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DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES~ BUREAU OF VITAL
5TATISTICS, AMENDMENT UNIT~ shall and it is hereby ordered to
amend the above-named child's/children's birth cer[ificate(s~ Co
sh~w the above-named father's n$me.
6. Thar pursuant to Section 443.051~ Florida Statutes
(1985) and Section 462te) of the Title IV-A of the Social
Security Act that the Department of Labor and Employment Security
shall deduct and withhold from the Unemployment Compensation
otherwise payable to the Defendant SOx of the Unemployment
Compensation or the amount of child support as ordered above
whichever equals the greater amount but does not exceed the court
ordered support amount.
7. Additionally. it is further ordered thaC the
Respondent/Payor shall promptly notify the Clerk of Court of all
changes in his or her mailing and residence, and all changes in
the name and address of his or her employer within seven (7) days
of such change.
8. That this Court reserves jurisdiction for the
purpose of detesmining the amount due from the Respondent to the
Petitioner, if any, as reimbursement of past AFDC payments
received by or on behalf of the before-named child(ren).
9. That in the e~Tent the Defendant/Obligor becomes
unemployed, he/she shall seek employment and he/she shall
cooperate with the Department of Labor and Employment Services of
- the State o€ Florida and make reports to the Department of Health
and Rehabilitatfve Services of the State of Florida, Child
Support Enforcement Unit, of his/her efforts to maintain
e~ploynent~ on a weekly basis,
10. (Applies only if box is checked)
~ The Court finds that the Obligor has access ~t A
rza~~n~ble rate to group health insurance. It is thereupon
ordered and adjudged that said ObligoY shall, in addition to all '
other terms of this Order, provide health insurance for the
child(ren) set forth herein for so long as the child(ren) are
dependant under Florida law. The Obligor shall f ile proof of
said health insurance coverage in this file and send a copy to
all parties within 15 days of the date of this order. -
DONE AND ORDERED at ,
~ County, Florida, on this ~ ay of
, 19~'.
~ s~ o n~ u~`t
Copies furnished to:
All parties hereto.
/ 7 Copy delivered to Obligor in open court on date of
this Order.
1022388
'90 JAN 31 A 8 :1~ ~
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