Kelly Blue v. Julie Maxine Jones

IN THE DISTRICT COURT OF CANADIAN COUNTY STATE OF OKLAHOMA KELLY BLUE, individually and as guardian of K. G. BLUE, a minor child, Plaintiffs, vs. JULIE MAXINE JONES, individually, and STATE FARM LIFE INSURANCE COMPANY, an Illinois Corporation, and THE ESTATE OF MICHAEL K. BLUE, Deceased, Defendants. PAUL HESSE CASE NO.: CJ-2026-370 FILED HOLLY EATON COURT CLERK, CANADIAN COUNTY, OKLAHOMA APR 24 2026 DEPUTY PETITION COMES NOW, KELLY BLUE, individually and as guardian of K.G. BLUE, a minor child, and for her cause of action against Julie Maxine Jones, individually, State Farm Life Insurance Company, a Corporation domicile in Illinois doing business in Oklahoma, and The Estate of Michael K. Blue, Deceased, alleges and states as follows: PARTIES 1. The Plaintiff, Kelly Blue, is a resident of Canadian County, Oklahoma. 2. The Plaintiff, K. G. Blue by and through his guardian, Kelly Blue, is a resident of Canadian County, Oklahoma. 3. The Defendant, Julie Maxine Jones, is a resident of Canadian County, Oklahoma. 4. State Farm Life Insurance Company is a life insurance company domicile in Illinois and conducting business in Oklahoma. 5. Decedent, Michael K. Blue, died a resident of Canadian County, Oklahoma on April 20, 2026. 6. Jurisdiction and venue are proper in the District Court of Canadian County, Oklahoma. GENERAL ALLEGATIONS 7. Plaintiff, Kelly Blue and Michael K. Blue, now deceased, were married and produced one child, Plaintiff, K. G. Blue, a minor child. 8. A Decree of Divorce and Dissolution of Marriage in Canadian County, Oklahoma case number FD-2025-210 was entered on July 31, 2025, granting Plaintiff, Kelly Blue and Michael K. Blue, deceased, a divorce from each other, attached hereto as "Exhibit A." 9. Said Decree was agreed to and signed by both parties who declared to the Court that both parties request that said agreement be presented for its review and approval. 10. The Decree divides the parties’ marital property which included a State Farm Life Policy #LF-4032-7126. The Court ordered that said policy was to be payable to a Trust created for the benefit of the Plaintiff, K. G. Blue, which is to “provide for disbursements to [said Plaintiff]’s well-being and care…” See Decree of Divorce and Dissolution of Marriage at ¶10(b), attached hereto as Exhibit “A”, and incorporated by reference. 11. Said Decree further states that the Decree is fair and equitable to the parties, and that “the same should be entered as and be merged into the judgment, orders, and decrees of this Court and at this time.” Id at ¶20. 12. Decedent, Michael K. Blue, did not create the Court ordered Trust for the benefit of Plaintiff, K. G. Blue, a minor child. 13. On or about October 24, 2025, under ninety days (90) days from the date the Decree with said orders entered, Decedent, Michael K. Blue, changed the beneficiary of policy LF-4032-7126 to Plaintiff, Julie Maxine Jones, which is in direct violation of said Court orders. 14. Decedent subsequently died April 20, 2026. FIRST CAUSE OF ACTION: FRAUD AND DECEIT In support of their First Cause of Action, Plaintiffs incorporate all allegations set forth above and further states: 15. Under 76 Okla. Stat. § 2, a person who willfully deceives another, with intent to induce him to alter his position to his injury or risk, is liable for any damage which he thereby suffers. 16. Decedent is liable for any damages Plaintiffs have suffered because of his deceit. 17. In exchange for a full and equitable property settlement in the above-referenced divorce action, Decedent, Michael K. Blue, represented to Plaintiff, Kelly Blue, that he would leave State Farm Life Insurance policy # LF-4032-7126 for the benefit of Plaintiff, K.G. Blue’s well-being and care. 18. At the time the representation was made or when the decree was signed, either Decedent knew that the representation was false, he made the promise with no intent to perform it, or he used the promise to gain an advantage in the settlement. 19. Plaintiffs relied on Decedent’s promises to do what he agreed to and to follow the Court’s orders. 20. Decedent did not act as agreed upon by the parties and ordered by the Court, as he changed the beneficiary designation to Plaintiff, Julie Maxine Jones (hereinafter “Defendant Jones"), after the agreement was made, the Decree was signed, and the Court entered its orders. 21. Decedent died, and therefore, the policy is now vested and payable to Defendant Jones. 22. Plaintiffs will suffer harm and loss due to the Decedent’s failure to act as agreed upon and ordered by the Court. 23. Plaintiff, Kelly Blue, would not have agreed to the terms in the Decree had she not been induced by the Decedent’s promises. 24. Therefore, Defendant, State Farm Life Insurance Company should pay the proceeds of the policy to Kelly Blue, guardian for the minor child, K. G. Blue, Plaintiffs. 