WCCSH 5/1/06 Modification Court Related Offices Court Self-Help Center Courthouse, Room C-108 262-548-7524 http://courtselfhelp.waukeshacounty.gov Hours of Operation: Walk-ins: Mon Wed Fri By Appointment: 8:30 am - 12 pm Tues 12:30 pm - 4 pm 12:00 pm - 4 pm Thurs 8:30 am -12 pm 8:30 am - 4 pm *Limited to 30 minutes By phone: Tues 9:00 -10:00 am Thurs 2:00 - 3:00 pm *Limited to 5 minutes Family Legal Clinic: Wednesdays 4:30-6:30 pm (by appointment only) 20 minutes of free legal advice Child Support Agency Administration Building, Room 348 414-615-2586 Open: Mon-Fri 8:00 am - 4:30 pm Family Court Office Courthouse, Room C-112 262-548-7544 Open: Mon-Fri 8:00 am - 4:30 pm Waukesha County Courthouse, 515 W. Moreland Blvd, Waukesha, WI 53188 Notary Public Services are available at no charge in the Family Court Office and Copies can be made in the Court Self-Help Center for $.15 per page You may use this packet to request a change or an addition to a court order or judgment. Do Not use this packet if: You and the other party agree to the changes (use the Stipulation Packet) Your divorce, legal separation, or paternity judgment has not yet been granted You want to enforce a court order or judgment (use the Contempt Packet) P3100 ▪ Modification▪ Page 1 of 4 WCCSH Rev. 1/09 American LegalNet, Inc. www.FormsWorkflow.com Legal Custody and/or Physical Placement Disputes: Mediation is an option parties may use to try to come to an agreement with the assistance of an impartial third party. The first session is free; however, once you have used the first session there is a fee for additional sessions. You may either: • request mediation before you file this request for a court date, or • the court will order you and the other party to attend mediation if you have not already attempted it for this issue. If the parties are unable to come to an agreement, the court may appoint an attorney to represent the best interest of the children known as a Guardian ad Litem (GAL). A deposit is required and will be applied to the fees incurred by the GAL. The court will determine who must pay which portion of the deposit and any additional fees that may be assessed. The court may also order a physical placement study to be completed by Family Court Services. A social worker conducts an investigation and the results are used by the court to help decide what is in the children’s best interest. NOTICE: Family and divorce laws change often. These forms may not be appropriate for all situations. They are intended to be useful in many cases and may have to be changed in some way to fit your case. Talk to a lawyer or make an appointment with the Family Legal Clinic if you are unsure whether these forms are the most appropriate for your situation. The staff in Court Self-Help Center cannot give legal advice, but can review forms for completeness and answer basic procedural questions. FEES Modify Legal Custody or Physical Placement Modify all other types of orders Mediation (second session) Mediation (three or more sessions) Physical Placement Study GAL Deposit $ 50.00 $ 30.00 $ 100.00 $ 200.00 $ 900.00 $1,000.00 The party filing this motion should be prepared to pay any and all fees. Procedural Checklist Getting a Court Date 1. Complete the Notice of Motion and Motion (FA-4170). 2. Go to the Court Self-Help Center during regular business hours or call to make an appointment to have your form reviewed for completeness. See page 1. 3. Go to the customer service window of the Family Court Office. The clerks will: Collect the appropriate filing and copy fees. Assign you a court date. Make your copies (3 or 4 depending on the State’s interest). Return the appropriate number of copies to you. P3100 ▪ Modification▪ Page 2 of 4 WCCSH Rev. 1/09 American LegalNet, Inc. www.FormsWorkflow.com Notifying the Other Party (Service) 4. Give the other party(s) notice of the hearing by having them served with the Notice of Motion and Motion (FA-4170) and the Income and Expense Statement (FA-4138). See the Service Packet for options and procedural instructions for having someone served. Deadline: The other party(s) must be notified properly and provided with the forms no later than five (5) business days before the date of the hearing if served by personal service and mailed eight (8) business days before the date of the hearing if served