FA-20-7368
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`Joseph Lawrence.McShan's total monthly household expenses are unknown.
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`14. Rachael Yadira Rivera's total monthly household expenses are unknown.
`Joseph Lawrence McShan's last.known.employer is:
`15.
`Rochester Motor Co
`Rochester Ford/toyota
`4900 Highway 52 N
`Rochester, MN 55901e0163
`Joseph Lawrence McShan's monthly income received is $2773.00. Said
`income was determined by:
`* Hourly wage of $16.00 per hour, based on 40 hours per week.
`Joseph Lawrence McShan's monthly gross.income as calculated under
`Minnesota Statutes, section 518A.29 is $2773.00.
`18. Rachael Yadira Rivera receives:
`* MFIP Cash, creating an assignment under Minnesota and Federal Law.
`For the month of 02/2022,
`the MFIP (TANF) cash grant amount was
`$751.00 per month. This amount may vary from month to month. From
`02/01/2022 to 04/30/2022, $2253.00 of Cash Assistance has been
`expended. During this time period,
`0 months were Non-Cash or
`Non—Public Assistance.
`* Medical Assistance.
`,Rachael, :Xad'ira Rivera's last known employer is:
`lllies Nohava Heinen Prop Mgmt
`IIriih Property Mgmt
`Inc,
`175'7th Ave S
`Waite Park,IMN'56387-1362
`20. Rachael Xadira Rivera is:
`* Unemployed
`21_ There is no direct.evidehCe of Rachael Yadira Rivera's income.
`22. Rachael Yadira Rivera is a recipient of TANF and.Child Support should
`not be calculated based upon a determination of potential income.
`23. Rachael Yadira Rivera has a.legal obligation to support the following
`in Rachael Yadira Rivera's household:
`nonjoint child(ren) who reside(s)
`Analys E. Rivera DOB 07/18/2011
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`IV~D Case No: 001443770532
`Doc ID? 109C5005000000194Z
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`55-FA-20-7368
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`Rachael Yadira Rivera's monthly gross income as calculated under
`Minnesota Statutes, section 518A.29 is $0.00.
`Income for Determining Child Support
`Joseph Lawrence McShan's Parental
`is $2773.00 and.Rachael Yadira Riverals Parental
`Income for
`(PICS)
`is $0.00 as calculated on the Child
`Determining Child Support
`(PICS)
`Support Guideline Worksheet attached hereto. The parties' combined PICS
`is $2773.00.
`Joseph Lawrence McShan's percentage share of the parties'
`combined PICS is.100%'and Rachael Yadira Rivera's percentage share is
`0%.
`The Basic Support obligation reflects no parenting time for Joseph
`Lawrence McShan because there is no measurable court ordered parenting
`time.
`Joseph Lawrence McShan'szasic Support obligation according to the
`Minnesota Child Support Guidelines is $580.00.
`Joseph Lawrence McShan carries health care coverage which does not
`the joint child(ren). The cost of individual coverage is $187.00
`cover
`per month.
`* The additional cost to add the joint Child(ren)
`coverage is $407.00 per month.
`Joseph Lawrence McShan carries dental coverage which does not cover
`the
`joint child(ren). The cost of individual.coverage is $20.57 per month.
`* The additional cost to add the joint child(ren)
`to the dental
`coverage is $21.96 per month.
`Rachael Yadira Rivera does not have health care coverage for the joint
`child(ren) available through an employer or.group plan.
`Rachael Yadira Rivera does not have dental coverage for the joint
`child(ren) available through an employer or group plan.
`Joseph Lawrence McShan's health care coverage.is not appropriate
`because;
`the cost is prohibitiVe.
`is/are recipient(s) of public coverage in the form
`The joint'childpren)
`of Medical Assistance,.and Rachael Yadira Rivera pays $0.00 per month
`towards the cost of the_public coverage.
`Joseph Lawrence McShan's Medical.Support obligation should be $21.00
`per month, after applying Joseph Lawrence McShan's income to the
`MinnesotaCare premium table, as the joint child(ren) are on public
`coverage and there is no appropriate health care coverage available.
