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Motion For Modification Of Child Support Form. This is a Kansas form and can be use in 7th Judicial District (Douglas County) Local District Court.
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Tags: Motion For Modification Of Child Support, Kansas Local District Court, 7th Judicial District (Douglas County)
DISTRICT COURT TRUSTEE
PS-9
SEVENTH JUDICIAL DISTRICT
JUDICIAL CENTER, 111 E. 11TH
LAWRENCE, KANSAS 66044-2966
785-832-5315
Fax: 785-838-2408
Pro Se
Motion for Modification of Child Support
1.
Make a copy of the blank Post-Decree Domestic Relations Affidavit.
2.
Fill out completely using typewriter or printed in black ink:
a)
b)
c)
d)
e)
f)
Motion
Notice of hearing
(contact the District Judge Pro Tem Division Administrative Assistant, 330-2817,
for hearing date and time)
Certificate of mailing
Post-Decree Domestic Relations Affidavit
Copies of your most recent paycheck stub which includes year-to-date totals and a
copy of last year’s income tax return
Child support worksheet
Note: Further explanations may be found on the next page.
3.
File the original and 5 copies of the Motion with the notice of hearing and certificate of mailing
sections completed, b) completed post-decree domestic relations affidavit, c) proof of income
attachments, and d) child support worksheet to the Clerk of the District Court. Write “District Judge
Pro Tem” on the top of one of your copies.
Pursuant to K.S.A. 60-1621, a $33 filing fee must be paid when filing your motion.
4.
The Clerk of the District Court will “file stamp” all copies, keep the originals and the District Judge
Pro Tem copy, and give you back the additional copies. You will need to send/bring a copy to:
District Court Trustee Office
Judicial Center
111 East 11th Street
OR
Lawrence, KS 66044
(If you have a case open
with the Court Trustee)
Social & Rehabilitation Services
1901 Delaware
Lawrence, KS 66046
(If you have a case open
with the SRS office)
For Certified Mail Service: You must now serve a “file-stamped” copy of the motion, notice of
hearing, post-decree domestic relations affidavit, proof of income attachments, child support
worksheet AND a BLANK Post-Decree Domestic Relations Affidavit on the
petitioner/respondent and his/her attorney of record by Certified Mail (Return Receipt Requested).
After Service of Certified Mail (after the green card is returned to you): You must now fill out
the form entitled, “Return of Service for Certified Mail.” Fill out the form, attach the green card, and
file it with the Clerk of the District Court.
5.
IT IS UP TO YOU to get the correct papers filed and proper service completed in order for your
case to go forward on its assigned hearing date and time.
PLEASE REMEMBER!! A copy of all paperwork that you have filed with the Clerk of the District
Court needs to be given to the Court Trustee Office or SRS at the address indicated above if you
currently have an open enforcement case with them.
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Child Support Modification Procedure
The following information is provided to assist you in obtaining a modification of your child support.
The office of the Court Trustee does not represent any party to this case. The Court Trustee operates
independently to ensure that the child support orders are enforced and to see that the Child Support
Guidelines are followed. The Kansas Child Support Guidelines are the rules which must be followed in
setting the amount of child support to be paid. There are specific rules which must be followed under
these guidelines. The following information is designed to assist you in following these guidelines.
If you can afford to hire an attorney to represent you in modifying your support obligation, you
should seriously consider retaining an attorney to represent you.
The following documents must be filed with the court when seeking a child support modification:
1.
Motion to Modify Support. For your convenience, a standard motion is included with this
information which you may complete. Please note that you must mail a copy of your motion
to the parties involved in your case -- specifically, the District Court Trustee or SRS if you
have an open case with either agency, the person to whom you pay support, and his/her
attorney if she/he has an attorney. The original motion must be filed in District Court. A
hearing cannot be held until your motion has been filed in District Court. Promptness is
very important, as your child support cannot be modified until a formal motion has been
filed. The Court cannot reduce/increase child support which has already become due prior
to the filing of your motion.