by mail. 5. Make a copy of the proof of service (Affidavit of Service, Admission of Service, or Affidavit of Mailing) for your records and bring the original to court on the date of the hearing. Warning: Without proof of service, the court cannot proceed with the hearing. NOTE: If, for any reason, you need to cancel or postpone your court hearing, you must send a written request to the court and all parties (including the Child Support Division, if a party). Once the Court has made a decision, you must then notify the other parties of the Court’s decision and new date, if one was assigned. Preparing for and Going to Court 6. Take the following items with you to court: Original proof of service. Original and two (2) copies (3 if the State is a party) of your completed, dated, and signed Income and Expense Statement (FA-4138) and required attachments. Any other documents (including copies) you think may help you make your case. If you wish to have other people testify for you, make sure they come to court in person. A letter from them is not acceptable. 7. Go to the correct courtroom at least 20 minutes before your assigned court time and let the bailiff or court clerk know that you have arrived (you may sit in the hall or watch court). 8. When your case is called, present your case to the Judge/Court Commissioner: Be prepared to state your side of each issue clearly and completely. Be prepared to answer questions that may be asked of you by the Court or others. If you wish to offer written evidence or documents to the court, give the original to the court and a copy to the other side. While you are in court, use the forms you prepared as an outline to remind you of each issue you want resolved. 9. The Judge/Court Commissioner will state his/her decisions/rulings to you. Take notes because you must be able to write the ruling on a specific form called Decision and Order (FA-4175). The court may also set another hearing you to return to court. After Court 10. After your court hearing, complete the Decision and Order (FA-4175). P3100 ▪ Modification▪ Page 3 of 4 WCCSH Rev. 1/09 American LegalNet, Inc. www.FormsWorkflow.com 11. Go to the Court Self-Help Center to have your form reviewed for completeness. 12. Make four (4) copies (5 if the State is a party) of the completed Decision and Order. 13. Before filing, send one copy under the 5-day rule to the other party(ies). 14. File the original, the remaining three copies of the Order, and two self-addressed stamped envelopes (one addressed to you, one addressed to the other party) in the Family Court Office in person or by mail. 15. The court will hold the Decision and Order for five (5) days to give the other party(s) time to review the order and object to how accurately it has been completed. If there are no objections within the five days and the court agrees with how you have written the Order, the assigned court official will approve and send each party a signed copy. P3100 ▪ Modification▪ Page 4 of 4 WCCSH Rev. 1/09 American LegalNet, Inc. www.FormsWorkflow.com PRINT in BLACK ink Enter the name of the county in which the original case was filed. For Official Use STATE OF WISCONSIN, CIRCUIT COURT, COUNTY Check marriage or paternity. If paternity, enter initials of child. Enter the name, address and daytime phone number of the petitioner or joint petitioner from the original case file. On the far right, mark the box for the change(s) you are requesting and enter the original case number. In RE: The Enter the name, address, and daytime phone number of the respondent or joint petitioner from the original case file. Respondent/Joint Petitioner: Check if the State of Wisconsin is a party or not. If you are unsure, you may call your local Child Support Agency. paternity of: marriage Petitioner/Joint Petitioner: First name Middle name Last name Current Mailing Address City State Zip Daytime Phone Number vs. First name Notice of Motion and Motion to Change: Middle name Legal Custody Physical Placement Child Support Maintenance Other: Last name Current Mailing Address City State Zip Daytime Phone Number The State of Wisconsin (Child Support Agency) is is not a party to this action. Case No. NOTICE OF MOTION Enter the name of the person to whom this motion is directed. TO: You are notified that at the following date and time: Before: For