251 Superior Court of Arizona in Maricopa County Page 1 of 1 DRMSS31f - 010119 ALL RIGHTS RESERVED Use current version of document Person Filing: (1) Address (if not protected): City, State, Zip Code: Telephone: Email Address: ATLAS Number: Representing Self, without a Lawyer or Attorney for Petitioner OR Respondent SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY (2) Case Number: Name of Petitioner / Party A (in original case) ATLAS Number: (2) REQUEST FOR HEARING ( Simplified Process ) Name of Respondent / Party B (in original case) A Petition to Modify (change) Child S The information provided on the Child Support that was the basis for the request to modify (change) child support is not accurate. I am attaching the required completed Child Support that shows what I believe to be accurate information. I request that a hearing be set so that I can explain to the judge or commissioner my position. I further request that costs and fees incurred in responding to this matter be ordered to be paid by the other party. (3) COUNTER PETITION I further request the child support be modified to an amount different from the amount requested by the other party. Dated: STATE OF COUNTY OF Subscribed and sworn to or affirmed before me this: by (date) . (notary seal) Deputy Clerk or Notary Public 1. Upon filing the Request for Hearing, the filing party must immediately mail or otherwise deliver a copy of this Request to the other party or his/her attorney. If either party is currently using or has used the State IV-D Agency for child support services (Division of Child Support Enforcement or their representative), the State must also be mailed or provided with a copy of the Request, which can be mailed to: Office of the Attorney General Child Support Services Section 2005 N. Central Avenue Mail Drop 7611 Phoenix, AZ 85004 2. If a hearing or conference is scheduled, the court may enter a judgment for past- service costs, other court costs, and/or attorney fees. For Clerk Use Only American LegalNet, Inc. www.FormsWorkFlow.com