25. Even if Decedent had no fraudulent intent in changing the beneficiary designation, he committed constructive fraud under 15 Okla. Stat. § 15 by breaching his contractual duties to Plaintiffs and thereby gaining an advantage by misleading her to her prejudice. 26. The amount of total damages are 100% of the proceeds of the State Farm Life Insurance policy # LF-4032-7126, owned by Decedent, Michael K. Blue, which should be ordered payable to Plaintiffs Kelly Blue as guardian of Plaintiff, K. G. Blue. SECOND CAUSE OF ACTION: UNJUST ENRICHMENT In support of their Second Cause of Action, Plaintiffs incorporate all allegations set forth above and further states: 27. Since Decedent changed said policy’s beneficiary to Defendant Jones, and he died April 20, 2026, the policy as written is now vested. 28. Defendant Jones is set to receive the proceeds of a life insurance policy that rightfully belongs to Plaintiff, K. G. Blue. 29. Due to Decedent’s promises and the Court’s orders in the Decree, if payment is made to Defendant Jones then she will be unjustly enriched as she is to receive a benefit at the expense of the Plaintiffs. 30. The amount of total damages are 100% of the proceeds of the State Farm Life Insurance policy # LF-4032-7126 which should be ordered payable to Plaintiffs Kelly Blue as guardian of Plaintiff, K. G. Blue. THIRD CAUSE OF ACTION: CONSTRUCTIVE TRUST In support of their Third Cause of Action, Plaintiffs incorporate all allegations set forth above and further states: 31. Kelly Blue and Michael K. Blue were in a confidential relationship when they entered into an agreement to settle their divorce by a consent decree. 32. The parties agreed that the State Farm Life Insurance policy # LF-4032-7126 was to be left to a trust for the benefit of Plaintiff, K.G. Blue’s well-being and care. 33. The intent of this agreement and the subsequent consent Decree was to settle all marital property claims and for the provision of the care of their minor child, K. G. Blue. 34. Decedent had a duty under said Decree to follow Court order and abide by the agreements reflected in said Decree. 35. Plaintiff Kelly Blue was misled to her detriment when Decedent changed the beneficiary designation to Defendant Jones. 36. Decedent knew the agreement he made, the Court orders that were entered, and the terms of the Decree as evidenced by his signature but unilaterally changed the beneficiary on said life insurance policy in the favor of Defendant Jones. 37. Even if Decedent had no fraudulent intent in changing the beneficiary designation, he committed constructive fraud under 15 Okla. Stat. § 15 by breaching his contractual duties to Plaintiffs and thereby gaining an advantage by misleading her to her prejudice. 38. Defendant Jones’ receiving the proceeds of the life insurance proceeds is against equity and good conscience and the Court should impose a constructive trust on the life insurance proceeds in favor of Kelly Blue as guardian of Plaintiff, K. G. Blue. FOURTH CAUSE OF ACTION: INJUNCTIVE RELIEF 39. Plaintiff requested an injunction enjoining Defendant, State Farm Insurance Company from paying the proceeds from policy # LF-4032-7126 owned by Michael K. Blue, Deceased. 40. Injunctive relief is necessary to prevent harm to the Plaintiffs because of immediate risk of loss. 41. Plaintiffs are likely to succeed on the merits, there is a risk of irreparable harm to Plaintiffs if the injunction is denied, and said threatened injury outweighs the injury the opposing party will suffer under the injunction; and the injunction is in the public interest. Dowell v. Pletcher, 2013 OK 50, ¶7, 304 P.3d 457, 460; See also, 12 O.S. § 1382. WHEREFORE, Plaintiffs, Kelly Blue and Kelly Blue as guardian of K. G. Blue, a minor child, request that the Court grant judgment in their favor as set out below and for such other relief as the Court may deem equitable and proper: A. Judgment declaring the terms of the Decree of Divorce and Dissolution of Marriage in Canadian County, Oklahoma case number FD-2025-210 that was entered on July 31, 2025, are enforceable and were reduced to judgment. B. Judgment granting 100% of the proceeds of State Farm Life Insurance policy # LF-4032-7126 payable to Kelly Blue as guardian of K. G. Blue, a minor child. C. Judgment that 100% of the proceeds from State Farm Life Insurance policy # LF-4032-7126 is impressed with a constructive trust in favor of the minor child, K. G. Blue. D. Judgment enjoining State Farm Life Insurance from paying any proceeds from State Farm Life Insurance policy # LF-4032-7126 until further order of this Court or trial on the merits. E. Judgment for attorney fees and costs for recovering property and for overriding equitable consideration that demand the award. Respectfully submitted, [Signature] Donna M. Compton Garland, OBA #31008 B.I.C. LEGAL, PLLC 104 W. Gray Street Norman, OK 73069 405-568-3828 [email protected] Attorney for Plaintiffs VERIFICATION STATE OF OKLAHOMA ) COUNTY OF CLEVELAND ) SS: KELLY BLUE, of lawful age and being first