IN THE CIRCUIT COURT OF THE SEVENTEENTH JUDICIAL CIRCUIT,

IN AND FOR BROWARD COUNTY, FLORIDA

Case No.: 15-001441

Division: FC
CONSTANCE SCHULTZ,
Petitioner,

and

HENRY BRIAN SCHULTZ,

Respondent,
________________________________/

MOTION FOR CREDIT FOR DIRECT CHILD SUPPORT

PAYMENTS

Respondent requests that the Court enter an order for credit for direct child
support payments in favor of the parent who provides support who is
the Respondent and provides the following reasons as grounds:

1. A final judgment or order titled

{title of final judgment or order}

in this case was entered on , by

{date} {court, city, and state}
.
2. This order of the Court required that child support payments be made
through the State Disbursement Unit for disbursement to the parent
receiving support.

3. Pursuant to the attached Affidavit, the parent providing support, made

payments totaling $_______________ directly to the parent receiving
support.

WHEREFORE, the Respondent respectfully request that the Court enter

an order directing the Clerk of Court, Domestic Relations Division to
credit the above referenced support record in the amount of
$ ______________________.
I certify that a copy of this document was mailed to the person(s) listed
below on
____________________ .

Other party or his/her attorney:

Name:
Address:
City, State, Zip:
Fax Number:

I understand that I am swearing or affirming under oath to the

truthfulness of the claims made above and that the punishment for
knowingly making a false statement includes fines and/or
imprisonment.

Dated: _________________________

Signature of Party __________________________

 Printed Name: HENRY SCHULTZ

Address:
City, State, Zip:
Telephone Number:
Fax Number:

State of Florida
County of Broward

Sworn to (or affirmed) and subscribed before me this _______day of ___________,

2017, by HENRY SCHULTZ.

___________________________________________________________
(Signature of Notary Public - State of Florida)

___________________________________________________________
(Print, Type, or Stamp Commissioned Name of Notary Public)

Personally Known ___________ OR Produced Identification ___________

Type of Identification Produced ___________________________________