2.
Post-Decree Domestic Relations Affidavit. The Kansas Child Support Guidelines require
this form be completed and filed with your motion. Failure to include this form with your
motion could result in your motion being dismissed. The Post-Decree Domestic
Relations Affidavit must be signed in the presence of a notary public. You must
complete all information in the affidavit as it pertains to you. A Post-Decree Domestic
Relations Affidavit is attached. This affidavit complies with the Kansas Child Support
Guidelines.
3.
Child Support Worksheet. Another document which must be included with your motion is
the worksheet. This form shows the amount to which your child support should be
modified. A worksheet which complies with the Kansas Child Support Guidelines is
attached. In order to complete the worksheet, your present earnings information and the
earnings of the other party must be provided. Proof of earnings may include copies of your
pay stubs, unemployment, retirement, social security, and worker’s compensation benefits,
and income tax returns. You may review a copy of the Kansas Child Support Guidelines to
assist you in preparing your child support worksheet at the office of the Court Trustee or on
the internet at www.kscourts.org/ctruls/cs102903.pdf. The Court Trustee, however, cannot
help you complete your worksheet. There are Kansas child support calculator programs
available on the internet. The Court Trustee office is aware of these programs but does not
endorse the use of, or reliability of, any of these programs.
If you provide health insurance for the child(ren) in this matter, you should also provide
proof of the insurance costs.
Failure to complete the forms and present them to the Court may prevent you from obtaining a
hearing before the District Judge Pro Tem. All documents must be completed and filed with the Court
before a hearing can be scheduled.
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IN THE DISTRICT COURT OF DOUGLAS COUNTY, KANSAS
In the Matter of
,
Petitioner,
vs.
,
Respondent.
)
)
)
)
)
)
)
)
Case No. DG
Division 3
MOTION FOR MODIFICATION OF CHILD SUPPORT
COMES NOW the (Petitioner/Respondent) and moves the Court to modify the current Order of
Support for the following reasons:
I have attached a completed copy of my Post-Decree Domestic Relations Affidavit, along with a copy of
the most recent paycheck stub with year-to-date totals, a copy of last year’s income tax return, and a
completed Child Support Worksheet.
WHEREFORE, the (Petitioner/Respondent) moves the Court for a modification of the current
Support Order of the Court.
NOTICE OF HEARING
Please take notice that the above Motion for Modification of Child Support has been set for hearing
before the District Judge Pro Tem in the Pro Tem Division Courtroom of the Judicial and Law Enforcement
Center, 111 East 11th Street, Lawrence, Kansas, on:
NOTE: Both parties are required by Kansas law to fill out and file a Domestic Relations Affidavit with
attached copy of the most recent paycheck stub with year-to-date totals and a copy of last year’s income tax return
with the Clerk of the District Court no later than five (5) days prior to the hearing.
Your signature
Pro se
Address
Phone
CERTIFICATE OF MAILING
A copy of this Motion for Modification of Support has been sent by Certified Mail/Return Receipt Requested to
(Petitioner/Respondent) and their attorney of record at the following addresses:
Date
(Your signature again here)
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IN THE DISTRICT COURT OF DOUGLAS COUNTY, KANSAS
IN THE MATTER OF
,
Petitioner,
and
,
Respondent.
)
)
)
)
)
)
)
)
)
Case No. DG
Division 3
RETURN OF SERVICE FOR CERTIFIED MAIL
State of Kansas
County of Douglas
)
)
)
ss.
The undersigned, being duly sworn, states: I have served a Motion for
on the Petitioner/Respondent, and the following Return for Receipt
of Service was served on the litigant by certified mail on
, 20
, at the time and
place as listed on the enclosed card.
(When you receive the signed green card back
from the other party, tape it here.)
Check here if service by certified mail was refused. (If refused, I certify that I sent a true copy of the motion
by first-class mail after the certified letter was refused.)
Your signature
Subscribed and sworn to before me on this
day of
Pro se
, 20
.