duly sworn, states that she has read the foregoing Petition, that she is familiar with the contents thereof, and that the allegations set forth therein are true and correct. _____________________________________ KELLY BLUE Subscribed and sworn before me this 24th day of April 2026. My Commission Expires: 3/29/29 Notary Public Petition Final Audit Report Created: 2026-04-24 By: Melissa Milburn ([email protected]) Status: Signed Transaction ID: CBJCHBCAABAAp7Zba0s4WuOqFcvfJwb88GJzn3-4mTKS "Petition" History Document created by Melissa Milburn ([email protected]) 2026-04-24 - 4:33:17 PM GMT Document emailed to Kelly D. Blue ([email protected]) for signature 2026-04-24 - 4:33:22 PM GMT Email viewed by Kelly D. Blue ([email protected]) 2026-04-24 - 4:52:06 PM GMT Document e-signed by Kelly D. Blue ([email protected]) Signature Date: 2026-04-24 - 5:06:03 PM GMT - Time Source: server Agreement completed. 2026-04-24 - 5:06:03 PM GMT IN THE DISTRICT COURT OF CANADIAN COUNTY STATE OF OKLAHOMA IN RE THE MARRIAGE OF KELLY BLUE, and MICHAEL BLUE, Petitioner, Respondent. DECREE OF DIVORCE AND DISSOLUTION OF MARRIAGE On July 31, 2025, this matter was presented for hearing by agreement of the parties. Petitioner, Kelly Blue appeared by and through her attorney of record, Harold G. Drain. Respondent, Micheal Blue appeared pro se. The parties requested that said agreement be presented to the Court for its review, approval and merger into the judgement, decrees and orders of the Court at this time. Whereupon the Court proceeded to review the court file and appearance docket and receive the evidence and argument of counsel On this July 31, 2025, being fully advised in the premises, the Court found, ordered, adjudged and decreed as follows: 1. That this Court has jurisdiction and venue over the subject matter and the parties to this action, by virtue of the fact that Petitioner is now, and has been for more than six months next preceding the filing of the Petitioner's petition, herein, a bona fide resident in good faith of the State of Oklahoma; and has been for more than thirty days prior to the filing of Petitioner's petition herein, an actual resident in good faith of Canadian County Oklahoma. 2. Petitioner and Respondent were lawfully married on September 15, 2007, in Yukon, Oklahoma, and have ever since been husband and wife. 3. That parties are entitled to a decree of dissolution of marriage from each other upon the grounds of incompatibility; 4. There is one minor child of the marriage, to wit; K.G. Blue born August 2009 in Oklahoma Petitioner is not pregnant. 5. Under all applicable state and federal law, including the Uniform Child Custody Jurisdiction and Enforcement Act, 43 O.S. 551-101 et seq., and Oklahoma Uniform Interstate Family Support Act, 43 O.S. 601-100 et seq., and the Federal Parental Kidnapping Act, 28 U.S.C. 1738 A, this Court has and should exercise jurisdiction to enter child custody visitation and support decrees under said state and federal law and enter orders concerning the same as more specifically herein set forth. More particularly: a. Oklahoma is the home state of said minor child as the term is defined by said statutes and it has since remained is now their home state. b. It is in the best interest of the minor child that this state continues to assume jurisdiction because the child and the parties have significant connections with this state, and there is available in this state substantial evidence concerning the child's present and future care, protection, training and personal relationships and the child is physically present in this state. a. Other than the parties hereto, no other person has or claims to have custody or visitation rights concerning the minor child. Other than this actions, no other action has been filed in this or any other state in which the custody, visitation or support of the minor child has been at issue and Petitioner has not participated in any such other litigation as a party, witness or in any other capacity. c. no prior actions have been filed in this or in any other state concerning the custody, visitation or support of the minor child and no party hereto has participated in any such litigation as a party, witness or in any other capacity. d. That the Indian Child Welfare Act of 1978, 25 U.S.C.A., 1901 et seq., the Oklahoma Indian Child Welfare Act, 10 O.S.A., 40 et seq., are inapplicable; e. The Court has jurisdiction over all necessary parties concerning the issues of child support, visitation and custody and the Court shall exercise its jurisdiction to enter this Consent Decree of Dissolution of Marriage. 6. The parties have entered into an agreement which fully settles, compromises and resolves all issues between them herein. More particularly, the parties have agreed that the Court should enter the following judgment, orders and decrees, to wit: a. Custody of the said minor child will be awarded to the Petitioner with sole custody and Respondent having Canadian County Standard Visitation. Attached hereto as Exhibit "A" 7. Respondent shall pay child support to Petitioner pursuant to the Oklahoma state Child Support Guidelines, attached hereto as Exhibit "B," in the amount of $610.46 per month. 