STATE OF INDIANA ) IN THE ) SS: ) CASE NO. COUNTY OF IN RE THE SUPERIOR/CIRCUIT COURT OF: Petitioner, V. Respondent. VERIFIED PETITION FOR MODIFICATION OF CHILD SUPPORT Comes now ______________________________, pro se, and hereby files a Verified Petition for Modification of Child Support, and states as follows: 1. That parties have __________ minor child(ren), namely: Name Date of birth ______________________________ _________________ ______________________________ _________________ ______________________________ _________________ ______________________________ _________________ 2. On _________________, this Court ordered that ______________________________ pay child support to ______________________________ in the weekly amount of ________________ for the abovenamed child(ren) effective on _________________. 3. Since that time, there has been a change in circumstances, so substantial and continuing as to make the terms of the current support order unreasonable for the following reasons: 4. Child support should be modified to reflect the substantial change in circumstances as outlined above. 5. Page 1 of 2 A hearing should be set to determine if child support should be changed. Form PS-31168-3 Revised by State Court Administration 10/10 American LegalNet, Inc. www.FormsWorkFlow.com WHEREFORE, ______________________________ requests that this Court set this matter for hearing, and upon hearing, modify the existing child support as is appropriate, and order all other further relief that is just and proper in the premises. I affirm under the penalties of perjury that the foregoing representations are true. ___________________________________ Signature CERTIFICATE OF SERVICE I hereby certify that I sent a copy of this Petition by first class mail to the opposing attorney, or the opposing party if the opposing party is not represented by an attorney, on _________________. ___________________________________ Signature Page 2 of 2 Form PS-31168-3 Revised by State Court Administration 10/10 American LegalNet, Inc. www.FormsWorkFlow.com