400-00803 226 Motion to Modify Child Support, Maintenance Supplement (09/2018)Page 1 of 3 STATE OF VERMONT SUPERIOR COURT FAMILY DIVISION Unit Docket No. Name DOB V. Name DOB NOTICE OF APPEARANCE & INTENT TO REPRESENT MYSELF I intend to represent myself and hereby enter my appearance with the Court. No attorney will represent me in this case unless an attorney or I notify the Court otherwise. I understand that IT IS MY RESPONSIBILITY TO: 1.Notify the Court in writing if I change my address or phone number; and2.Send copies of any papers I file with the Court to the other party in this case. All Court papers may be mailed to me by first class mail at the address listed below. Name: Date of Birth: Street Address: City/State/Zip: Mailing Address (if different from Street Address): City/State/Zip: Email Address: Daytime Phone: Evening Phone: MOTION TO MODIFY CHILD SUPPORT, and/or MAINTENANCE SUPPLEMENT 1.I am thePlaintiffDefendantOffice of Child Support 2.The other party is thePlaintiffDefendant 3.I request that the Court modify a child support order issued on (date) .By this CourtBy another Court: Name of Court Address of Court 4.The children for whom support was ordered are:NameDate of Birth 5.I am the child(ren)222s (check the appropriate box)Parent or guardianSupport assigneeOther (describe): American LegalNet, Inc. www.FormsWorkFlow.com 400-00803 226 Motion to Modify Child Support, Maintenance Supplement (09/2018)Page 2 of 3 6.The other party is the child(ren)222s: (check the appropriate box)Parent or guardianSupport assigneeOther (describe): 7.The obligation under the current order is:I am required to pay: (check the appropriate box & fill in information)$ per in Child Support$ per in Maintenance SupplementThe other party is required to pay: (check the appropriate box & fill in information) $ per in Child Support$ per in Maintenance Supplement I am requesting that the Court modify the child support and/or maintenance supplement by:increasing the monthly support amount.decreasing the monthly support amount.There has been a real, substantial and unanticipated change in circumstances because:(check all that apply) My income has decreased.My income has increased.Other party222s income has increased.Other party222s income has decreased.I am unemployed.Other party is unemployed.The number of children subject to the order has changed.It has been more than 3 years since child support was modified.I am disabled because: If child support were calculated today under the Child Support Guidelines, the existing monthly supportamount would:Increase by more than 10%Decrease by more than 10%I do not know what the current support obligation would be under the Child Support Guidelines.In support of this motion, I have attached an Affidavit of Income and Expenses. American LegalNet, Inc. www.FormsWorkFlow.com 400-00803 226 Motion to Modify Child Support, Maintenance Supplement (09/2018)Page 3 of 3 REQUEST TO THE COURT I request that the Court: Modify the monthly child support obligation using the Child Support Guidelines. Increase child support obligation $per month. Decrease child support obligation $per month. Increase maintenance supplement obligation $per month. Decrease maintenance supplement obligation $per month. Grant any other relief this Court determines is appropriate. I hereby swear or affirm that the information above is true to the best of my knowledge and belief. Dated Signature Signed and sworn to or affirmed before me: Date Signature of Notary Public Expiration Date American LegalNet, Inc. www.FormsWorkFlow.com