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`to the health care
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`35. Based upon each party's percentage share of combined PICS as set out in
`the Child Support Guideline Worksheets:
`Joseph Lawrence McShan's share of the uninsured and/or unreimbursed
`medical expenses is 100%.
`* Rachael Yadira Rivera's share of the uninsured and/or unreimbursed
`medical expenses is 0%.
`36. Rachael Yadira Rivera has no work or education related child care
`expenses for the joint child(ren).
`37. From 02/01/2022 to 04/30/2022,
`Joseph Lawrence McShan has not
`contributed to the support of the joint-child(ren).
`38. Rachael Yadira Rivera previously received public.assistance which
`created an assignment of support-rights under Minnesota and Federal
`Law, as follows:
`the amount of
`* MFIP (TANF) cash. From 02/01/2022 to 04/30/2022,
`$2253.00 has been expended. During this time period,
`0 months were
`'non-cash or non-public assistance.
`* Medical Assistance.
`Joseph Lawrence McShan has the ability
`* From 02/01/2022 to 04/30/2022,
`the State for
`$1740.00 for Ba
`Support to reimburse
`aesistance expended, as calculated.on,the Reimbursem*nt Worksheet.
`+1Three months of basic support at $580.00 per month.
`Joseph Lawrence McShan has the ability
`* From 02/01/2022 to 04/30/2022,
`'to pay $63.00 to reimburse the State for past.Medical Support, as
`calculated On the Reimbursem*nt Worksheet-
`* Three'months of medical support at $21.00 per month.
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`Findi
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`of Fact herein,
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`the court makes the following:
`CONCLUSIONS OE TJWT
`JUrisdiCtion in.this matter=is obtained pursuant to MinneSOta Statutes,
`section 48457Q2.
`The joint minor child(ren) hasjhave a need for support and the parents
`have a duty to support the joint minor child(ren) as set forth in the
`Order below.
`3.1'he 'est"ab_li_'shm'e'ntf of; support- is;
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`in .ajgcqxaance: with the Minnesovta child
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`55-FA-20-7368
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`Support Guidelines and other factors pursuant to Minnesota Statutes,
`Chapter 518A.
`there is no basis for a deviation from'the
`* Based upon the evidence,
`Minnesota Child Support Guidelines and failure to deviate would not
`cause an extreme hardship on Joseph Lawrence McShan.
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`Based upon the foregoing Findings of Fact and COnclusions of Law, the Court
`makes the following:
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`Joseph
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`ORDER
`Beginning 05/01/2022, and_continuing'eaCh month thereafter,
`Lawrence McShan shall pay:
`* $580.00 per month as ongoing Basic Support.
`* $21.00 per month as ongoing Medical Support for the joint child(ren),
`for any month that Medical Assistance is.in place. For any month that
`Medical Assistance is not in place,
`the ongoing Medical Support
`is $0.00 and Joseph Lawrence
`obligation for the joint child(ren)
`McShan must pay 100% of the joint.chi1d(ren)'s uninsured and/or
`unreimbursed medical expenses.
`* $0.00 per month for Joseph Lawrence McShan's joint child(ren)'s
`ongoing Child Care Support.
`* The total monthly payment is $601.00
`2. Health care and/or-dental coverage-and'uninsured,and/or'unreimbursed
`medical expenses are ordered as follows;
`*'Uninsured,and/or*unrefmburSed medical expenses sha11,be apportioned
`according'to eaCh party"siproportionate-income.
`Joseph'Lawrence
`and Rachael Yadira Rivera shall pay
`shall pay 100
`of
`the
`IcShan
`child(r
`bursed medical exp
`To,recover these costs,
`the requesting party must.follow the
`'procedures as set out in Minnesota Statutes, section 518A.41,
`subdivision 17 and 518A.41, Subdivision 18.
`* The above amounts owed by Joseph Lawrence McShan are considered
`additional Child Support for the purpose of enforcement and are
`subject to automatic income withholding.
`Joseph Lawrence McShan owes the following amounts as reimbursem*nt for
`past support provided, and judgment.is granted against Joseph Lawrence
`McShan in the following amounts as set forth in this Order:
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`55-FA-20-7368
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`* $1740.00 to reimburse the State fOr.past Basic Support for public
`assistance cash payments paid from 02/01/2022 to 04/30/2022.
