Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Petition For Modification Of Child Support Form. This is a Washington form and can be use in Domestic Relations Statewide.
Tags: Petition For Modification Of Child Support, DRPSCU 06.0100, Washington Statewide, Domestic Relations
Superior Court of Washington
County of
In re:
No.
Petitioner,
and
Petition for Modification
of Child Support
(PTMD)
Respondent.
I. Basis
(Name of requesting party)_________________________________________________ represents to the
court that:
1.1
Place of Residence
The petitioner resides in (county and state only) ________________________________________.
The child(ren) reside(s) in (county and state only)_______________________________________.
The respondent resides in (county and state only) _______________________________________.
1.2
Jurisdiction Over Parents
This court has jurisdiction over the parents for the reasons that follow.
[]
[]
[]
1.3
There is a Washington Order of Child Support.
Both parties currently reside in the state of Washington.
Other:
Most Recent Support Order
The most recent support order was entered in (county and state) ____________________________
on (date) ________________________________________.
Pet for Mod of Child Suppt (PTMD) - Page 1 of 4
WPF DRPSCU 06.0100 Mandatory (6/2010) - RCW 26.09.170; .175
American LegalNet, Inc.
www.FormsWorkFlow.com
The order requires (name) _________________________________________ to pay
$___________ per month for the support of (list name(s) of the child(ren)):
1.4
Reasons for Modifying Child Support
[]
A party commenced this action.
[]
The DSHS commenced this action under RCW 26.09.170(8), or RCW 26.09.170(9) and/or
RCW 26.09.175(3) and:
[]
Public assistance money is being paid to or for the benefit of a child; or
[]
A party to the order in a nonassistance case requested a review; or
[]
Another state or jurisdiction requested a modification of the order.
OR
AND, the order of child support should be modified for the following reasons:
[]
There has been the following substantial change of circumstances since the order was
entered (explain):
[]
No post-secondary support was ordered and the right to request post-secondary child
support was not reserved. (Name of child) _________________________ is in need of
post secondary educational support because the child is in fact dependent and is relying
upon the parents for the reasonable necessities of life and there has been the following
substantial change of circumstances since the order was entered (explain):
[]
(Name of child) _______________________________________ is a dependent adult child
and support should be extended beyond his or her 18th birthday because:
Pet for Mod of Child Suppt (PTMD) - Page 2 of 4
WPF DRPSCU 06.0100 Mandatory (6/2010) - RCW 26.09.170; .175
American LegalNet, Inc.
www.FormsWorkFlow.com
[]
Whether or not there is a substantial change of circumstances, the previous order was
entered more than a year ago and:
[]
[]
[]
[]
[]
1.5
Other:
Starting Date of Modified Order
[]
[]
1.6
The order works a severe economic hardship.
The child has moved to a new age category for support purposes.
The child is still in high school and there is a need to extend support beyond the
child’s 18th birthday to allow the child to complete high school.
An automatic adjustment of support should be added consistent with RCW
26.09.100.
Does not apply.
The starting date of the modified child support order should be the date on which this
petition is filed.
Other
II. Relief Requested
The court should modify the order of child support by:
[X]
[]
[]
requiring either or both parents to maintain or provide medical support consistent with
RCW 26.09.105, including but not limited to health insurance coverage for the child(ren), and by
requiring each parent to contribute his or her proportionate share of uninsured medical expenses.
ordering child support payments which are based upon the Washington State child support statutes.
A copy of the child support worksheet is filed with this action.
ordering repayment or credit for overpaid child support since the date of filing this petition.
Pet for Mod of Child Suppt (PTMD) - Page 3 of 4
WPF DRPSCU 06.0100 Mandatory (6/2010) - RCW 26.09.170; .175
American LegalNet, Inc.
www.FormsWorkFlow.com
[]
[]
[]
[]
[]
[]
[]
ordering payment of underpaid child support since the date of filing this petition or entering
judgment in that amount.
requiring a periodic adjustment of support.
extending child support beyond (name of child) ___________________________________’s 18th
birthday to allow the child to complete high school.
extending child support beyond (name of child)___________________________________’s 18th
birthday until (he) (she) is no longer dependent upon either or both parents and is capable of selfsupport.
allowing for post secondary educational support for (name of child) _______________________.
ordering the payment of day care.
ordering the payment of educational expenses.
ordering the payment of long distance transportation expenses.
ordering the payment of uninsured medical expenses.
awarding the tax exemption for the child(ren) as follows:
[]
[]
ordering the payment of attorney fees and costs.
other:
[]
[]
[]
Dated:
Signature of Requesting Party or Lawyer/WSBA No.
Print or Type Name
I declare under penalty of perjury under the laws of the state of Washington that the foregoing is true and
correct.
Signed at (city) _______________________ (state) ______________ on (date) _______________________.
Signature of Requesting Party
Print or Type Name
Pet for Mod of Child Suppt (PTMD) - Page 4 of 4
WPF DRPSCU 06.0100 Mandatory (6/2010) - RCW 26.09.170; .175
American LegalNet, Inc.
www.FormsWorkFlow.com