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Motion And Decleration To Modify Child Support Form. This is a Hawaii form and can be use in Family Court Statewide.
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Tags: Motion And Decleration To Modify Child Support, Hawaii Statewide, Family Court
FAMILY COURT
MOTION AND DECLARATION
________JUDICIAL CIRCUIT TO MODIFY CHILD SUPPORT
STATE OF HAWAI‘I
CASE NUMBER
FC-
NO.
[ ] CHILD SUPPORT ENFORCEMENT AGENCY,
STATE OF HAWAI‘I, and
This document was prepared by: [ ] Petitioner/Plaintiff
[ ] Defendant,
[ ] Attorney for [ ]Petitioner/Plaintiff [ ]Defendant
[ ] MOTHER
Name
[ ] FATHER
PETITIONER(S)/
PLAINTIFF(S),
Address
vs.
City, State, Zip Code
[ ] MOTHER
[ ] MOTHER
[ ] FATHER
[ ] FATHER
[ ] CARETAKER
[ ] CARETAKER
[ ] and CHILD SUPPORT ENFORCEMENT
AGENCY, STATE OF HAWAI‘I,
DEFENDANT(S).
Telephone Number
ATTACHMENTS:
[ ] FINANCIAL INFORMATION SHEET
[ ] INCOME/EXPENSE AND ASSET/DEBT STATEMENTS
[ ] CHILD SUPPORT GUIDELINES WORKSHEET
[ ] COPY OF LAST THREE (3) PAY STUBS
[ ] OTHER
[X] HEARING SCHEDULING ORDER
I am the [ ]Mother [ ]Father [ ]Caretaker in this case. I am referred to as the Movant in this motion. The other
party(ies) is/are referred to as Respondent(s) in this Motion. This Motion is made pursuant to Rule 7 of the Hawai‘i
Family Court Rules and Rules of the Circuit Courts. The following statements are made in support of this Motion:
1. CHILD(REN) INVOLVED IN THIS REQUEST FOR CHILD SUPPORT MODIFICATION: (Name and birth
date of each child)
2. DATE THE LAST CHILD SUPPORT ORDER WAS FILED:
3. CHILD SUPPORT/MEDICAL COVERAGE MODIFICATION REQUESTED:
[ ] Child support should be (check one): [ ]increased [ ]decreased [ ]terminated [ ]suspended.
[ ] Medical coverage for the child(ren) should be provided by [ ]Mother [ ]Father.
[ ] Other:
4. THIS CHANGE IS REQUESTED BECAUSE: (Check all that apply)
[ ]4A.
A ten percent (10%) increase or decrease occurred in the Child Support Guidelines amount since the
existing child support order went into effect.
[ ]4B.
There is a need to provide for health care for the child(ren).
[ ]4C.
Three (3) years have passed from the prior child support order and I am requesting a review and an
adjustment of that order.
[ ]4D.
I am currently unemployed because of the following reason:
.
[ ]4E.
Significant changes of circumstances of either a parent or the child(ren) has/have occurred as follows:
.
I declare under penalty of perjury of law that the foregoing is true and correct.
DATE
SIGNATURE
FO R CO URT USE ON LY
01/2005
M OT ION AND DECLARAT ION T O M OD IFY CH ILD SUPPORT
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