CS-PO200i R. 08/10 Child Support Enforcement Request for Support Order Review Print Your Full Name: You may ask us to review your support order to see if the ongoing amount or health insurance terms should be changed. If the review shows the order should be changed, we will take legal action to change the order based on the results of the review. You can ask for a review • If it has been three years or longer since the order started or changed, or • If there has been a permanent, major change in your income or the needs of the child(ren) Here’s what we will do if you or the other parent asks us to review the support order • Ask both parents to give us current income information. • Use current information to see what would be ordered under the state’s child support guidelines based on the current situation of both parents. • Decide if either parent should be ordered to get health insurance for the child(ren). • Finish the review and take action to change the order, if needed, as long as the case is open. • If Florida does not have jurisdiction to change the order, we will send the request to the state that has jurisdiction. If we review the order and take legal action to change it • The amount due under the order and/or the health insurance terms of the order could be changed. If the order is changed, we will enforce the terms of the new order. • We will take action to change the order if the review shows the order amount should go up or down, either way. But we will not try to change the order unless your situation or the other parent’s situation has changed, or if there would be a very small change in the order. You will get notice of any legal action we take. • Any future change in the amount due does not affect unpaid support that is now owed. Any unpaid support now owed will still be owed. If you want us to review your support order • Check ‘Please review my support order’ on the other side of this form • Fill in all the information • Sign and date • Take this form to a Child Support office near you or mail it to: Mail to: Florida Department of Revenue Child Supprt Enforcement Program American LegalNet, Inc. www.FormsWorkFlow.com CS-PO200i R. 08/10 Please review my support order with because: (Print other parent’s full name) (Check all that apply) My income has changed. My income is now $ The other parent’s income has changed. It is now $ each . each . No health care coverage was ordered. The needs of the child(ren) have changed because Other If you ask us to review the order and it has been less than three years since the order started or the order was changed, you must show us records or have other information to prove that your situation or the other parent’s situation has changed. Examples include pay stubs, statements from child care providers, medical bills, or information about a new employer. Once we get a completed request form and supporting records, we will need at least 60 days to complete our review. Please review my support order CSE Case Number: Court Case Number __________________________________ (If known) Last four digits of my Social Security Number: (If known) Print Your Full Name Address Signature City, State, Zip Date Phone Number Legal Authority: The state’s child support guidelines are at section 61.30, Florida Statutes. To contact us: • Call 1-800-622 KIDS (5437) • Call 1-305-530-2600 if your case is handled in Miami-Dade County • Call 1-941-741-4039 if your case is handled in Manatee County Or go to http://myflorida.com/dor/childsupport Social Security number disclosure is mandatory based on Title 42 United States Code sections 666(a)(13), 653a, and 654a(e), and on section 409.2577, Florida Statutes. We collect social security numbers for child support purposes. For more information go to http://dor.myflorida.com/dor/privacy.html American LegalNet, Inc. www.FormsWorkFlow.com