Notary Public
My commission expires:
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IN THE DISTRICT COURT OF DOUGLAS COUNTY, KANSAS
In the Matter of:
)
)
)
)
)
)
)
)
,
and
.
Case No.DG
Division 3
POST-DECREE DOMESTIC RELATIONS AFFIDAVIT
OF
(Your name)
To be used with post-decree Motions to Modify Child Support ONLY.
1.
Your Name:
First
Middle
Last
Residence:
Street Address
Home phone number
City
Work phone number
State
Zip
Year of birth
2.
Please provide information on minor children of the relationship in this case for whom child support is being calculated.
Name
Year of Birth
Resides With:
3.
Please provide information on minor children of previous relationships and facts as to custody and support payments
paid or received, if any.
Resides With:
Year of Birth
Support Paid/Rec’d
Case No/County
Name
4.
Please provide information on minor children of current relationship that are living with you.
(Please include biological/adopted children only.)
Name
Year of Birth
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5.
You are employed by:
Name:
Address:
6.
Income for Wage Earner:
A.
Gross earnings per pay period
$
How often?
(weekly, every two weeks, twice per month, monthly)
B.
Other income received
$
How often?
(weekly, every two weeks, twice per month, monthly)
7.
Monthly income for Self- Employed
A.
Gross Income
B.
Other income received
C.
Reasonable Business Expenses
(Itemize on attached exhibit)
D.
Self-Employment Tax
E.
Estimated Tax Payments
$
$
$
$
$
8.
Are you receiving Unemployment Compensation? Yes / No
For how many weeks are you eligible?
Weekly amount: $
9.
Are you receiving Social Security Supplemental Income or Social Security Disability benefits? Yes / No
If yes, $
per month
What date did you start receiving it? _________________
10.
Work-Related Child Care Expenses for child(ren) for whom support is being calculated: (You must attach
proof of payment such as canceled checks, receipts, child care tax credit schedule, printouts or letter from child care
provider.)
A.
Name and Address of Provider
B.
11.
Weekly School Year Expense
$___________________
Weekly Summer Expense
$___________________
Name and Address of Provider
Who provides health insurance for child(ren)? _______ Father ______ Mother ______ Other
A.
Name and address of health insurance plan:
B.
Persons insured on plan:
C.
Monthly cost of employee only coverage for:
health insurance
$
dental insurance
$
vision insurance
$
drug prescription insurance
$
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D.
Monthly cost insured is currently paying for (including costs to add dependents):
health insurance
$
dental insurance
$
vision insurance
$
drug prescription insurance
$
E.
If your employer provides a benefit allowance and you choose a plan which equals, exceeds,
or is less than that allowance, please provide amount of allowance and your additional
contribution, if any. Also, if your employer pays you for declining insurance or choosing
a less expensive plan, please provide the monthly amount you receive:
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
12. Who claims child(ren) for income tax purposes?
_______Father ______ Mother
OR
You file taxes as: _____Single
_______Alternate/Share exemptions
_____Head of Household
_____Joint
_____Other
13. Child Support Adjustments requested: (If no adjustment is requested, do not complete this section. The requesting
party must prove the basis for the adjustments.)
_____ Long Distance Parenting Time Adjustment
(+/-)$
_____ Parenting Time Adjustment
(+/-)$
_____ Income Tax Adjustment (if not sharing or alternating exemption(s))
(+/-)$
_____ Special Needs
(+/-)$
_____ Agreement Past Minority (when parent having primary residency seeks
increase for child(ren) under 18)
(+/-)$
_____ Overall Financial Condition
(+/-)$
14. Attached is: _____
_____
_____
_____
_____
_____
_____
Current pay statement
Itemized list of reasonable business expenses
Last year’s Federal Income Tax Return
W-2 (if tax return not yet completed)
Written proof of work-related child care costs
Written proof of insurance costs
Other (statement regarding requested child support adjustment(s))
I have read the above affidavit and to the best of my knowledge and belief the information is
accurate and complete.