8. Extracurricular Expenses: Parties agree to split extra expenses 50/50. 9. Tax Credit: Petitioner shall claim the child as her exemption on Federal and State taxes every year. 10. Life Insurance Policy: The parties have different life insurance policies and have agreed to the following terms. a. To ensure child support, Respondent shall list Petitioner as the Beneficiary on Policy # LF-2738-5032 for the full term of the policy, estimated November, 2029. b. Respondent will create a Trust and name it as the beneficiary for Policy # LF-4032-7126. Said Trust will name Kyler Blue as a beneficiary to said Trust and Respondent agrees to provide for disbursements to Kyler Blue's well-being and care as Respondent deems appropriate. c. Petitioner will keep Policy #LF-2738-5166 active and in full force. d. Parties will spit monthly premium 50/50 on policy #LF-2738-5032 (approximately $145.92 each). e. Respondent shall pay 100% of the premium for Policy # LF 4032-7126. f. Petitioner shall pay 100% of the premium for Policy #LF-2738-5166. g. The "return of premium" State Farm Life Policy #LF2738-5032, shall be awarded to Petitioner. The estimated date of said "return of premium" payment is November 2029. If Respondent receives this directly from State Farm, he shall transfer said funds to Petitioner within 5 days of receipt. h. State Farm shall receive a copy of this Decree and is on notice that if the Respondent changes the beneficiary before December 31, 2028, then they are to notify Kelly Blue. 11. Cash Settlement: Respondent shall pay the Petitioner a total of $8,000.00 for reimbursement and settlement represented by the following: $3,075.36 (half of Chase card balance), $792.50 (half of Kohls card balance); $2,500.00 reimbursement of legal fees; and $1,632.14 miscellaneous expense reimbursement. The Respondent shall pay the Petitioner $8,000.00 to Petitioner within 30 days of the entry of the Decree. 12. Health Insurance. If allowed by Petitioner's health insurance plan Respondent may remain on Petitioner's medical plan until end of 2025. If exercised, Respondent shall directly pay the Petitioner the sum of $218.71 a month for his share of the premium. 13. Division of Personal and Intangible Property: The parties property shall be divided as follows: a. Property Settlement: 14. As Petitioner’s equitable division of the marital assets, she will be awarded all right, title, and/or interest in the following property to wit; a. All of the personal property in her possession. b. All retirement accounts in her name. c. All bank accounts in her name. d. The 2015 GMC Acadia Vin# 1GKKVRKD4FJ359177, subject to any debt associated with. Said debt should be refinanced or paid off within 60 days of this Decree. If Petitioner is unable to refinance or payoff cannot be accomplished due to credit or lender rejection, she will immediately notify Respondent and keep him informed of her efforts. e. $8,000 cash payment from the Respondent as listed in Paragraph 11 above. 15. Petitioner will be ordered to pay, and to indemnify and hold Respondent harmless from all claim, loss, demand and liability from, the following debts of Petitioner, to wit: I. All debts in Petitioner’s name. II. Half of the total debt associated with the TruSky Credit Card (Total debt approximately $23,232.00). III. Full balance of Chase Card—See Paragraph 11. IV. Full balance of Kohls Card—See Paragraph 11. V. Half of the total debt associated with CK Energy (Total debt approximately $2,224.00). VI. All of the Petitioner’s student loans ($36,460.00). 16.. Respondent will be awarded, free and clear of all right, title or interest of Petitioner, the following property, to wit: a. All of the personal property in his possession. b. The 2014 GMC Sierria VIN# 3GTU22WEJ1EG437217, subject to any debt associated with. Said debt should be refinanced or paid off within 60 days of this Decree. If Respondent is unable to refinance or payoff cannot be accomplished due to credit or lender rejection, he will immediately notify Petitioner and keep her informed of her efforts. c. All retirement accounts in his name. d. All bank accounts in his name and in the name of Hawthorne Construction Co., LLC. 17. Respondent will be ordered to pay, and to indemnify and hold Petitioner harmless from all claims, loss, demand and liability from, the following debts of Respondent, to wit: I. All debts in Respondent’s name. II. All debts acquired by Respondent before or during the marriage. III. Half of the total debt associated with the TruSky Credit Card (Total debt approximately $23,232). IV. All of the debt associated with the Ally Credit Card V. All of the debt associated with the US Bank Card VI. Half of the total debt associated with the CK Energy (Total debt approximately $2,224) VII. All of the Respondent’s medical debt, Approximately $23,526.00. VIII. All of the Respondents student loans. Approximately $493.00. IX. $8,000 cash to the Petitioner as set forth in Paragraph 11 above. 