`* $63.00 to reimburse the State for past.Medical Support from
`02/01/2022 to 04/30/2022.
`* Monthly payment on the reimbursem*nt amount shall be an additional
`20% of the ongoing support obligation until the reimbursem*nt is paid
`in full.
`Judgment entry and docketing is stayed as long as Joseph Lawrence
`Mcshan complies with the payment conditions set forth in this Order.
`The Child Support payments shall continue until
`(all)
`the joint
`the age of 18, or age 20 if
`child(ren) covered by the Order reach(es)
`still
`in secondary school; or until the joint child(ren) covered by the
`Order become emancipated or die(s); or until further order of the
`court.
`6. All payments ordered shall.be immediately withheld by Joseph Lawrence
`McShan's present and future employer(s) or other payor(s) of funds in
`accordance with Minnesota Statutes, section 518A.53.
`7. Until or unless income withholding i3?in.Effect for Joseph Lawrence
`Mcshan, alltpayments should be.made to'fihe MN Child Support Payment
`(CSPC). Payments can be made to CSPC either online using
`Center
`M nnescta Child Support Online (MCSO) at
`WWW.childsupportgdhsmstate.mn.us or mailed to:
`N'Child Support Payment Center
`P.O. Box 64326
`St. Paul, MN 55164—0326
`If support payments are not paid when due,
`Joseph Lawrence McShan's
`or payorfs} of funds shall withhold from his/her income,
`additional amount of 20% of the ongoing Child Support until the
`arrearages are paid in accordance with Minnesota Statutes, Section
`'51'8Aw53.
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`Appendix A and COLA
`* The attaChed Appendix A is incorporated and made a part of this
`(COLA) shall be determined by
`Order. The Cost of Living-Adjustment
`using the U.S. Department of Labor} Bureau of Labor Statistics,
`Consumer Price Index (CPI), Minneapolis/St. Paul, for all urban
`(CPI—U). The.Cost of Living Adjustment shall.be based on
`consumers
`the Child Support amount prior to offsets
`10. All written correspondence should be submitted to the County Child
`Support Office at:
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`IVeD Case No: 001443770502
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`55-FA-20-7368
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`Olmsted County Community Services
`Child Support Recovery
`2117 Campus Dr Se Ste 100
`Rochester MN 55904—4825
`The parties must notify the County Child Support Office of a change of
`address, residence, employment, or health care coverage within ten (10)
`days of the change. Any later actions brought or notices sent in this
`case that do not require personal service may be sent to the last known
`address provided by the_parties to the County.
`The parties are placed.on notice that in accordance with Minnesota
`that upon hiring,
`Statutes, section 518A.41,
`the parties must notify
`the employer of his or her court ordered Child Support obligation(s),
`if any, and to obtain health care and/or dental coverage as ordered. If
`the public authority's notice to the new
`a party changes employment,
`employer shall enroll the joint child(ren) under the health care and/or
`dental coverage program of the new employer, unless the party contests
`the enrollment.
`Even if Joseph Lawrence McShan makes the installment payments required
`by this Order,
`the State may use the state and federal tax refund
`intercept process to collect support_arrears and other debts created by
`this Order.
`Joseph Lawrence McShan is pladed on notiCe that in accordance with
`Minnesota Statutes, section 518A.66, if he or\she is licensed by an
`occupational licensing board or state agency issuing occupational
`licenses, and if he or she is in arrears
`in an amount equal to or
`greater than three times his or her total monthly support payment, and
`has not executed and complied with a written payment,agreement,
`the
`Child Support Office shall direct or the court shall order the
`licensing board or state agency to suspend JQSeph.Lawrence McShan's
`license.
`Joseph Lawrence McShan is placed on notice that in accordance with
`if he or she has a driver's
`Minnesota Statutes, section 518A.65,
`license, and if he or she is in arrears
`in an amount equal to or
`greater than three times Joseph Lawrence McShan's total monthly support
`the court.shall order the Commissioner of Public Safety to
`payment,
`suspend Joseph Lawrence McShan's driver's license or operating
`privileges unless the court determines that he or she has executed and
`is in compliance with a written.payment agreement.
