400-00803 – Motion to Modify Child Support, Maintenance Supplement (09/2018) Page 1 of 3
DOB
V.
Name
NOTICE OF APPEARANCE & INTENT TO REPRESENT MYSELF
I intend to represent myself and hereby enter my appearance with the Court. No attorney will represent me
in this case unless an attorney or I notify the Court otherwise.
I understand that IT IS MY RESPONSIBILITY TO:
1. Notify the Court in writing if I change my address or phone number; and
2. Send copies of any papers I file with the Court to the other party in this case.
All Court papers may be mailed to me by first class mail at the address listed below.
Name: __________________________________________ Date of Birth: ______________________
Street Address: ___________________________________ City/State/Zip: _____________________
Mailing Address (if different from Street Address): _____________________________________________________
City/State/Zip: ___________________________________ Email Address: _____________________
Daytime Phone: __________________________________ Evening Phone: _____________________
MOTION TO MODIFY CHILD SUPPORT, and/or MAINTENANCE SUPPLEMENT
1.
I am the ☐ Plaintiff ☐ Defendant ☐ Office of Child Support
2.
The other party is the ☐ Plaintiff ☐ Defendant
3.
I request that the Court modify a child support order issued on (date) _______________________.
☐
By this Court
☐ By another Court: __________________________________________________________
Name of Court
_____________________________________________________________
Address of Court
4. The children for whom support was ordered are:
Name Date of Birth
_______________________________ ____________________________
_______________________________ ____________________________
_______________________________ ____________________________
_______________________________ ____________________________
_______________________________ ____________________________
5. I am the child(ren)’s (check the appropriate box)
☐ Parent or guardian
☐ Support assignee
☐ Other (describe): __________________________________________________________________