OTSEGO COUNTY FRIEND OF THE COURT
SUPPORT REVIEW REQUEST FORM
Case No. _________________________
Please Print Clearly
Your Name: _____________________ Current Address: ______________________________________
City/State: ______________________ Zip: __________ Birth Date: ____________________________
Home Telephone: _____________ Daytime and/or Cell Number: _______________ SSN: ___________
The Friend of the Court will review child support orders automatically once every 36 months if the child or the
custodial parent is receiving public assistance. In other cases, the Friend of the Court will conduct a statutory
review on written request of a party, but not more often than once every 36 months, unless a party proves a
substantial change of circumstances. A modification of support based upon a statutory review will become
effective the date the judge signs the Uniform Support Order. For the party who wishes to have the modification
of support become effective the date the request for a review was made should file a court motion requesting the
change. Form motions are available from the Friend of the Court.
Check the box that applies:
I am requesting a statutory review of support.
I am requesting a review of support because of the following specific/substantial change of circumstance :
(Attach documentation as it pertains to your change in circumstance such as a current pay stub, social security disability/SSI
benefit award/change related to a party or a child, letter from physician/mental health professional regarding inability to work due
to lengthy illness, proof of significant medical expenses or changes in the physical, mental or educational needs of the child, proof
of income reduction related to active military duty to last at least six months, receipt of unemployment, worker’s compensation or
receipt of public assistance, temporary or permanent changes in the physical custody of a child the court has not ordered.
Date: ________________________ Signature: ________________________________