Court Use Only: This section will be completed by the court. Location: Date: a.m./p.m. , or as soon as the matter may be heard, Time: I will be asking the court to change the existing order in this case as indicated below. If you object to this motion, you need to appear and say so. Otherwise, the court may proceed without you and grant the request. You may contact the Family Court Commissioner for more information on modifying and enforcing court orders or judgments. FA-4170V, 01/08 Notice of Motion and Motion to Change: Support/Legal Custody/Physical Placement §§767.105, 767.451, and 767.59, Wisconsin Statutes This form shall not be modified, It may be supplemented with additional material. Page 1 of 3 American LegalNet, Inc. www.FormsWorkflow.com Notice of Motion and Motion to Change: Support/Legal Custody/Physical Placement Page 2 of 3 Case No. __________ MOTION If you are requesting any changes to legal custody or physical placement, check A, enter the names of the children involved, and check all that apply in 1-6. Complete all relevant information, and attach a copy of your proposed placement schedule, if applicable. 1. I am requesting that the court: Change the existing legal custody or physical placement of the following children: A. 1. 2. 3. 4. 5. 6. To joint legal custody with both parents. To sole legal custody with me. From primary physical placement with (name of parent): . to: (name of parent): . From share placement to primary placement with (name of parent): From the current placement schedule (if any) to a new schedule I have attached. unsupervised. supervised To require placement be The other party and I: Indicate if you have or have not attempted Mediation. If you have, indicate the date of the Mediation session. B. If you are requesting any changes related to a support order, check B, check all that apply in 14, and complete all relevant information for each section checked. In C, enter any other changes you may have. attempted mediation on (date) have not attempted mediation for this issue. . Change the following support orders as follows: to: per Child support that is currently $ 1. A new amount based on state child support standards determined by the a. court. . per A new set amount of $ b. . Held open as of (date) c. . d. Payments to be made by (name of parent) to: per Maintenance (spousal support) that is currently $ 2. An amount to be determined by the court based on current income. a. . per A new set amount of $ b. to: per Arrears payment that is currently $ 3. An amount to be determined by the court. a. . per A new set amount of $ b. Arrears balance as it is currently reflected in the WI SCTF KIDS computer 4. because: to $ system as $ I have made support or other payments directly to the other party. a. I dispute the amount that is currently on record. b. I will be able to provide documentation to the court that supports my request. NOTICE: Both parties must bring to court their fully completed, dated, and signed Income and Expense Statement and all required attachments. C. Other change(s): See attached Enter the date the current court order or judgment was signed by a court official. Check all that apply in A-G. If other, enter the change in circumstance that has prompted you to bring this Motion. . 2. The court order that I am asking to be modified was dated: 3. This request is based on the following substantial change in circumstances that have occurred since the entry of the prior court order in this case: A child who was living with the other parent is now living with me. A. A child is no longer eligible for child support because the child has reached age 18, or B. is over 18 but under 19, and is no longer pursuing a course of education leading to a high school diploma or its equivalent. One of the parties has or will be moving to a different residence. C. myself has changed. the other party Employment or work shift of D. myself has changed. the other party Income or wages of E. The party to whom I owe maintenance has remarried. F. Other: G. FA-4170V, 01/08 Notice of Motion and Motion to Change: Support/Legal Custody/Physical Placement §§767.105, 767.451, and 767.59, Wisconsin Statutes This form shall not be modified, It may be supplemented with additional material. Page 2 of 3 American LegalNet, Inc. www.FormsWorkflow.com Notice of Motion and Motion