FLR-15A-E (2008/04)
Page 5 of 9
Form 15A: Change Information Form (page 5)
Court file number
18.
I am asking that child support be changed to an amount that is less than the table amount listed in the Child
Support Guidelines. The reason(s) for my request is/are that:
The parties agree to a different amount.
I have attached a separate sheet to this form that explains why this is an appropriate amount of child
support.
The recipient is getting social assistance payments from a public agency whose consent to this
arrangement is needed. I am attaching the agency’s consent to this form.
As can be seen from paragraphs 6 and 8 above, the parties have shared custody of the child(ren) (the payor
has a child at least 40% of the time).
I have attached a separate sheet to this form that compares the table amounts from the Child Support
Guidelines for each of the parties, shows the increased cost of the shared custody arrangement, the
financial circumstances of each party and of each child for whom support is claimed.
The parties are agreeing to this arrangement and I have attached a separate sheet to this form that
explains why this is an appropriate amount of child support.
As can be seen from paragraphs 6 and 8 above, custody of the children is split between the parties. I have
attached a separate sheet to this form that calculates the difference between the amount that each party
would otherwise pay to the other under the Child Support Guidelines.
A child is 18 or more years old and I attach to this form a separate sheet that calculates the amount of
support for this child.
A child contributes to his/her own support and I attach to this form a separate sheet showing the amount of
the child’s own income and/or assets.
The payor’s annual income is over $150,000 and I have attached to this form a separate sheet that calculates
the amount of support that I want to be put in an order.
Under the order/agreement,
(name(s) of child(ren))
is/are the subject of special provisions that I have detailed on a separate sheet that I have attached to this form.
The payor stands in the place of a parent to
(name(s) of child(ren))
and I attach to this form a separate sheet that gives the details of another parent’s duty to pay support for this/
these child(ren), as well as the details of the calculation of the amount of support requested.
The amount listed in the Child Support Guidelines would cause undue hardship to me or to the child(ren) for
whom support is claimed. I attach to this form a separate sheet that compares the standards of living of the
parties and calculates the amount of support that should be paid.
19. I ask that the outstanding child support owed be paid as follows:
The child support owed to
(name of recipient)
be fixed at $ as of
(date)
.
(Name of payor)
pay to (name of recipient)
$ per month, with payments to begin on (date)
until the full amount owing is paid.
The child support owed to
(name of agency or other person)
be fixed at $ as of
(date)
.
(Name of payor)
pay to (name of agency or other person)
$ per month, with payments to begin on (date)
until the full amount owing is paid.