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In the heart of addressing domestic violence concerns within the jurisdictions of Alaska, the DV-101 form emerges as a significant tool for victims seeking protection and stability. Primarily used during the petition for a long-term domestic violence protective order, this form doubles as a mandate for providing detailed child support information. It underscores the necessity for both parties involved in such legal matters to disclose comprehensive income, deductions, and child support obligations to ensure that fairness and the child's welfare take precedence in court decisions. Beyond this financial disclosure, the DV-101 form encapsulates provisions for health care coverage, addressing children's healthcare expenses not covered by insurance, and delineating responsibilities for travel expenses related to visitation rights. In its holistic approach, the document not only facilitates a protective mechanism for those impacted by domestic violence but also intricately ties into ensuring that child support considerations are thoroughly addressed, demonstrating the intertwined nature of protection, parental responsibilities, and child welfare in legal proceedings. The necessity to attach recent financial documents, along with an affidavit affirming the veracity of the provided information under penalty of perjury, reinforces the form's role in fostering a transparent and equitable process. This process is further supported by the statutes and Civil Rule 90.3, highlighting a structured legal framework aimed at safeguarding the interests of vulnerable family members while navigating the complexities of domestic violence cases in Alaska.

Document Example

IN THE DISTRICT/SUPERIOR COURT FOR THE STATE OF ALASKA AT

PETITIONER (protected person),

M

Birthdate:

 

 

Petitioner is a child. Who is signing for the child?

Name:Birthdate: Relationship to child:

)

)

F)

)

)

)

)

v.

RESPONDENT (restrained person),

M

Birthdate

 

 

Respondent is a child. Who is signing for the child?

Name:Birthdate: Relationship to child:

)

) Case No.CI

)

F)

)

)

) CHILD SUPPORT INFORMATION

)

)

INSTRUCTIONS. If child support is requested in a petition for a long-term domestic violence protective order, each party must complete one of these information sheets and bring it to the court hearing on the protective order or file it with the court before that hearing. If you need help filling out the form, a court clerk can help you.

Provide information about yourself and, to the extent it is available, about the other party. A court clerk can notarize this document for you at no charge. The information in this form is required by Civil Rule 90.3 and the statutes listed at the bottom of this form. If you want a copy of Civil Rule 90.3, ask the clerk for a copy of the booklet about child support, DR-310. The rule is in the back of the booklet.

Each party must attach a copy of his or her most recent federal tax return and most recent pay stubs to verify income and deductions.

AFFIDAVIT

I swear or affirm under penalty of perjury that the following information is true to the best of my knowledge and belief.

I.Other Child Support Orders

There are no other child support orders currently in effect concerning the children involved in this case.

The following child support order(s) concerning these children is/are still in effect:

Case No.

 

Effective Date:

Page 1 of 4

Civil Rule 90.3

DV-101 (6/11)(cs)

AS 25.27.062(a)

CHILD SUPPORT INFORMATION

AS 25.27.060(c)

II.Income Information. The following income and deductions are

monthly

yearly.

I have attached a copy of my most recent federal tax return and pay stubs to verify this

information. [Note: Delete social security numbers and account numbers from any documents you attach.]

PETITIONER

A.Gross Income (Do not list ATAP or SSI below.) Gross wages

Value of employer-provided housing/food/etc. Unemployment compensation

Permanent fund dividend Other:

TOTAL INCOME

B.Deductions Allowable Under Civil Rule 90.3 Federal, state and local income tax Social security tax or self-employment tax Medicare tax

Employment security tax Mandatory retirement contributions Mandatory union dues

Voluntary retirement contributions if plan earnings are tax-free or tax-deferred, up to 7.5% of gross wages and self-employment income when combined with mandatory contributions

Other mandatory deductions (specify)

Child support/alimony ordered in other cases and currently being paid

Child support for children from prior relationships living with this parent, calculated under Civil Rule 90.3

Work-related child care for children of this marriage

TOTAL DEDUCTIONS

C. Net Income

TOTAL INCOME from section A

TOTAL DEDUCTIONS from section B

Subtract deductions from income to get

NET INCOME

D.Adjusted Annual Income

1.If the above figures are based on monthly information, multiply NET INCOME from section C by 12 to get

ADJUSTED ANNUAL INCOME

2.If the above figures are based on yearly information, repeat the NET INCOME amount from section C to show

ADJUSTED ANNUAL INCOME

Page 2 of 4

DV-101 (6/11)(cs)

CHILD SUPPORT INFORMATION

RESPONDENT

Civil Rule 90.3

AS 25.27.062(a)

AS 25.27.060(c)

III.Health Care Coverage for the Children. A. Health Insurance.