18. Joint Bank Accounts: Any joint bank accounts will be closed and the money will be split 50/50 between the parties. 19. Taxes: The parties will cooperate in taking care of any back taxes. They will split any debt or refunds associated with. Parties will file 2025 taxes separately. 20. This Decree is fair and equitable to each party and is hereby, approved by the Court and the same should be entered as and be merged into the judgment, orders and decrees of this Court and at this time. 21. The parties are divorced and their marital relation is terminated and dissolved, which decree is final on this date. The parties are admonished to be in compliance with the law of this state prohibiting remarriage of the parties (except to each other) until six months pass from this date. 22. Petitioner is awarded, as her separate property, free and clear of all right, title, interest or claim of Respondent. 23. Respondent is awarded, as his separate property, free and clear of all right, title, interest or claim of Petitioner. 24. As to each and all of the foregoing awards and orders pertaining to real and/or personal property, each party is ordered, on this date, to execute and deliver to the other all such good, sufficient and acknowledged documents of title, transfer and delivery as are necessary to accomplish and effectuate conveyance, transfer of title and delivery of each and all of the foregoing awards and orders of real and/or personal property to each respective party. In the event that either party fails to do so, and on this date, this Decree of Divorce and Dissolution of Marriage shall fully operate as such execution, conveyance, transfer of title and delivery as to each and all of the foregoing orders and awards. IT IS SO ORDERED! Signed on 31, July, 2025. JUDGE OF THE DISTRICT COURT LORY K. DEWEY Approved For Entry: Harold G. Drain OBA #18368 508 West Vandament Suite 203 Yukon, Oklahoma 73099 Telephone (405) 535-4555 Fax (405) 972-3329 Attorney for Petitioner Kelly Blue, Petitioner Micheel Blue Respondent, Pro se IN THE DISTRICT COURT OF CANADIAN COUNTY STATE OF OKLAHOMA IN RE THE MARRIAGE OF: Petitioner, and Respondent. Case No. PARENTING SCHEDULE i. REGULAR PARENTING SCHEDULE: The Mother/Father (circle one) shall have parenting time with the minor child(ren) of the parties every other weekend from Thursday after school or day care until Monday morning when the Mother/Father returns the child(ren) to school or day care plus every other Wednesday evening from after school or day care until 6:30 p.m. ii. HOLIDAY SCHEDULE: <table> <tr> <th>HOLIDAY</th> <th>EVEN YEARS</th> <th>ODD YEARS</th> </tr> <tr> <td>Spring Break</td> <td>Mother</td> <td>Father</td> </tr> <tr> <td>Easter Weekend</td> <td>Father</td> <td>Mother</td> </tr> <tr> <td>Mother's Day</td> <td>Mother</td> <td>Mother</td> </tr> <tr> <td>Memorial Day Weekend</td> <td>Mother</td> <td>Father</td> </tr> <tr> <td>Father's Day</td> <td>Father</td> <td>Father</td> </tr> <tr> <td>Labor Day Weekend</td> <td>Father</td> <td>Mother</td> </tr> <tr> <td>Fall Break</td> <td>Mother</td> <td>Father</td> </tr> <tr> <td>Halloween</td> <td>Mother</td> <td>Father</td> </tr> <tr> <td>First Portion of Thanksgiving Break</td> <td>Mother</td> <td>Father</td> </tr> <tr> <td>Second Portion of Thanksgiving Break</td> <td>Father</td> <td>Mother</td> </tr> <tr> <td>First Portion of Winter Break</td> <td>Mother</td> <td>Father</td> </tr> <tr> <td>Second Portion of Winter Break</td> <td>Father</td> <td>Mother</td> </tr> </table> iii. SUMMER SCHEDULE: The parents shall rotate parenting time every week during the summer on Fridays at 6:00 p.m. This shall begin the Friday after Memorial Day with the parent who did not have Memorial Day weekend. The summer rotation shall end the Friday before the child(ren) returns to school or would return to school if of school age. iv. HOLIDAY EXCHANGES: A. Spring Break, Easter Weekend, Mother's Day, Labor Day Weekend and Fall Break begin after school or day care the day school lets out until the morning school resumes. B. Memorial Day Weekend begins the Friday before Memorial Day at 6:00 p.m. until Tuesday at 8:00 a.m. C. Father's Day begins the Friday before Father's Day at 6:00 p.m. until Monday at 8:00 a.m. D. Halloween begins October 31st after school or day care until the morning of November 1st when school resumes or 8:00 a.m. if there is no school on November 1st. E. First Portion of Thanksgiving Break begins after school or day care the Friday before Thanksgiving until Wednesday at 6:00 p.m. Second Portion of Thanksgiving Break begins Wednesday at 6:00 p.m. until the morning school resumes. F. First Portion of Winter Break begins after school or day care