Rule 17.300--Form 301: Application to Modify Child Support Read the Guide to Representing Yourself in a Child Support Modification Case in Iowa on the Iowa Judicial Branch website before using this form. � � You cannot use this form to change child custody, physical care, or visitation arrangements. You cannot use this form if there is no current Iowa court order or decree setting child support. � � Use this form only if you want to increase, decrease, or stop child support. "Applicant" is the person who files the first paper (an Application) to start a case to modify (change) child support. Applicant could have been either Petitioner or Respondent in the original case. If filing electronically, you must provide any protected information in full on form 311. If filing in paper, you may use form 311 to provide any protected information in full. If you do not understand how to use this form, or if you should use this form, talk to an attorney. In the Iowa District Court for County of current child support order County Upon the Petition of Equity case no. (As stated in the current support order) Petitioner Full name of Petitioner as it is in the original case Application to Modify Child Support and concerning Respondent Full name of Respondent as it is in the original case 1. Personal Information Fill in all information that you know. If you have been assaulted by your spouse and fear for your safety, you may leave your street address, phone number, and email blank. A. Applicant's (the party seeking to modify child support) information: Full name: first, middle, last Applicant's present street address County City Birth year State ZIP code ( B. Other parent's information: Full name: first, middle, last Other parent's present street address County City ) Email address Phone number Birth year State ZIP code ( ) Email address Phone number If you need assistance to participate in court due to a disability, contact the disability coordinator at: (_______) __________________ Persons who are hearing or speech impaired may call Relay Iowa TTY (1-800-735-2942). Disability coordinators cannot provide legal advice. Disability coordinator contact information available at: http://www.iowacourts.gov/Administration/Directories/ADA_Access/ . February 2014 Rule 17.300--Form 301 Page 1 of 6 American LegalNet, Inc. www.FormsWorkFlow.com Rule 17.300--Form 301: Application to Modify Child Support, continued C. Other person (non-parent) who receives child support Check one (1) (2) There is no other person (non-parent) who receives child support in this case. There is another person (non-parent) who receives child support in this case. If someone other than a parent gets child support in this case, check box (2) and fill in below the person's name, year of birth, present residence, and contact information. Full name: first, middle, last Present street address County City State Birth year ZIP code ( ) Email address Phone number 2. General Information about this Case A. Current child support order (1) Date the current child support order was entered: Month (2) County and state where the order was entered: County (3) Case number on the current child support order: Case number (4) Person who pays child support in this case: Name: first, last (5) Person who receives child support in this case: Name: first, last (6) Current amount of child support paid: $ Amount per Frequency . State Day , 20 Year B. Copy of current child support order (1) (2) Check one A copy of the current child support order is attached. A copy of the current child support order is not attached. Check one C. Child Support Recovery Unit (CSRU) (1) (2) The Child Support Recovery Unit (CSRU) is involved in this case. If CSRU is involved in this case, see the Important Notice to Applicant on page six of this form. The Child Support Recovery Unit (CSRU) is not involved in this case. Check one D. Collection Services Center (CSC) (1) The CSC number is: (2) The Collection Services Center (CSC) is involved in this case. The Collection Services Center (CSC) is not involved in this case. February 2014 Rule 17.300--Form 301 Page 2 of 6 American LegalNet, Inc. www.FormsWorkFlow.com Rule 17.300--Form 301: Application to Modify Child Support, continued E. Other child support orders (1) (2) Check one There are no other child support orders for the child or children involved in this case. There are other child support orders for the child or children involved in this case. They are: Case Number County State Case Number County State Check this box if you are attaching a separate sheet listing additional child support orders. F. The following children are covered by the current child support order: First, middle, & last initials of each child (1) (2) (3) Birth year First, middle, & last initials of each child (4) (5) (6) Birth year Check this box if you have attached a separate sheet listing additional children. G. The child support amount should be changed because (1) Check all that are true There is a juvenile court order that changed where the child or children are living. The person paying support has custody of the children. If you check (1), write the county where the juvenile court order was entered and the case number. County (2) (3) (4) (5) (6) Case Number One or more of the children live with the parent who is paying support. There is no court order that sets up custody. One or more of the children no longer qualify for child support. My (Applicant's) income has gone down. Respondent's (other parent's) income has gone up. Other reason Explain Show Lines Hide Lines H. Child support amount should be (1) (2) (3) February 2014 Check all that apply Raised Explain Lowered Explain Stopped Explain Rule 17.300--Form 301 Page 3 of 6 American LegalNet, Inc. www.FormsWorkFlow.com Rule 17.300--Form 301: Application to Modify Child Support, continued I. Tax deduction for the children Check (1) or (2) (1) (2) There is no court order at this time on tax deductions for the children. There is a court order at this time on tax deductions for the children. If you check (2), check a or b: a. b. A court order currently says who gets the tax deduction for the child or children and it should stay the same. A court order currently says who gets the tax deduction for the child or children and it should be changed. Explain Show Lines Hide Lines J. Health care expenses for the children Check (1) or (2) (1) (2) There is no court order at this time on who pays health care exp