1.Does the petitioner have health insurance available for the child(ren) at reasonable cost through his/her employer, union or otherwise?

Yes

No

If yes, state name and address of employer, union or other

source through which insurance is provided or available.

Name:

 

 

 

 

 

 

 

Address:

 

 

 

 

 

 

Cost to petitioner: $

 

 

per

month

 

2.Does the respondent have health insurance available for the child(ren) at reasonable cost through his/her employer, union or otherwise?

Yes

No

If yes, state name and address of employer, union or other

source through which insurance is provided or available.

Name:

 

 

 

 

 

 

 

Address:

 

 

 

 

 

 

Cost to respondent: $

 

 

per

month

 

3. Are the children eligible for services through the Indian Health Service?

Yes

No

4. Do the children have other health insurance or care available?

Yes Describe:

No

B.Children’s Health Care Expenses Not Covered By Insurance.

Is there any reason why the court should not require the parties to share equally the cost of reasonable health care expenses not covered by insurance?

IV. Travel Expenses. Travel expenses to exercise visitation should be allocated between the parties as follows:

Page 3 of 4

Civil Rule 90.3

DV-101 (6/11)(cs)

AS 25.27.062(a)

CHILD SUPPORT INFORMATION

AS 25.27.060(c)

V.Immediate Income Withholding.

The Alaska Statutes require that child support be withheld from the income of the person paying support and paid through the Child Support Services Division (CSSD) unless one of the following exceptions is approved by the court:

We have made the following alternative arrangement (Note that if you receive ATAP, CSSD must agree to the arrangement):

Also, the person paying support agrees to keep the other party (or CSSD if CSSD is enforcing the order) informed of his/her current employer and the availability of employment-related health insurance coverage for the child(ren) until the support order is satisfied.

We believe there is good cause not to require immediate income withholding because it is not in the best interests of the child(ren) for the following reason:

Also, the person paying support agrees to keep the other party (or CSSD if CSSD is enforcing the order) informed of his/her current employer and the availability of employment-related health insurance coverage for the child(ren) until the support order is satisfied.

The person paying support currently receives social security or other disability compensation that includes regular payments to the child(ren) at least equal to the child support owed each month. Monthly payment to child(ren): $

Source of payment:

Note: To the extent that these payments to the children do not satisfy the monthly amount owed, the court will order that the remaining amount due be withheld from income.

VI. If you want the assistance of the Child Support Services Division (CSSD) to enforce the support order and keep records of the payments, you must apply for CSSD services. You can get an application from CSSD or you can fill out court form DR-315 (available at the clerk’s office) and mail it to CSSD at 550 West 7th Ave., Suite 310, Anchorage, AK 99501.

 

 

 

 

 

 

Signature

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Type or Print Name

Subscribed and sworn to or affirmed before me at

 

 

 

, Alaska

on

 

 

.

 

 

 

 

 

 

Date

 

 

 

 

 

 

 

 

 

 

 

(SEAL)

 

 

 

 

Clerk of Court, Notary Public or other

 

 

 

 

 

 

person authorized to administer oaths.

 

 

 

 

 

 

My commission expires:

 

Page 4 of 4

Civil Rule 90.3

DV-101 (6/11)(cs)

AS 25.27.062(a)

CHILD SUPPORT INFORMATION

AS 25.27.060(c)

Document Specifics

Fact Detail
Purpose The Alaska DV-101 form is used for providing child support information in cases involving a petition for a long-term domestic violence protective order.
Required Attachments Parties must attach their most recent federal tax return and pay stubs to verify income and deductions.
Notarization A court clerk can notarize this document at no charge.
Governing Laws This form is required by Civil Rule 90.3, AS 25.27.062(a), and AS 25.27.060(c).
Healthcare and Travel Expenses It addresses health care coverage for children, allocation of children’s health care expenses not covered by insurance, and travel expenses for visitation.

