Name: Mailing Address: Daytime Telephone Representing Self, Without a Lawyer IN THE SUPERIOR COURT OF ARIZONA, YAVAPAI COUNTY Regarding the matter of DO ATLAS #: PETITION TO MODIFY A SUPPORT ORDER Petitioner and (Standard Process) [652] [ ] Child Support [ ] Spousal Maintenance Respondent STATEMENTS TO THE COURT UNDER OATH 1. 2. Petitioner's Name: Address: County: SSN Occupation: Date of Birth: Respondent's Name: Address: County: 3. Date of Birth: SSN Occupation: INFORMATION ABOUT THE CURRENT SUPPORT ORDER I WANT TO CHANGE Date of order: Case Number: Name and location of court that issued the support order: Current amount ordered to be paid: The current order requires (name of person who pays) to make payment for: Child Support $ per Spousal Maintenance $ per Other $ per Payments in Arrears $ per Superior Court of Arizona in Yavapai County Page 1 of 3 DRMCSSP11f American LegalNet, Inc. www.FormsWorkflow.com 4. INFORMATION ABOUT OTHER COURT CASES TO ENFORCE OR CHANGE THIS COURT ORDER INVOLVING THE PETITIONER AND THE RESPONDENT. [ ] Current enforcement or modification cases: No other cases are pending in any court for enforcement of this court order. (This must be true and you must check this box.) [ ] Past enforcement or modification cases: If you or the other party have filed for enforcement or modification of the court order in the past, you must complete the following information, otherwise write “none” in the space provided. Use additional paper if necessary: Names of Parties: Date of order, judgment, decree: Explain what order or judgment said Case No. Location of court (city and county 5. SUBSTANTIAL AND CONTINUING CHANGE. This is the substantial and continuing change in my circumstances that entitles me to a change in support: 6. [ ] I REQUEST A CHANGE IN CHILD SUPPORT. I am filing a Parent’s Worksheet for Child Support Amount and an Affidavit of Financial Information. According to the worksheet calculations, the child support amount should be $ per month. [ ] I request a deviation from the Guidelines: [ ] Application of the Guidelines is [ ] inappropriate because [ ] A. [ ] 7. OR [ ] unjust The parties have signed a written agreement, free of duress or coercion, with knowledge of the amount of support that would have been ordered under the Guidelines. A copy of the agreement is attached. DES provides Child Support Enforcement Services to at least one of the parties: [ ] Yes [ ] No [ ] Unknown I REQUEST A CHANGE IN SPOUSAL MAINTENANCE. I am filing an Affidavit of Financial Information. Spousal maintenance amount should be $ per month beginning , 20 , and continuing until , 20 , and subject to change as ordered by the Court. This is an [ ] increase OR [ ] decrease OR [ ] continuance in payment. If a hearing is set, I estimate the amount of time required to be Superior Court of Arizona in Yavapai County Page 2 of 3 [ ] minutes OR [ ] hours. DRMCSSP11f American LegalNet, Inc. www.FormsWorkflow.com REQUESTS TO THE COURT: 1. [ ] Child Support be ordered in the amount of $ 2. [ ] Spousal Maintenance be ordered in the amount of $ 3. Any other orders the Court deems fair and just. per per OATH AND VERIFICATION STATE OF County of ) ) ss. I, being duly sworn and under oath, state that I have read this Petition and all the statements are accurate and complete to the best of my knowledge and belief. By SUBSCRIBED AND SWORN to before me this . day of , 20 , My Commission Expires: Notary Public Superior Court of Arizona in Yavapai County Page 3 of 3 DRMCSSP11f American LegalNet, Inc. www.FormsWorkflow.com