to Change: Support/Legal Custody/Physical Placement Page 3 of 3 Case No. __________ 4. The facts explaining the substantial change in circumstances are: Describe the facts that justify the change you want. Attach additional pages, if necessary. See attached If you need help in this matter because of a disability, please call: Sign and print your name. Signature Enter the date on which you signed your name. Print or Type Name Date Note: This signature does not need to be notarized. A copy of this Notice of Motion and Motion must be served upon all other parties at least 5 business days before the date of the hearing. If service is by mail, it must be mailed at least 8 business days before the date of the hearing. See the Service Packet for more information. FA-4170V, 01/08 Notice of Motion and Motion to Change: Support/Legal Custody/Physical Placement §§767.105, 767.451, and 767.59, Wisconsin Statutes This form shall not be modified, It may be supplemented with additional material. Page 3 of 3 American LegalNet, Inc. www.FormsWorkflow.com PRINT in BLACK ink Enter the name of the county in which this case is filed. This form is used for divorce, legal separation and paternity cases. Some information may not apply to your case. For Official Use STATE OF WISCONSIN, CIRCUIT COURT, COUNTY INCOME & EXPENSE STATEMENT Enter the case number and child support IV-D KIDS number, if known. Case No. IV-D KIDS Case No. Failure by either party to complete and file this form as required will authorize the court to accept the statement of the other party as the basis for its decisions. Deliberate failure to provide complete disclosure is a crime. Attach additional pages if space is not sufficient. 1. PROOF OF INCOME Attach a statement reflecting income earned to date for the current year. Attach most recent W-2 Statement.     2. GENERAL INFORMATION Name Address Address City Phone (day) Zip State 3. CURRENT MEMBERS OF YOUR HOUSEHOLD Enter the name and relationship of all people actually living in your household at this time. Check yes or no to identify if they contribute to payment of household expenses.  5¡  ¦£4  ¦  # 2 3 ¦ ¥¦ ¥¢©0©)(©"'¦ % $ 1 #  # ¦ !   & #  ! #  !" ©©¨  ¢ ¦ ¦ ¤ ¢ §¥£¡ I live alone 7 A 7 @ 7 9 7 86 4. MONTHLY INCOME Income from wages / salary is received (check one): To calculate monthly gross income use the multiplier shown: every other week (bi-weekly) -multiply bi-weekly income by 2.15 weekly -multiply weekly income by 4.3 twice a month-multiply semi-monthly income by 2 monthly MONTHLY GROSS INCOME 1. Gross monthly income (before taxes and deductions) from salary and wages, including commissions, allowances and overtime. Pensions, retirement funds and social security benefits received Disability, Unemployment Insurance and/or public assistance funds received Interest and Dividends received 7. Child Support and maintenance (spousal support) received Rental payments received (from property you rent to others) Bonuses received Other sources of income received: (please specify) Total Gross Income (add lines 1-9) 86 7 I 8G H 7 F 7 E 7 D 7 C 7 B 7 A 7 @ 7 9 FA-4138 Pro Se, 01/07 Income and Expense Statement §§767.127 and 946.32(1)(a), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 1 of 2 American LegalNet, Inc. www.FormsWorkflow.com MONTHLY DEDUCTIONS 11. Number of tax exemptions claimed 12. Monthly federal and state income tax, Social Security, and Medicare withholdings 13. Medical insurance 14. Other insurance (Life, disability, etc.) 15. Union or other dues 16. Retirement, pension and/or deferred compensation fund 17. Child support or spousal support payment deductions 18. Other deductions: (please specify) 19. 20. 21. Total Monthly Deductions (add lines 12 – 20) MONTHLY NET INCOME (subtract line 21 from line 10) 5. CURRENT MONTHLY HOUSEHOLD EXPENSES Monthly Household Expenses 1. Rent/mortgage payment/property taxes/home or rent insurance (primary residence) 2. Food 3. Utilities (electricity, heat, water, sewage, trash) 4. Telephone (local, long distance & cellular) 5. Cable/Satellite and Internet Services 6. Insurance (life, health, accident, auto, liability, disability, excluding insurance that is paid through payroll deductions) 7. Auto payments (loans/leases), auto expenses (gas, oil, repairs, maintenance), and transportation (other than automobile) 8. Medical, dental and prescription drug expenses (not covered by insurance) 9. Childcare (babysitting and day care) 10. 