Instructions on How to Fill Out Alaska Dv 101

Filling out the Alaska DV-101 form, a Child Support Information sheet, is crucial in proceedings for a long-term domestic violence protective order when child support is sought. This form aids the court in making informed decisions regarding child support arrangements by providing detailed information about the incomes, expenses, and existing child support orders of both parties involved. Comprehensive and accurate completion of this form ensures a smoother court process and contributes to the establishment of fair and effective child support orders.

  1. Start by entering the case number and court location (district/superior) at the top of the form.
  2. Fill in the petitioner's and respondent's names, birthdates, and select the appropriate gender marker. If the petitioner or respondent is a minor, provide the name, birthdate, and relationship of the individual filling the form on behalf of the child.
  3. Under "Other Child Support Orders," disclose whether there are any current child support orders affecting the children involved in this case. If yes, list each order’s case number and effective date.
  4. For the section "Income Information," choose whether the financial amounts you'll list are on a monthly or yearly basis. Then proceed to attach your most recent federal tax return and pay stubs, ensuring social security and account numbers are redacted for privacy.
  5. In subsection "A. Gross Income," itemize all sources of your income, including wages, unemployment compensation, and any other relevant sources, then calculate the total.
  6. Within "B. Deductions Allowable Under Civil Rule 90.3," list all applicable deductions from your income, such as taxes, social security tax, mandatory contributions, and child support payments for children from other relationships. Subtract these from your total income to find your net income.
  7. Calculate your "Adjusted Annual Income" based on the previously calculated net income. Multiply by 12 if the provided figures were monthly.
  8. In section "III. Health Care Coverage for the Children," address the availability and source of health insurance for the child(ren), any related costs, and specify any health expenses not covered by insurance.
  9. Discuss how travel expenses related to visitation should be shared in section "IV. Travel Expenses."
  10. Section "V. Immediate Income Withholding" requires stating whether income withholding is necessary for child support or if there's an alternative arrangement or legitimate reason to avoid it. Additionally, ensure to agree to keep each other informed about employment and health insurance availability.
  11. If seeking enforcement or record-keeping assistance from the Child Support Services Division (CSSW), complete and attach the required form DR-315 to apply for CSSD services.
  12. Sign the form and provide your name, typed or printed, at the bottom. The form must be notarized, so sign it in front of a notary public or a person authorized to administer oaths. Enter the date and location of signing, and the notary will complete their section, including their seal and commission expiry.

Once the form is fully completed and notarized, it should be submitted to the court either during the hearing for the protective order or filed beforehand, as per the instructions provided. Attaching the required documents, such as tax returns and pay stubs, is crucial for verifying the financial information reported. This careful documentation plays a key role in the court's ability to make informed decisions regarding child support, helping to ensure the best interests of the children involved are met.

What You Should Know About This Form

What is the purpose of the Alaska DV-101 form?

The Alaska DV-101 form is designed to provide detailed child support information in cases where a long-term domestic violence protective order is requested. It requires parties to give comprehensive data about their income, existing child support orders, healthcare coverage for children, and any other child-related expenses. This ensures that all financial aspects affecting the child are considered when issuing a protective order.

Who needs to fill out the Alaska DV-101 form?

Any party requesting child support in conjunction with a petition for a long-term domestic violence protective order in Alaska must fill out the DV-101 form. This requirement applies both to the petitioner (the person seeking protection) and the respondent (the person from whom protection is sought), provided child support issues are relevant to their case.

How can someone get assistance with filling out the DV-101 form?

Court clerks are available to offer help with filling out the form. Although they cannot provide legal advice, they can guide on how to correctly fill out the form and what kind of information needs to be included. Additionally, court clerks can notarize the completed document at no extra cost.

Is it mandatory to attach tax returns and pay stubs to the DV-101 form?

Yes, attaching the most recent federal tax return and pay stubs is mandatory for verifying the income and deductions reported on the DV-101 form. However, when attaching these documents, it's important to remove or black out sensitive information like social security numbers and account numbers to protect personal data.

