(1) Person Filing: Mailing Address: City, State, Zip Code: Daytime / Evening Phone: In this case I am a: Petitioner Attorney Name: / Respondent Represented by Attorney Bar No.: For Clerk’s Use Only SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY (3) Petitioner (in original case) (2) Case No. ATLAS No. PETITION FOR HEARING RE: EX PARTE ORDER OF ASSIGNMENT A.R.S. § 25-504 Respondent (in original case) THIS FORM IS NOT TO BE USED TO REQUEST A CHANGE IN YOUR EXISTING SUPPORT ORDER. THIS FORM ONLY APPLIES TO THE EX PARTE ORDER OF ASSIGNMENT. (3) I, ask the court to set a hearing within ten (10) days before the Ex Parte Order of Assignment becomes binding on my first employer/payor served with the Ex Parte Order of Assignment. This petition is filed within SEVEN DAYS from the date the Petition for Assignment, Ex Parte Order of Assignment and Notice were delivered to me. (4) This Petition for Hearing is based on the following statement(s) regarding the Ex Parte Order of Assignment. (Check all boxes that apply) The person named in the Ex Parte Order is not me (Mistaken Identity). The amount shown in the Ex Parte Order is incorrect or has been modified. The child support or spousal maintenance order has been dismissed or is no longer valid. The current child support or spousal maintenance is no longer owing. All arrearages/interest have been paid/satisfied and are no longer owing. (5) I request the Court to order the Support Payment Clearinghouse to hold any payments received pursuant to the Ex Parte Order of Assignment until after the hearing. I realize that this hold will not be instant and that monies will continue to be sent out until a judicial determination is made. By signing this form I state to the Court, under penalty of perjury, the information I have given is true and correct. (6) Date © Superior Court of Arizona in Maricopa County August 9, 2007 ALL RIGHTS RESERVED Signature of Requesting Party Page 1 of 1 DRWA31f Use most current version WAN American LegalNet, Inc. www.FormsWorkflow.com