11. Child support or spousal support payments (Exclude payments made through payroll deductions) Other expenses Other Monthly installment payments: 12. Mortgage (other than primary mortgage) 13. Other vehicle payments (RV, boat, ATV) 14. Credit card debt (total minimum monthly payments) 15. Court ordered obligations 16. Student loans 17. Other personal loans 18. TOTAL MONTHLY EXPENSES (Add lines 1-18) do not have assets ( do 6. I fair market value of $10,000 or more at this time. with a total Xf3afUh8iXX3d)U3v3Qcb f8QcaRt8fa`rfec3U8icU83U8ac3h3f3fa3833ca3Q XV U3RP x Ve Q ` Ye p w V V e p Q u Te b ` Y s V ie Y q b Q g b g W d p i Yb Q g ` Qe de Y Q W d Qb ` Y W T S Q 7. DECLARATION: I declare under penalty of perjury that the above, including all attachments, is true and correct as of the date signed below. Sign and print your name. Enter the date on which you signed your name. Signature Print or Type Name Note: This signature does not need to be notarized. Date FA-4138 Pro Se, 01/07 Income and Expense Statement §§767.127 and 946.32(1)(a), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 2 of 2 American LegalNet, Inc. www.FormsWorkflow.com PRINT in BLACK ink Enter the name of the county in which the original case was filed. Check marriage or paternity. If paternity, enter initials of child. Enter the name, address, and daytime phone number of the petitioner or joint petitioner from the original case file. On the far right, mark the box for the change(s) you requested and enter the original case number. For Official Use STATE OF WISCONSIN, CIRCUIT COURT, COUNTY In RE: The marriage paternity of: Petitioner/Joint Petitioner: First name Middle name Last name Current Mailing Address City State Zip Daytime phone number vs. Decision & Order on Motion or OTSC to Change: Respondent/Joint Petitioner: Enter the name, address, and daytime phone number of the respondent or joint petitioner from the original case file. First name STOP! Do not complete the remainder of this form unless required by the court official who is hearing this case. Enter the name of the court official who held the hearing and the address and date [month, day, year] on which it was held. Legal Custody Physical Placement Child Support Maintenance Other: Last name Current Mailing Address City Check if the State of Wisconsin is a party or not. If you are unsure, you may call your local Child Support Agency. Middle name State Zip Daytime phone number The State of Wisconsin (Child Support Agency) is is not a party to this action. Case No. DECISION AND ORDER ON MOTION or ORDER TO SHOW CAUSE: HEARING A hearing was conducted in this matter as follows: 1. Before: Circuit Court Judge/Circuit Court Commissioner 2. Location: 3. Date: APPEARANCES Check one box from 1 and check a or b. If b, enter the name of the attorney. 1. Former Wife/Mother: appeared by phone appeared in person was self-represented. A. was represented by Attorney B. Check one box from 2 and check a or b. If b, enter the name of the attorney. 2. Former Husband/Father: appeared by phone appeared in person was self-represented. A. was represented by Attorney B. Check a, b, c, or d. If b, c, or d, enter the name of the individual who appeared. 3. Others appearing at the hearing: None. A. Child Support Agency by B. Guardian ad Litem (GAL) C. Other D. FA-4175V, 01/08 Decision & Order on Motion or Order to Show Cause to Change: Legal Custody/ Physical Custody/Child Support/Maintenance/Other did not appear AND . did not appear AND . . . . §§767.451 and 767.59, Wisconsin Statutes This form shall not be modified, It may be supplemented with additional material. Page 1 of 3 American LegalNet, Inc. www.FormsWorkflow.com Decision & Order on Motion or Order to Show Cause to Change Page 2 of 3 Case No. ____________ FINDINGS and ORDER: Based on the findings and reasons stated. IT IS ORDERED: Check A, B, or C. Check A if the court denied the request to change the order. 1. The Motion or Order to Show Cause is: DENIED because no substantial change in circumstance was found. The current A. order remains in effect. B. DEFERRED to collect more information. Before making a final decision the court orders the following: 1. Check B, if the judge ordered the parties to do certain things before he/she makes a decision. 