What should be done if there are existing child support orders?

If there are any other child support orders already in effect concerning the children involved in the case, they must be disclosed in the DV-101 form. Details about these orders, such as case numbers and effective dates, should be included to ensure the court has a complete financial overview regarding the children's support.

How is income calculated on the DV-101 form?

On the DV-101 form, income must be detailed comprehensively, including gross income from all sources except for ATAP or SSI. Deductions allowable under Civil Rule 90.3 are then subtracted to calculate the net income. This approach ensures a fair assessment of financial capabilities when determining child support obligations.

What information about health care coverage is required?

The form requests details on whether health insurance for the child or children is available to either parent at a reasonable cost through an employer, union, or other source. Information about the cost, provider, and any eligible services through the Indian Health Service or other health insurance must also be provided.

What should be indicated about children’s health care expenses not covered by insurance?

Parties should disclose if there are reasons the court should not require them to equally share the costs of the children’s health care expenses that are not covered by insurance. This ensures any special circumstances or financial hardships are considered in the final order.

How are travel expenses for visitation addressed?

The form allows parties to suggest how travel expenses related to visitation should be divided between them. This inclusion ensures that the financial impact of maintaining a relationship with the child is fairly allocated.

What if I want the assistance of the Child Support Services Division (CSSD)?

If you seek the CSSD's assistance to enforce the support order and keep records of the payments, you must apply for their services separately. An application for CSSD services can be obtained directly from their office or filled out using court form DR-315, which is then mailed to the CSSD's address provided on the DV-101 form.

Common mistakes

Filling out the Alaska DV-101 form for Child Support Information requires careful attention to detail. Common mistakes can lead to processing delays or issues in the accurate assessment of child support. Here are seven common errors to avoid:

  1. Not providing complete income information. Applicants must include all sources of income, such as wages, unemployment compensation, and Permanent Fund dividends, to ensure an accurate calculation.

  2. Failing to attach the required documents, namely the most recent federal tax return and pay stubs. This documentation is critical to verifying the income and deductions reported on the form.

  3. Omission of other child support orders. If there are any other child support orders currently in effect for the children involved, these must be disclosed.

  4. Incorrectly calculating allowable deductions. Deductions must be in line with those specified under Civil Rule 90.3, including but not limited to, employment taxes and mandatory retirement contributions.

  5. Not redacting sensitive information from attached documents. Social security numbers and account numbers must be deleted to protect personal data.

  6. Incomplete health care coverage information for the children. This includes failing to provide details on the availability of health insurance through employers or other sources and not discussing health care expenses not covered by insurance.

  7. Misunderstanding the requirements for immediate income withholding. Specific circumstances might exempt some from immediate income withholding, but these exceptions need to be clearly stated and justified.

Additionally, here are a few tips to ensure a smoother process:

  • Read instructions thoroughly before filling out the form.

  • Seek clarification from a court clerk if any part of the form is unclear.

  • Double-check all calculations and entered information for accuracy.

Avoiding these common pitfalls not only facilitates a smoother process but also contributes to the well-being of all parties involved by ensuring a fair and accurate assessment of child support responsibilities.

Documents used along the form

When dealing with cases involving domestic violence and child support in Alaska, various forms and documents are required alongside the Alaska DV-101 form. These documents ensure that all aspects of the petitioner's and respondent's circumstances are considered. This list will help in gathering the necessary documentation to support a case fully.

  • Petition for Domestic Violence Protective Order (DV-100): This form initiates the process for obtaining a protective order against domestic violence. It requires detailed information about the parties involved, the nature of the relationship, and the specific instances of domestic violence.
  • Response to Petition for Domestic Violence Protective Order (DV-120): This form is used by the respondent to answer the allegations made in the DV-100 petition. The respondent can agree with, deny, or claim no knowledge of the allegations.
  • Child Custody Jurisdiction Affidavit (DR-150): This affidavit is necessary when child custody issues are part of the case. It provides the court with the information needed to determine jurisdiction over the child custody matter.
  • Income Withholding for Support (DR-300): This document is used to order an employer to withhold a portion of the respondent's earnings for child support. It ensures that child support payments are made consistently.
  • Request for Hearing (SHC-1625): If either party disagrees with the initial protective order or any other court decision, they can use this form to request a hearing. It gives the party a chance to present their case in more detail.