`Service of a copy of the final order may be made upon JOseph Lawrence
`McShan or upOngJoSeph Lawrence McShan's attorney in accordance with
`Minnesota Court Rulesr
`Service of a copy of the final order may be made upon Rachael Yadira
`Rivera or upOngRachael'Yadira Rivera's attorney'in accordance with
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`55-FA-20-7368
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`Minnesota Court Rules.
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`IT IS SO ORDERED
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`LET JUDGMENT BE ENTERED ACCORDINGLY
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`Dated:
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`Child.SupportfiMagistrate
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`I,HEREBX:CERTIF¥ THAT THE FACTS AND'ORDER SET EORTH.ABOVE CONSTITUTE THE
`JUDGMENT OF THIS COURT.
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`Olmsted County Court Administrator
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`Olmsted'county'DeputYVCourt'Administrator
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`Date ofi Filing:
`:
`refiiewed and agreed to the attadhed Findings of Fact, Conclusions
`Law, and Order Establishing Child Support and Order for Judgment and
`Judgme nt .
`Electronically Signed By
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`Date
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`l
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`._,
`,> -3
`W"
`I"
`v
`Geofirey A. Hjerleid
`DocVerslon 2.0 on 121712022 9:22:49 AM
`Geoffrey A. Hjerleid
`ASSistant County Attorney
`'Registration No. 208620
`Olmsted County Attorney
`151 4th St Se
`Rochester, MN 55904
`(507) 328-7600
`Email for eFiling purposes only
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`IV~D Case No: fibl443770532
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`APPENDIX-A
`NOTICE IS HEREBY GIVEN TonTHEEPARTIESi
`I. PAYMENTS TO PUBLIC AGENCY1.ACGording to Minnesota Statutes, section 518A.50, payments ordered for
`maintenance and support must be paid to the Minnesota child support payment center as
`long as the person
`entitled to receive the payments is receiving or has applied for public assistance or has applied for
`support and maintenance collection services. Parents mail payments tor P.O. Box 64326, St. Paul, MN
`55164-0326. Employers mail payments to: P.O. Box 64306, St. Paul, MN 55164.
`II. DEPRIVING ANOTHER OF CUSTODIAL OR PARENTAL RIGHTS —_A FELONY. A person may be charged with a
`felony who conceals a minor child or takes, obtains, retains, or fails to return a minor child from or to
`the child's parent
`(or person with custodial or parenting-time rights), according to Minnesota Statutes,
`section 609.26. A copy of that section is available from any court administrator.
`III. NONSUPPORT OF A SPOUSE OR CHILD - CRIMINAL PENALTIES. A person who fails to pay court-ordered
`child support or maintenance may be charged with a crime, which may include misdemeanor, gross
`misdemeanor, or felony charges, according to Minnesota Statutes, section 609.375. A copy of that section
`is available from any district court clerk.
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`A.
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`D.
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`IVL RULES OF SUPPORT, MAINTENANCE, PARENTING.TIME.
`IPayment of support or spousal maintenance is to be as ordered, and.the giving of gifts or"making
`'purchases of food, clothing, and the like will.not fulfill theiobligationh
`JPayment of support must be made as it becomes due, and failure to secure or denial of parenting time
`is NOT an excuse for nonpayment,§but the aggrieved-party must seek relief through a proper motion
`filed with the court.
`C. Nonpayment'of,supportflis not grounds'to deny parenting'time. The party entitled to receive.support may
`'apply for support and collection services, file a contempt motion, or obtain a judgment as provided in
`Minnesota Statutes, section 548.091.
`The payment of support or spousal maintenance takes priority over payment of debts and other
`obligations.
`A party who accepts additional obligations of support does so with the full knowledge of the party's
`E.
`prior obligation under this proceeding.
`F. Child support or maintenance is based on annual
`income, and it is the responsibility of a person with
`seasonal employment to budget_income so that payments are made throughout the year as ordered.
`A Parental Guide to Making Child—Focused Parenting Time Decisions is available from any court
`administrator.
