IN THE CIRCUIT COURT OF JACKSON COUNTY, MISSOURI AT KANSAS CITY AT INDEPENDENCE __________________________________________________ P ETITIONER, VS. CASE NO. ___________________________________ __________________________________________________ RESPONDENT. ACKNOWLEDGMENT/ANSWER TO AFFIDAVIT FOR TERMINATION OF CHILD SUPPORT AND MODIFICATION If you agree with the statements made in the affidavit and agree to termination of the obligation to pay child support for the child, you may, but are not required to, file an Acknowledgment with the Court. Upon your filing of an Acknowledgment, a Judgment terminating the obligation to pay support for the child will be entered. (Check the box that applies to you:) I ___________________________________ , agree with the statements made in this Affidavit and agree that the obligation to pay support for the child be terminated. I further agree that the order to pay child support be amended to $ ___________________________ dollars per week per month for the current child support amounts due for the remaining minor child(ren). If you disagree with the statements made in the Affidavit and object to termination of the obligation to pay support for the child, or disagree on the amount of child support to be paid for the remaining children you must fill out and file this Answer within (30) thirty days of the date you received the Affidavit to: Jackson County Circuit Court Jackson County Circuit Court Civil Records Department / Domestic Relations Civil Records Department th rd nd 415 E. 12 Street, 3 Floor 308 W. Kansas Street, 2 Floor K ansas City, Missouri 64106 I ndependence, Missouri 64050 I __________________________________ , disagree with the statements made in the Affidavit for the following reasons: ______________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ If your order for child support sets forth a lump sum of child support for more than one child rather than an individual amount for each child you need to complete tFohre m 14 Child Support Worksheet and Income and Expense Statement so the Judge can determine the correct amount of child support to be paid for the remaining child(ren). You are also required to send a copy of the Answer/Acknowledgment to the parent who filed the affidavi t. The statements made in this Acknowledgment/Answer are true to my best knowledge and belief and are made under penalty of perjury ________________________________ _____________________________________________________ D Sate ign PRearceenoivfat itnug re Support