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Child Support Review Letter - Template, Sample Form Pro · US-law

✓ Valid in United States · drafted to comply with local law

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Child Support Review Letter - Template, Sample Form
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Telephone: ________
Email: ________

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RE: Request for Administrative Review and Modification of Child Support Order

Case/Docket No.: ________
Court/Agency of Jurisdiction: ________
State: ________
Obligor (Paying Parent): ________
Obligee (Receiving Parent): ________

To Whom It May Concern:

§ 1. Purpose of Request. Pursuant to applicable state law and the federal periodic-review provisions of Title IV-D of the Social Security Act (42 U.S.C. § 666(a)(10)) and 45 C.F.R. § 303.8, I respectfully request a review and, if warranted, a modification of my existing child support obligation entered in the above-referenced matter for my minor child, ________, born ________.

§ 2. Current Order. Under the current order, I am obligated to pay to ________ child support in the amount of $________ (________) per month.

§ 3. Origin of the Obligation. This support obligation was established by a divorce decree/order entered on ________ by the court identified above.

§ 4. Basis for Review. I request this review for the following reason(s): (a) a substantial period of time has elapsed since the order was last reviewed, the most recent review having occurred on or about ________; and (b) there has been a substantial and continuing change in circumstances, as more particularly described below:

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§ 5. Supporting Documentation. In support of this request, and consistent with the financial-disclosure requirements applicable to support proceedings, I enclose the following supporting documentation:

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§ 6. Contact Information for Obligor. Should you require any additional information or documentation from me, or wish to schedule a conference or hearing, please contact me at the address set forth above or by the following means:

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§ 7. Contact Information for Obligee. The other parent, ________, may be contacted at the following address:

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§ 9. Verification. I declare under penalty of perjury under the laws of the State of ________ that the foregoing is true and correct to the best of my knowledge and belief.


Sincerely,


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Dated: ________

Enclosures: ________

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