`interception of state
`The nonpayment.of support may be enforced through the denial of'student.grants;
`licenses; referral to
`and federal tax refunds; suspension of driver's, recreational, and;occupational
`the department;of revenue or private collection agencies; seizure of assets,
`including bank accounts
`and other assets held by financial institutions) reporting to credit bureaus;
`income withholding, and contempt proceedings; and other enforcement methods allowed by law.
`The public authority may suspend or resume collection of the amount allocated[for childgcare
`enpenses_if the_conditions of Minnesota Statutes, section 518Ag40, subdivision'4, are met,
`The public authority may remove or resume a medical support offset if conditions of.section
`.518A.41, subdivision 16, are met.
`V. MODIFYING CHILD SUPPORT, If either the obligor or obligee is laid off from employment or receives a
`pay reduction, child support may be modified,'increased, or decreased. Any modification will only take
`effect when it is ordered by the court, and will only relate back to the time that a motion is filed.
`Either the obligor or obligee may file a motion to modify child support, and may request the public agency
`for help. UNTIL A MOTION IS FILED, THE CHILD SUPPORT OBLIGATION WILL CONTINUE AT THE CURRENT LEVEL. THE
`COURT IS NOT PERMITTED TO REDUCE SUPPORT.RETROACTIVELY.
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`G.
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`H.
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`I.
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`J_
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`VI. PARENTAL RIGHTS FROM MINNESOTA STATUTES! SECTION 518.17, SUBDIVISION 3.
`UNLESS OTHERWISE PROVIDED BY THE COURT;
`to, and to receive copies of, school, medical, dental, religious
`Each party has the right of access
`A.
`training, police reports, and other important records and information about the minor children. Each
`insurance available to the
`party has the right of access
`to information regarding health or dental
`minor children; Presentation of a copy of this order to the custodian of a record or other
`information about the minor-children constitutes sufficient authorization for the release of the
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`55-FA-20-7368
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`B)
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`C.
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`D.
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`E.
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`information to.the.requesting party.
`_record or
`to the name and'address-of the school
`Each party has the right toTbe informed by the other party as
`of attendance of the minor children, Each party has the right to be informed by school offic1als
`about the childrenls welfare! educational progress;and status, and to attend school and parent
`iteacher conferences. The_school,isinot.réquired to.hdld a separate conference for each party.
`Each party has the right to be notified by the other party of an accident or serious illness of a
`minor child,
`including the name of the_health_care provider and the place of treatment.
`Each party has the right to be notified by the other party if the minor child is the victim of an
`including the name of the investigating law enforcement officer or agency. There is
`alleged crime,
`no duty to notify if the party to be notified is the alleged perpetrator.
`Each party has the right of reasonable access and telephone contact with the minor children.
`VII. WAGE AND INCOME DEDUCTION OF SUPPORT AND MAINTENANCE. Child support and/or spousal maintenance
`may be withheld from income, with or without notice to the person obligated to pay, when the conditions of
`Minnesota Statutes, section 518A.53, have been met. A copy of that section is available from any court
`administrator.
`VIII. CHANGE OF ADDRESS OR RESIDENCE. Unless otherwise ordered, each party shall notify the other
`if applicable, of the following
`the court, and the public authority responsible for.collection,
`party,
`telephone number, driverls
`information within ten days of any change: residential and mailing address,
`license number, social security number, and name, address, and telephone number of the employer.
`IX. COST OF LIVING INCREASE OF SUPPORT AND MAINTENANCE. Basic support and/or spousal maintenance may
`be adjusted every two years based upon a change in the cost of living (using the U.S. Department of Labor,
`Bureau of Labor Statistics, consumer price index Mp1s. St. Paul, for all urban consumers (CPI-U), unless
`otherwise specified in this order) when the conditions.of Minnesota Statutes, section 518A.75, are met.
`Cost of living increases are compounded. A copy of Minnesota Statutes, section 518A.75, and forms
`necessary to request or contest a cost of living increase are available from any court administrator.
`"If a person fails to make a child support payment,
`X.
`the payment owed
`JUDGMENTS FOR UNPAID SUPPORT.