2. If B, check all that apply and complete the corresponding information as necessary. 3. 4. C. The parties attend mediation with no payment is required. a. wife/mother to pay $ b. husband/father to pay $ c. Attorney no payment is required. a. wife/mother to pay $ b. husband/father to pay $ c. towards the mediation fee by towards the mediation fee by . . be appointed as GAL and: . . towards the GAL fee by towards the GAL fee by A physical placement study be conducted by no payment is required. a. towards the study fee by: wife/mother to pay $ b. towards the study fee by: husband/father to pay $ c. . . . Other: GRANTED as follows: 1. Check C, if the judge ordered changes to the current court order. If C, check all that apply in 1-4, and complete the corresponding information as was ordered by the court. The legal custody or physical placement of the following children: is changed as follows: To joint legal custody with both parents. a. To sole legal custody with: (name of parent) b. From primary physical placement with (name of parent): c. to (name of parent): From share placement to primary placement with (name of parent): d. unsupervised as follows: supervised To require placement be: e. f. g. 2. . . According to the attached placement schedule. Other: Change the financial orders as follows: per to $ held open Child support a. beginning on the first day of the month of Payments shall be made by (name of parent) Maintenance (spousal support) to $ b. beginning on the first day of the month of per per Arrears payment to $ c. . beginning on the first day of the month of Arrears balance is set in the WI SCTF KIDS computer system d. as of the first day of the month of at $ Arrears Interest is set in the WI SCTF KIDS computer system e. as of the first day of the month of at $ FA-4175V, 01/08 Decision & Order on Motion or Order to Show Cause to Change: Legal Custody/ Physical Custody/Child Support/Maintenance/Other §§767.451 and 767.59, Wisconsin Statutes This form shall not be modified, It may be supplemented with additional material. Page 2 of 3 American LegalNet, Inc. www.FormsWorkflow.com . . . Decision & Order on Motion or Order to Show Cause to Change Page 3 of 3 Case No. ____________ Payments shall be made: No payments are ordered to be made. 1. to the Wisconsin Support Collections Trust Fund (WI SCTF) at Box 2. 74200, Milwaukee, Wisconsin 53274-0200. Directly from the payer to WI SCTF (only allowable if self-employed). a. By income assignment from the payer’s employer as indicated below: b. Employer name: Address of payroll office: Zip: State: City: Fax: Phone: Enter how the court ordered the payments to be made. 3. Other financial orders: 4. Other non-financial order(s): See attached See attached Check A or B. If B, enter the date and time of the review hearing, the judge who will preside, and the room number where the hearing will take place. 2. A future hearing: is NOT required. A. is set for (date) B. before time in Room # am/pm . 3. Both parties shall notify the Clerk of Courts and the local Child Support Agency in writing, within 10 business days of any change of address, employment, and of any substantial change in income affecting the ability to pay support. This notification does not change the support order. Any party may file moving papers to change this order. 4. If this matter was heard by a Court Commissioner, and either party requests a new hearing, a Request for New (DeNovo) Hearing must be filed with the Clerk of Courts within the time period established by local court rule. 5. If this matter was heard by a Circuit Court Judge, this is a final judgment/order for purposes of appeal. FAILURE TO OBEY THIS ORDER IS PUNISHABLE AS CONTEMPT OF COURT AND MAY RESULT IN A JAIL SENTENCE. BY THE COURT: Signature Name Printed or Typed For Court Use Only Date When you submit this order to the court, you must send copies to the other party(s). The other party(s) has up to 5 business days to object to the accuracy of this order. FA-4175V, 01/08 Decision & Order on Motion or Order to Show Cause to Change: Legal Custody/ Physical Custody/Child Support/Maintenance/Other §§767.451 and 767.59, Wisconsin Statutes This form shall not be modified, It may be supplemented with additional material. Page 3 of 3 American LegalNet, Inc. www.FormsWorkflow.com