(Your name)
SUBSCRIBED AND SWORN TO before me this ______ day of ___________________, 20
.
NOTARY PUBLIC
My appointment expires: __________________
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IN THE DISTRICT COURT OF DOUGLAS COUNTY, KANSAS
In the Matter of
)
)
)
)
)
)
)
)
,
Petitioner,
and
,
Respondent.
Case No. DG
Division 3
CHILD SUPPORT WORKSHEET
MOTHER
A.
B.
INCOME COMPUTATION – WAGE EARNER
1.
Domestic Gross Income
(Insert on Line C.1. below)*
$
Self-Employment Gross Income*
Reasonable Business Expenses
Domestic Gross Income
(Insert on Line C.1. below)
(-)
ADJUSTMENTS TO DOMESTIC GROSS INCOME
1.
2.
3.
4.
5.
D.
$
INCOME COMPUTATION – SELF-EMPLOYED
1.
2.
3.
C.
FATHER
Domestic Gross Income
Court-Ordered Child Support Paid
Court-Ordered Maintenance Paid
Court-Ordered Maintenance Received
Child Support Income
(Insert on Line D.1. below)
(-)
(-)
(+)
COMPUTATION OF CHILD SUPPORT
1.
Child Support Income
2.
Proportionate Shares of Combined Income
(Each parent’s income divided by combined income)
Gross Child Support Obligation**
(Using the combined income from Line D.1.,
find the amount for each child and enter total for
all children)
3.
Age of Children
Number Per Age Category
Total Amount
+
=
0-5
6-11
+
%
12-18
%
Total
+
=
* Interstate Pay Differential Adjustment?
Yes
No
**Multiple Family Application?
Yes
No
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Case No. DG
MOTHER
4.
Health and Dental Insurance Premium
$
FATHER
+ $
=
5.
Work-Related Child Care Costs
Formula: Amt. – ((Amt. X %) + (.25 x (Amt. x %)))
for each child care credit
Example: 200 – ((200 x .30%) + (.25 x (200 x .30%)))
6. Parents’ Total Child Support Obligation
7.
8.
9.
E.
(Line D.3. plus Lines D.4. & D.5.)
Parental Child Support Obligation
(Line D.2. times Line D.6. for each parent)
Adjustment for Insurance and Child Care
(Subtract for actual payment made for items
D.4. and D.5.)
Basic Parental Child Support Obligation
(Line D.7. minus Line D.8.;
Insert on Line F.1. below)
(-)
CHILD SUPPORT ADJUSTMENTS
APPLICABLE
N/A
CATEGORY
1.
Long Distance Parenting Time Costs
2.
Parenting Time Adjustment (if b. %___)
3.
Income Tax Considerations
4.
Special Needs
5.
Agreement Past Majority
6.
Overall Financial Condition
7. TOTAL (Insert on Line F.2. below)
F.
=
AMOUNT ALLOWED
MOTHER
FATHER
(+/-)
(+/-)
(+/-)
(+/-)
(+/-)
(+/-)
(+/-)
(+/-)
(+/-)
(+/-)
(+/-)
(+/-)
DEVIATION(S) FROM REBUTTABLE PRESUMPTION AMOUNT
AMOUNT ALLOWED
MOTHER
FATHER
1.
2.
3.
4.
5.
Basic Parental Child Support Obligation
(Line D.9. from above)
Total Child Support Adjustments
(+/-)
(Line E.7. from above)
Adjusted Subtotal (Line F.1. +/- Line F.2.)
Enforcement Fee Allowance**
Percentage
(Applied only to Nonresidential Parent) Flat Fee $
((Line F.3. x Collection Fee %) x .5)
or (Monthly Flat Fee x .5)
(+)
Net Parental Child Support Obligation
(Line F.3. + Line F.4.)
%
(+)
**Parent with nonprimary residency
District Judge Pro Tem
Prepared By:
(Your signature here)
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