`becomes a judgment against the person responsible to make the payment by operation of law on or after the
`date the payment is due, and the person entitled to receive the payment or the public agency may obtain
`entry and docketing of the judgment without notice to the person responsible to make the payment.
`XI.
`JUDGMENTS FOR UNPAID MAINTENANCE.
`A judgment for unpaid spousal maintenance may be entered and docketed when the conditions
`of Minnesota Statutes, section 548.091, are met} A copy of that section.is available
`from any court.administrator.
`The_public authority\is not responsible for calculating interest on any judgment for
`unpaid spousal maintenance. When providing services in IVFD cases, adeefined in
`Minnesota Statutes, section.518A.26, subdivision 10, the public authority wi11.only collect interest
`:on spousal maintenance if spousal maintenance is reduced to a sum certain judgment.
`XII} ATTORNEY FEES AND COLLECTION COSTS FOR ENFORCEMENT OF CHILD SUPPORT. A judgmentgfor attorney fees
`and other collection costs incurred in enforcing a child support'order will be entered against the person
`responsible to pay support when the conditions of Minnesota Statutes, section 518A.735, are met" A copy of
`that section and forms necessary to request or contest these attorney fees and collection costs are
`available from any court administrators
`XIII. PARENTING TIME EXPEDITOR PROCESS. On request of either party or.on its own motion,
`the court may
`appoint a parenting time expeditor to resolve parenting time disputes under Minnesota Statutes, section
`518.1751. A copy of that section and a description of the expeditor process is available from any court
`administrator.
`
`A.
`
`B.
`
`XIV. PARENTING TIME-REMEDIES AND PENALTIES. Remedies and penalties for wrongful denial of parenting
`time are available under Minnesota Statutes, section 518.175, subdivision 6; These include compensatory
`parenting time; civil penalties; bond'requirements; contempt} and reversal of custody. A copy of that
`subdivision and forms for requesting relief are available from any court administrator.
`In addition to the Notices on pages 1 and 2, the following NOTICE applies to all orders addressing custody
`pursuant to Minn. Stat" Section.518117, subd.3a.
`12/6/2022
`
`

`

`55-FA-20-7368
`
`NOTICE
`
`EACH PARTY Is GRANTED THE: FOLLOWING RIGHTS;
`to, and to receive copies of, schooli medical, dental, religious training, police
`1; Right of access
`reports, and other important records and information about the minor children.
`insurance available to the minor
`Right of access
`to information regarding health or dental
`children.
`Right to be informed by the other party as to the name and address of the sdhool of attendance of
`the minor children.
`Right to be informed by school officials about the children's welfare, educational progress and
`is not required to hold a
`status, and to attend school and parent—teacher conferences. The school
`separate conference for each party, unless'attending the same conference would result in violation
`of a court order prohibiting contact with a party.
`Right to be notified by the other party of an accident or serious illness of a minor child,
`including the name of the health care provider and the place of treatment.
`Right to be notified by the other party if the minor child is the victim of an alleged crime,
`including the name of the investigating law enforcement officer or agency. There is no duty to
`notify if the party to be notified is the alleged perpetrator.
`Right to reasonable access and telephone or other electronic contact with the minor children.
`
`2 3 4
`
`5 6.
`
`7
`
`12/6/2022
`
`

`

`55-FA-20-7368
`
`SIX-MONTH REVIEW HEARING REQUEST
`INSTRUCTIONS
`
`See Minn. Stat. § 518.1781
`
`You have the right to request a review hearing within six months after entry of a decree of dissolution or
`legal separation or order that establishes child custody, parenting time, or child support. Minn. Stat. §
`518.1781 (2006). The form you will need to use to request a review hearing is attached.
`
`Purpose of Review Hearing: The purpose of the review hearing is to make certain parties are following
`the court order regarding parenting time and the payment of child support. The review hearing IS NOT
`an opportunity to present any other issues or to ask the court to establish or modify custody, parenting
`time, or support. The court CAN ONLY review parenting time and child support provisions as already
`established in the order. If there is no court ordered parenting time or child support, the court CANNOT
`create a parenting plan, establish parenting time, or child support at this review hearing. A petition or
`motion asking for any other type of relief from the court must be served and filed separately from this
`request. You may wish to contact an attorney or other legal services provider for more information
`regarding any other type of relief.