Understanding and preparing these forms and documents is crucial for anyone looking to navigate the complexities of domestic violence and child support cases in Alaska. Proper documentation supports the legal process, ensuring that all parties' rights and needs are considered. Whether seeking protection, disputing claims, or addressing child support and custody, these documents play a vital role in achieving a fair and just outcome.

Similar forms

The Alaska DV-100 form, also known as a request for a domestic violence protective order, shares similarities with the DV-101 form in that it initiates legal proceedings for individuals seeking protection. The DV-100 form is the initial step in the process, wherein the petitioner outlines the reasons for needing a protective order against the respondent. This form sets the stage for the detailed financial disclosures required in the DV-101, focusing mainly on establishing the need for legal protection rather than the financial aspects of child support and health insurance coverage.

The Child Support Order form, while specifically devoted to detailing arrangements for child support, intersects with the DV-101 form in its collection of detailed income information from both parties. This includes gross income, allowable deductions, and net income, similar to section II of the DV-101 form. The focus here is to determine the financial obligation of each parent towards their children, paralleling the DV-101's emphasis on accurately representing each party's financial situation to calculate child support within a protective order scenario.

The Financial Declaration form used in family court matters requires comprehensive financial disclosure from an individual, echoing the DV-101's requirement for detailed income and deduction information. The intent behind both forms is to provide the court with a full financial snapshot. However, the Financial Declaration form might be utilized in a variety of family law cases such as divorce, custody, and child support modifications, while DV-101 is specifically targeted towards cases involving protective orders with a component of child support.

The Request for Health Insurance Information form resembles the DV-101's section on health care coverage for children. It collects information about the availability and cost of health insurance for the child or children involved, from either parent's employer or other sources. Both forms aim to ensure that children's health care needs are addressed within legal proceedings, though the DV-101 incorporates this information into a broader request related to domestic violence and child support issues.

The Income Withholding for Support form is crucial for enforcing child support orders, automatically deducting support payments from the payer's wages. The DV-101 touches on this concept through its section on immediate income withholding, outlining circumstances under which income withholding should or should not be applied and detailing the process for voluntary or court-ordered withholding. The linkage between these documents lies in their shared goal of ensuring that child support payments are made consistently and reliably.

The Application for Services from the Child Support Services Division (CSSD) is connected to the DV-101 form through the final section of the DV-101, which suggests applying for CSSD services for enforcement and record-keeping of support orders. While the CSSD application is a standalone process for engaging the services of the CSSD in enforcing child support orders, its mention in the DV-101 form underscores the intertwined relationship between securing a protective order, establishing child support, and leveraging state resources for enforcement.

Dos and Don'ts

When filling out the Alaska DV-101 form, attention to detail is paramount to ensure that the information you provide is accurate and complete. Below are essential do's and don'ts to consider during this process:

  • Do read the entire form carefully before starting to fill it out. Understanding each section's requirements can help prevent mistakes and oversights.
  • Do black out sensitive information such as social security numbers and account numbers on any documents you attach to the form. This step is crucial for protecting your personal information.
  • Do provide detailed information regarding child support, including other orders currently in effect and accurate income and deduction figures. This detail is necessary for accurate calculation and fair determination of support obligations.
  • Do reach out to a court clerk if you need assistance filling out the form. They can offer guidance without charging a fee, ensuring that the form is completed correctly.
  • Do make sure to sign and date the form in front of a clerk of court, notary public, or another person authorized to administer oaths. This step finalizes the document and attests to the truthfulness of the information provided.
  • Don't leave any sections incomplete. If a section does not apply to your situation, write "N/A" to indicate this clearly. Incomplete forms can cause delays or even result in the need to refile.
  • Don't guess on figures or provide estimates for income and deductions. Use your most recent tax return and pay stubs as references to ensure the accuracy of the information provided.
  • Don't overlook the requirement to attach a copy of your most recent federal tax return and pay stubs. This documentation is vital for verifying the income and deductions you report.
  • Don't include any personal identifiers on attached documents beyond what is necessary. Protecting your privacy and security should remain a priority throughout this process.
  • Don't hesitate to ask for a copy of Civil Rule 90.3 or the DR-310 booklet on child support from the clerk if you need further clarification on these rules. Additional resources can provide valuable insight and ensure compliance.

