Superior Court of Washington County of In re: No. Petitioner, and Motion and Declaration for Adjustment of Child Support (MT) Respondent. I. Motion The undersigned asks the court for an order adjusting the support provisions of the most recent Order of Child Support. This motion is based upon the following declaration and the Child Support Worksheet and Financial Declaration which are filed with this motion. Dated: Signature of Requesting Party or Lawyer/WSBA No. Print or Type Name II. Declaration The support provided for in the most recent order of child support should be adjusted for the following reasons. 2.1 Requesting Party [] I am a party to this action. [] The DSHS started 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 review of the order. OR Mtn/Decl Adj of Child Suppt (MT) - Page 1 of 4 WPF DRPSCU 06.0800 Mandatory (06/2012) - RCW 26.09.170 American LegalNet, Inc. www.FormsWorkFlow.com 2.2 More Than 24 Months and Change in Income of Parties [] [] 2.3 More Than 24 Months and Changes in Economic Table or Standards/RCW 26.19 [] [] 2.4 Does not apply. It is more than 24 months since the order was entered or since the last incremental change went into effect, whichever is later, and there have been changes in the economic table or standards in RCW 26.19 as follows: Periodic Adjustment Required [] [] 2.5 Does not apply. It is more than 24 months since the order was entered or since the last incremental change went into effect, whichever is later, and there has been a change in the incomes of the parties as follows: Does not apply. It has been 12 months since the order was entered and the order provides for support to be periodically adjusted and the court should order an adjustment as follows: Post Secondary Support [] [] Does not apply. The right to request post secondary support was reserved in the support order and the court needs to determine each parent’s obligation; Mtn/Decl Adj of Child Suppt (MT) - Page 2 of 4 WPF DRPSCU 06.0800 Mandatory (06/2012) - RCW 26.09.170 American LegalNet, Inc. www.FormsWorkFlow.com [] The previous support order provided that the parents shall pay for post secondary support and the court needs to allocate the expenses; And the factual basis is as follows: 2.6 Servicemembers Civil Relief Act Statement 2.6.1 A. Service member status -- (name of other party) __________________________: [ ] is not a service member; [ ] is on active duty in the U.S. armed forces (excluding National Guard and reserves); [ ] is on active duty and is a National Guard member or a Reservist residing in Washington; [ ] is not on active duty in the U.S. armed forces (excluding National Guard and reserves); [ ] is not on active duty and is a National Guard member or a Reservist residing in Washington; [ ] I am unable to determine whether the other party is or is not on active duty in the U.S. armed forces; [ ] I am unable to determine whether the other party is or is not on active duty as a National Guard member or a Reservist residing in Washington. B. Factual basis: [ ] See the attached Department of Defense Manpower Data Center Status Report Pursuant to Servicemembers Civil Relief Act (SCRA) obtained from https://www.dmdc.osd.mil/appj/scra/. (You must have the person’s social security number to search in this site.) [ ] Other factual basis: C. [ ] As indicated above, the other party is on active duty and (check all that apply): [ ] The other party is represented by an attorney. [ ] The court has appointed an attorney to represent the other party. [ ] A stay of these proceedings [ ] has [ ] has not been entered by the court. Mtn/Decl Adj of Child Suppt (MT) - Page 3 of 4 WPF DRPSCU 06.0800 Mandatory (06/2012) - RCW 26.09.170 American LegalNet, Inc. www.FormsWorkFlow.com 2.6.2 A. Dependent of a service member status -- (name of other party) ________________ ______________________________: [ ] is not a dependent of a resident of Washington who is on active duty and is a National Guard member or a Reservist; [ ] is a dependent of a resident of Washington who is on active duty and is a National Guard member or a Reservist; [ ] I am unable to determine whether the other party is a dependent of a resident of Washington who is on active duty and is a National Guard member or a Reservist. B. Factual basis: [ ] The other party failed to respond to a notice to him or her as a dependent of a person in Military Service that was [ ] served on [ ] mailed by first class mail on (date) ________________________________________, therefore he or she should be presumed not a dependent of a resident of Washington who is on active duty and is a National Guard member or a Reservist. [ ] Other factual basis: C. [ ] As indicated above, the other party is a dependent of a resident of Washington who is on active duty and is a National Guard member or a Reservist and (check all that apply): [ ] The other party is represented by an attorney. [ ] The court has appointed an attorney to represent the other party. [ ] A stay of these proceedings [ ] has [ ] has not been entered by the court. 2.7 Other 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 Mtn/Decl Adj of Child Suppt (MT) - Page 4 of 4 WPF DRPSCU 06.0800 Mandatory (06/2012) - RCW 26.09.170 American LegalNet, Inc. www.FormsWorkFlow.com