the day school lets out until December 25th at 3:00 p.m. Second portion of Winter Break begins December 25th at 3:00 p.m. until January 1st at 3:00 p.m. The child(ren) then return to the First Portion parent for the remainder of the holiday break. (The parents have the option of exchanging the child(ren) halfway during the Winter Break if agreed to in writing.) v. OTHER PROVISIONS: The Holiday Schedule supersedes the Regular Parenting Schedule and shall be governed by the school the child attends or would attend if of school age. Holidays that begin on a Friday do not change parenting time the day before. Liberal telephone communications between the parent and child(ren) is encouraged and shall occur. The parents may deviate from this schedule by mutual agreement. For all scheduled exchanges, the receiving parent should provide transportation unless otherwise agreed by the parents or ordered by the Court. The Parenting Schedule provides 135 nights when calculating child support. Revised: 5/8/2021 IN THE DISTRICT COURT OF CANADIAN COUNTY STATE OF OKLAHOMA Kelly Blue Petitioner and Michael Blue Respondent Dist. Ct. Case No. OAH Case No. FGN: CHILD SUPPORT COMPUTATION <table> <tr> <th>Calculation for number of children in this case</th> <th>1</th> <th colspan="3"></th> </tr> <tr> <th>Obligor (person who pays) is<br>(Enter "Father" or "Mother")</th> <th>Father</th> <th colspan="3"></th> </tr> <tr> <th>A</th> <th>Base monthly obligation</th> <th>Father</th> <th>Mother</th> <th>Combined</th> </tr> <tr> <td rowspan="3">1</td> <td>Gross monthly income<br>All sources, except income specifically excluded by 43 O.S. Section 118B(B)</td> <td>$8,666.16</td> <td>$4,416.16</td> <td>$11,082.32</td> </tr> <tr> <td>a. Amount of self-employment income included in Line 1</td> <td>$0.00</td> <td>$0.00</td> <td></td> </tr> <tr> <td>b. Deduction for self-employment tax<br>Multiply Line 1a by 7.65%</td> <td>$0.00</td> <td>$0.00</td> <td></td> </tr> <tr> <td rowspan="4">2</td> <td>Total gross monthly income<br>Line 1 minus Line 1b</td> <td>$6,666.16</td> <td>$4,416.16</td> <td></td> </tr> <tr> <td>a. Amount of SSA Title II benefits or veterans disability benefits paid for the benefit of the children.<br>Do NOT include SSI benefits. (Enter in the column for the disabled or retired parent.)</td> <td>$0.00</td> <td>$0.00</td> <td></td> </tr> <tr> <td>b. Court ordered support alimony actually paid in a prior case</td> <td>$0.00</td> <td>$0.00</td> <td></td> </tr> <tr> <td>c. Court ordered monthly adjustment for marital debt</td> <td>$0.00</td> <td>$0.00</td> <td></td> </tr> <tr> <td>d. Court ordered monthly child support actually paid for qualified out-of-home children</td> <td>$0.00</td> <td>$0.00</td> <td></td> </tr> </table> <table> <tr> <th>In-home Children Deduction Worksheet</th> <th></th> <th></th> <th></th> <th></th> </tr> <tr> <td>e. Number of qualified in-home children excluding children on this case</td> <td>0</td> <td>0</td> <td></td> <td></td> </tr> <tr> <td>f. Amount for qualified in-home children.<br>Apply Line 2 for each parent to Child Support Guideline Schedule amount using the number of children in Line 2e, and multiply guideline amount by 75%</td> <td>$0.00</td> <td>$0.00</td> <td></td> <td></td> </tr> <tr> <td>3 Adjusted gross monthly income (AGI)<br>Amount in Line 2 plus 2a, minus Lines 2b, 2c, 2d, and 2f</td> <td>$6,686.16</td> <td>$4,416.16</td> <td>$11,082.32</td> <td></td> </tr> <tr> <td>4 Percentage share of income<br>AGI for each parent divided by the combined AGI</td> <td>60.2%</td> <td>39.8%</td> <td>100%</td> <td></td> </tr> <tr> <td>5 Base monthly obligation<br>Apply combined AGI to Child Support Guideline Schedule and put total in combined base monthly obligation. Multiply the combined total by the percentage share of income for each parent.</td> <td>$724.22</td> <td>$479.78</td> <td>$1,204.00</td> <td></td> </tr> <tr> <td>B Parenting time adjustment, if used</td> <td>Father</td> <td>Mother</td> <td>Combined</td> <td></td> </tr> <tr> <td>6 Number of overnights with each parent<br>If less than 121 for either parent, skip to C.</td> <td>121</td> <td>244</td> <td>365</td> <td></td> </tr> <tr> <td>a. Percentage of overnights with each parent<br>Number of overnights for each parent divided by 365</td> <td>33.2%</td> <td>66.8%</td> <td>100%</td> <td></td> </tr> <tr> <td>b. Adjusted combined child support obligation<br>Adjustment factor is based on the parent with the fewest overnights. The result in the combined column is the combined monthly obligation in Line 5 multiplied by the adjustment factor.