Misconceptions

When dealing with the Alaska DV 101 form, which is essential for petitioning for a long-term domestic violence protective order and requesting child support, there are several common misconceptions. Understanding these misconceptions is crucial for accurately completing the form and navigating the legal process efficiently.

  • Misconception 1: The form is only for reporting domestic violence.
  • While the DV 101 form is used in the context of domestic violence, its primary focus in this instance is to gather information regarding child support as part of a petition for a protective order. The form collects financial data to inform child support decisions.

  • Misconception 2: Anyone can fill out the form on behalf of the child.
  • Only specific individuals, such as a parent or a legally authorized person, can complete the form for a child. This limitation ensures that the information provided is accurate and legally valid.

  • Misconception 3: Income information is optional.
  • Providing detailed income information is mandatory, not optional. This data, including gross income and deductions, is crucial for calculating the appropriate amount of child support.

  • Misconception 4: You don't need to attach tax returns or pay stubs.
  • Attaching the most recent federal tax return and pay stubs is a requirement, not a suggestion. These documents verify the income information provided on the form.

  • Misconception 5: The form covers all types of income.
  • Some types of income, such as ATAP (Alaska Temporary Assistance Program) or SSI (Supplemental Security Income), should not be listed in the gross income section, highlighting the need to understand which income types are relevant for this form.

  • Misconception 6: Health care coverage details are not important.
  • Information about health care coverage is vital, especially regarding its availability through employment and the associated costs, as it affects child support calculations and the health care responsibilities of each parent.

  • Misconception 7: Immediate income withholding is automatic.
  • The form allows for exceptions to immediate income withholding if an alternative arrangement is made or if it is deemed not in the child's best interest. This provides flexibility based on individual circumstances.

  • Misconception 8: Signing the form is the final step.
  • Signing the form is a crucial step as it involves affirming the accuracy of the information under penalty of perjury. However, further steps, such as filing the form with the court and attending the hearing, are necessary to action the protective order and child support request.

  • Misconception 9: The form does not require notarization.
  • The form must be notarized to ensure its authenticity, a step that can often be done at the court at no charge, underscoring the form's legal significance.

Understanding these misconceptions can guide individuals through the process of requesting a domestic violence protective order and associated child support with greater clarity and accuracy.

Key takeaways

When filling out and using the Alaska DV 101 form, which is crucial for those seeking a long-term domestic violence protective order that involves child support, there are several key takeaways to consider:

  • Child support requests as part of a petition for a domestic violence protective order require both parties to complete and submit the DV 101 form.
  • The information requested on this form is mandated by Civil Rule 90.3 and specific Alaska statutes, highlighting the legal necessity of detailed and accurate completion.
  • Assistance with filling out the form is available through court clerks, ensuring the form is completed correctly and effectively.
  • Documentation such as the most recent federal tax return and pay stubs are required to verify income and deductions, making transparency and access to financial documents essential.
  • Sensitive details like social security and account numbers must be redacted from the attached documents to protect personal information.
  • The form asks for details on existing child support orders, income information, health care coverage for the children involved, children’s health care expenses not covered by insurance, travel expenses related to visitation, and immediate income withholding. This comprehensive breakdown emphasizes the importance of providing a full financial picture.
  • Making alternative arrangements for income withholding, especially when the payer is receiving ATAP or other social security benefits, needs careful consideration and transparency between the parties.
  • The person paying support is also required to keep the other party informed of any changes to their employment status and the availability of health insurance coverage for the child(ren).
  • Applying for the assistance of the Child Support Services Division (CSSD) for enforcing the support order and keeping records of payments is an option that requires a separate application process, indicating the additional steps needed for long-term support and enforcement.

The completion and submission of the Alaska DV 101 form are steps toward securing a legal framework for child support within the context of a domestic violence protective order, underlining the legal system’s provision for safeguarding the welfare of children and addressing financial responsibilities in such situations.

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