`
`Instructions to the Party Requesting the Review Hearing: If you decide to request a review hearing,
`you must do the following within six months from the date of entry of the order or decree:
`
`(cid:120)
`
`remove this cover page and complete the Request for Hearing form. Make enough copies of the
`form and have it served upon all parties, including the County Attorney’s Office, if the county child
`support enforcement agency (public authority) is a party in the case. Keep a copy of the form for
`yourself.
`
`NOTE: YOU CANNOT HAND DELIVER OR MAIL THE REQUEST FOR HEARING
`YOURSELF. YOU MUST HAVE SOMEONE ELSE OVER THE AGE OF 18 WHO
`IS NOT A PARTY TO THE CASE HAND DELIVER OR MAIL THE REQUEST FOR
`HEARING FOR YOU
`
`(cid:120)
`
`return the completed original Request for Hearing form and a completed Affidavit of Service form
`to Court Administration in the county listed at the top of the Request for Hearing form. Court
`Administration will schedule a hearing and send all parties notice of the hearing date, time, and
`location.
`
`Proof of Child Support Payment: The person who pays support has to provide proof of all the child
`support payments he/she made. If a party is receiving public assistance or child support enforcement
`services from the county child support enforcement agency, either party may request that the county child
`support enforcement agency provide payment information to the parties and the court. Any request made
`to the county child support enforcement agency must be made at least 14 days before the hearing date.
`
`

`

`55-FA-20-7368
`
`SIX-MONTH REVIEW HEARING REQUEST
`See Minn. Stat. § 518.1781
`District Court
`Judicial District
`
`Court File Number:
`Case Type:
`
`Request for Six Month Review Hearing
`
`State of Minnesota
`County
`
`(cid:401) In Re the Marriage of:
`
`Plaintiff(s) / Petitioner
`
`vs / and
`
`Defendant / Respondent
`
`Intervenor
`
`Check the box or boxes that apply:
`
`Child Support
`(cid:401) The other party is not paying child support as ordered. (Briefly explain)
`
`Parenting Time provisions
`(cid:401) The other party has not complied with the court ordered parenting time as follows:
`
`Dated:
`
`Signature
`Print Name:
`Address:
`City/State/Zip:
`Telephone: ( )
`Attorney for:
`
`

`

`55-FA-20-7368
`
`District Court
`
`Judicial District:
`Court File Number:
`Case Type:
`
`
`
`
`
`(cid:853)(cid:36)(cid:73)(cid:73)(cid:76)(cid:71)(cid:68)(cid:89)(cid:76)(cid:87) of Personal Service
`(cid:853) Affidavit of Service By Mail
`
` State of Minnesota
`County
`
`(cid:401) In Re the Marriage of:
`
`Plaintiff / Petitioner
`
`vs / and
`
`Defendant / Respondent
`
`Intervenor
`
`STATE OF MINNESOTA
`COUNTY OF
`
`)
`) SS
`(County where Affidavit Signed)
`
`I,
`
`, being duly sworn, upon oath, state than on
`
`(Name of person who served documents)
`, I served the attached documents, namely
`
`upon (check one):
`
`made)
`or mailed)
` Plaintiff / Petitioner (Name)
`Defendant / Respondent (Name)
`County Agency (Name)
`Other (Name)
`by (check method of service used):
` Personally handing a true and correct copy of the document(s) to
`o’clock
`.m. at
`
`(Date service
`(Title of Documents hand delivered
`
`
`
`named above at
`
`(Address where documents delivered)
`named above by placing
` Mailing a true and correct copy of the document(s) to
`the document(s) in an envelope with sufficient postage in the United States mail at the Post Office located in the City of
`, State of
`, at the person’s last known
`
`address of:
`
`Dated:
`
`Sworn / affirmed before me this
`day of
`
`,
`
`Notary Public/ Deputy Court Administrator
`
`Signature ( Sign only in presence of Notary or Court Deputy)
`Print Name:
`Address:
`City/State/Zip:
`
`Telephone: (
`
`)
`
`