</td> <td>2</td> <td colspan="2">&lt;&lt;=&gt;&lt; Adjustment Factor<br>less than 121 = no factor<br>121-131 = 2<br>132-143 = 1.75<br>144-183 = 1.5</td> <td>$2,408.00</td> </tr> <tr> <td>c. Share of adjusted combined child support obligation<br>Combined Line 6b multiplied by the percentage share of income in Line 4</td> <td>$1,448.44</td> <td>$959.56</td> <td></td> <td></td> </tr> <tr> <td>d. Respective adjusted base child support obligation<br>Amount for each parent in Line 6c multiplied by the percentage of the other parent in Line 6a</td> <td>$968.27</td> <td>$318.10</td> <td></td> <td></td> </tr> <tr> <td>7 Adjusted base monthly obligation<br>Line 6d larger amount minus Line 6d smaller amount and the result is for the parent with the positive amount. If the parent has more than 205 in Line 6, use $0 for that parent. If either parent has less than 121 in Line 6, use the Line 5 amount for both parents.</td> <td>$650.17</td> <td>$0.00</td> <td></td> <td></td> </tr> <tr> <td>C Obligor (person who pays) is<br>(Enter "Father" or "Mother")</td> <td>Father</td> <td></td> <td></td> <td></td> </tr> </table> <table> <tr> <th>D</th> <th>Work and education-related child care expenses</th> <th>Father</th> <th>Mother</th> <th>Other Custodian</th> </tr> <tr> <td>8</td> <td>Monthly child care expenses for children in this case Include any co-payments being paid by a parent receiving OKDHS Child Care Subsidy.</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> </tr> <tr> <td>9</td> <td>Child care expense percentage share of the total Total child care expenses multiplied by percentage share of income for each parent Multiply Line 8 by Line 4</td> <td>$0.00</td> <td>$0.00</td> <td></td> </tr> <tr> <td>10</td> <td>Total child care adjustment to base monthly obligation Line 9 minus Line 8 (amount may be negative)</td> <td>$0.00</td> <td>$0.00</td> <td></td> </tr> <tr> <th>E</th> <th>Health Insurance premium</th> <th>Father</th> <th>Mother</th> <th>Other Custodian</th> </tr> <tr> <td>11</td> <td>Monthly health insurance premium costs This premium represents the actual premium cost for any child(ren) in this case only. Insurance Premium Worksheet is available if needed. Use Cash Medical Support if any child is not covered by Insurance.</td> <td>$0.00</td> <td>$140.00</td> <td>$0.00</td> </tr> <tr> <td>12</td> <td>Monthly health insurance share for each parent Percentage share of income in Line 4 multiplied by total current insurance cost for all persons in Line 11</td> <td>$84.21</td> <td>$55.79</td> <td></td> </tr> <tr> <td>13</td> <td>Total premium cost adjustment to base monthly obligation Line 12 minus Line 11 (amount may be negative)</td> <td>$84.21</td> <td>-$84.21</td> <td></td> </tr> <tr> <th>F</th> <th>Other contributions, if agreed or ordered</th> <th>Father</th> <th>Mother</th> <th>Other Custodian</th> </tr> <tr> <td>14</td> <td>Ongoing medical costs Cash medical support for fixed periodic payments for ongoing medical costs</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> </tr> <tr> <td></td> <td>a. Adjusted medical costs share Multiply total of Line 14 for all persons by Line 4</td> <td>$0.00</td> <td>$0.00</td> <td></td> </tr> <tr> <td></td> <td>b. Total ongoing medical costs adjustment to base monthly obligation Line 14a minus Line 14 (amount may be negative)</td> <td>$0.00</td> <td>$0.00</td> <td></td> </tr> <tr> <td>15</td> <td>Visitation transportation costs</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> </tr> <tr> <td></td> <td>a. Adjusted visitation costs share Multiply total of Line 15 for all persons by Line 4</td> <td>$0.00</td> <td>$0.00</td> <td></td> </tr> <tr> <td></td> <td>b. Total ongoing visitation costs adjustment to base monthly obligation Line 15a minus Line 15 (amount may be negative)</td> <td>$0.00</td> <td>$0.00</td> <td></td> </tr> <tr> <th>G</th> <th>Child Support obligation subtotal</th> <th>Father</th> <th>Mother</th> <th></th> </tr> <tr> <td>16</td> <td>Base monthly child support obligation less adjustments for child care and other contributions Add obligor Line 7 to Lines 10, 13 and 15b if positive amounts. Subtract Lines 10, 13 or 15b if negative amounts.</td> <td>$734.38</td> <td>$0.00</td> <td></td> </tr> </table> <table> <tr> <th>17</th> <td>SSA Title II benefits or veterans disability benefits paid for the benefit of the child<br>Line 2a for obligor</td> <td>$0.00</td> <td></td> </tr> <tr> <th>18</th> <td>Total monthly child support obligation less any SSA Title II benefits or veterans disability benefits paid for the benefit of the child<br>Line 16 minus Line 17 (amount may be negative)</td> <td>$734.38</td> <td>$0.00</td> </tr> <tr> <th>H</th> <th>Cash Medical Support</th> <th>Father</th> <th>Mother</th> <th>Combined</th> </tr> <tr> <th>19</th> <td>Enter number of children in this case not covered by health insurance. If none, skip to Line 24. Note: This may be different from the number of children on SoonerCare.</td> <td>0</td> <td></td> <td></td> </tr> <tr> <th>20</th> <td>Enter the SoonerCare or other health care government assistance applicant for the child(ren) In this case, if child(ren) are on SoonerCare. Enter "Father", "Mother", "other", or leave blank.</td> <td></td> <td></td> <td></td> </tr> </table> <table> <tr> <th>21</th> <td>Cash medical amount for obligor<br>If Line 19 is zero or the obligor is the person on Line 20, enter $0 in Line 23. If Line 19 is greater than zero and the obligor is not the person on Line 20, refer to the Cash Medical Income Guidelines Table. If the Obligor’s income is less than or equal to the amount on the table, enter $0. If greater, multiply $115 by the number of children in Line 19. Multiply the combined total by percentage shares from Line 4.</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> </tr> <tr> <th>22</th> <td>5% of Gross Monthly Income<br>Line 2 multiplied by 0.05<br>This represents the maximum amount of total medical allowed.</td> <td>$333.31</td> <td>$220.81</td> <td></td> </tr> <tr> <th>23</th> <td>Cash medical support in lieu of insurance<br>If Line 21 plus Line 13 is greater than Line 22, use Line 22 minus Line 13. If Line 21 plus Line 13 is less than or equal to Line 22, enter Line 21. Enter $0 if negative</td> <td>$0.00</td> <td>$0.00</td> <td></td> </tr> <tr> <th colspan="5">Current Monthly Support Obligation</th> </tr> <tr> <th rowspan="3">24</th> <td>a. Child support portion<br>If Line 14b is positive, Line 18 for obligor<br>If Line 14b is negative, reduce Line 18 by Line 14b<br>Enter $0 if negative</td> <td colspan="3">$734.38</td> </tr> <tr> <td>b. Cash medical portion<br>If Line 18 minus 14b is positive, Line 23 for obligor<br>If Line 18 minus 14b is negative, reduce Line 23 by Line 18 minus 14b. Enter $0 if negative</td> <td colspan="3">$0.00</td> </tr> <tr> <td>c. Ongoing medical costs portion<br>If Line 18 is positive, Line 14b for obligor<br>If Line 18 is negative, reduce 14b by Line 18<br>Enter $0 if negative</td> <td colspan="3">$0.00</td> </tr> <tr> <th>25</th> <td>Total obligation to be paid by the obligor<br>Line 24a plus 24b plus 24c</td> <td colspan="3">$734.38</td> </tr> </table> Father shall begin payments on August 1, 2025 and continue on the same date of each month until further order of the court. X Deviation from child support guidelines by Court-Specific findings of Court supporting each deviation: For the benefit of the child through other avenues and agreements, the parties agree for child support to be set at $610.46 per month, which is a downward deviation of $123.92 Dated: 7-31-85 JUDGE LORY K. DEWEY APPROVED AS TO FORM: Father printed name: Michael Blue Father signature: Attorney for father printed name: Mother printed name: Kelly Blue Mother signature: Attorney for mother printed name: Harold Drain Attorney for mother signature and OBA Number Other Custodian printed name: Other Custodian signature Attorney for Other Custodian printed name: Attorney for Other Custodian signature and OBA Number State's Attorney, CSS printed name: State's Attorney, CSS signature and OBA Number Insurance Premium WorksheetA1:F11 Use this form to compute the actual monthly premium for the children in the case. "Accessible" means there are available providers to meet the primary individual health care needs of the child(ren) no more than sixty (60) miles one way from the primary residence of the child(ren). You may not wish to use the insurance premium amount if the coverage does not meet this standard. <table> <tr> <th></th> <th>Father</th> <th>Mother</th> <th>Other Custodian</th> </tr> <tr> <td>11a. The actual monthly health premium cost paid by parent or other custodian for the adults and child(ren) in the household.</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> </tr> <tr> <td>11b. Cost of insurance for adults only</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> </tr> <tr> <td>11c. The number of dependent children being covered. This includes children on this case and other children covered on the health insurance.</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>11d. Premium cost per child Line a minus b, divided by Line c</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> </tr> <tr> <td>11e. The number of children on this order.</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>11 Monthly health insurance premium costs Line 11d multiplied by Line 11e</td> <td>$0.00</td> <td>$140.00</td> <td>$0.00</td> </tr> <tr> <td>12 Monthly health insurance share for each parent Percentage share of income in Line 4 multiplied by total current insurance cost for all persons in Line 11</td> <td>$84.21</td> <td>$55.79</td> <td></td> </tr> </table> <table> <tr> <th>5% of Gross Monthly Income<br>Line 2 of Comp. Form multiplied by 0.05<br>This represents the maximum amount of total medical allowed.<br>Note: Health insurance should be reasonable in cost which means the share of premium shown on Line 12 for the parent providing the coverage does not exceed 5% of gross monthly income. If Line 12 is greater than Line 22, parents may agree to use premium cost or must proceed to Section H. Cash Medical Support.<br>If more than one parent has insurance available, the court shall give priority to the preference of the custodial person unless not in best interest of the child(ren).</th> <td>$333.31</td> <td>$220.81</td> <td></td> </tr> </table>