Fillable Printable Application to Modify Child Support - Iowa

Application to Modify Child Support - Iowa

FL-301 APPLICATION TO MODIFY CHILD SUPPORT ONLY

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Form FL-301, page 1 of 4

A..

IN THE DISTRICT COURT FOR ______________________________________ COUNTY, IOWA

(County where the current child support is ordered)

B..

UPON THE PETITION OF

____________________________________________________

ETITIONER

(As it is in the original case)

____________________________________________________

ESPONDENT

(As it is in the original case)

Equity case number:

___________________________

Application to Modify

Child Support Only

(CLERK STAMPS HERE)

Stop! You must file this form in the same county where your current child support order

is entered. If you cannot file it in the same county, see an attorney.

C.. PERSONAL INFORMATION

1. Applicant's (your) name, year of birth and present residence:

_______________________________________________ _____________________________

(Full name) (Year of birth)

_______________________________________ _____________________ ______ ___________

(Present street address) (City) (State) (ZIP Code)

_______________________________________ (________)____________________

(County) (Phone number)

2. Other parent's name, year of birth, and present residence:

_______________________________________________ _____________________________

(Full name)

(Year of birth)

_______________________________________ _____________________ ______ ___________

(Present street address) (City) (State) (ZIP Code)

_______________________________________ (________)____________________

(County) (Phone number)

3. If someone other than a parent gets child support in this case, write the person’s name, year of

birth, and present address:

_______________________________________________ _____________________________

(Full name)

(Year of birth)

_______________________________________ _____________________ ______ ___________

(Present street address) (City) (State) (ZIP Code)

_______________________________________ (________)____________________

(County) (Phone number)

Form FL-301, page 2 of 4

D..

GENERAL INFORMATION ABOUT THIS CASE

4. Information about the current child support order:

a. Date entered: _____ /_____/ _________

(Month) (Day) (Year)

b. County and state where the current order is entered: _________________________________

c. Case number on the current child support order: ____________________________________

d. (Name) _______________________________________ pays child support in this case.

(Name) _______________________________________ receives child support in this case.

e. The current child support payment is: $__________ per _________________.

(Week or month)

5. (Check if true.) A copy of the current child support order is attached.

6. (Check all that are true.)

The Child Support Recovery Unit (CSRU) is involved in this case.

The Collection Services Center (CSC) is involved. The CSC number is: ________________

7. (Check if true.)

There are other child support orders for the child or children involved in this case. They are:

(If you check this box, write in the following information.)

Case # ____________________________ County & State ___________________________________.

8. The following children are covered by the current child support order:

First, middle & last

initials of each child Year of birth

(1)_______________ _________

(2)_______________ _________

(3)_______________ _________

(4)_______________ _________

First, middle & last

initials of each child Year of birth

(5)_______________ _________

(6)_______________ _________

(7)_______________ _________

(8)_______________ _________

Note: If you need more lines to list the children, attach a separate sheet and check this box:

Stop! If there is a court order that sets up custody and you need to change custody, you

cannot use this form. Talk to an attorney if you need to change custody

Form FL-301, page 3 of 4

Child support should be changed because: (Check all that are true.)

a. There is a juvenile court order that changed where the child or children were living. The

person paying support has custody of the children. (If you check a., write in the county

where the juvenile court order was entered and the case number.)

County: ________________________________ Case #: _________________________

b. One or more of the children live with the parent who is paying support. There is no court

order that sets up custody.

c. One or more of the children no longer qualify for child support.

d. My income has gone down.

e. The other parent’s income has gone up.

f. Other reason (explain): ____________________________________________________

________________________________________________________________________________

10. Child support should be: (Check all that apply; i

f you check more than one please explain on the

blank lines.)

a. Raised ______________________________________________________________

b. Lowered ______________________________________________________________

c. Stopped ______________________________________________________________

______________________________________________________________

11. Tax deduction for the child or children. (Check the one that is true.)

a. There is no court order at this time on tax deductions.

b. A court order currently says who gets the tax deduction for the child or children and it

should stay the same.

c. A court order currently says who gets the tax deduction for the child or children and it

should be changed.

12. Health care expenses for the child or children. (Check the one that is true.)

a. There is no court order at this time on who pays health care expenses.

b. A court order currently says who pays for health care expenses for the child or children

and it should stay the same.

c. A court order currently says who pays for health care expenses and it should be changed.

(If you check this box, explain what you want in 15 below.)

13. The other party is: (Check all that are true.) (If you check a. or b. see the instructions.)

In the military service. (Give the location.) ____________________________________

b. In prison or jail. (Give the location.) __________________________________________

14. (Check if true.)

There is a “protective order” or a “no contact order” between any of the parties and me.

If you check the box, write in the following information (Required):

a. County and state where the order came from: ______________________________________

b. Court case number: __________________________________

Form FL-301, page 4 of 4

15. Other information: _____________________________________________________________

____________________________________________________________________________

E..

REQUEST OF THE APPLICANT

(You are the Applicant)

16. Applicant asks the court to: (Check all that apply.)

a. Raise the current child support payment.

b. Lower the current child support payment.

c. End the current child support payment.

d. Set child support for the parent who does not have the children.

e. Change who gets the tax deduction for the child or children.

f. Change who pays for health care expenses for the child or children.

g. Order that the other party pay the court fees.

h. Order that the other party pay my attorney fees.

i. Other request: ____________________________________________________________

_________________________________________________________________________________

F..

ATTORNEY HELP

(Check one.) a. An attorney did not help me prepare or fill in this paper.

b. An attorney helped me prepare or fill in this paper.

(If you check b., you must fill in the following information.)

_________________________________________ ___________________________________

(Name of attorney or organization, if any) (Attorney’s P.I.N. # – Ask the attorney)

_________________________________________________ _____________________ ________ ___________

(Business address of attorney or organization) (City) (State) (ZIP Code)

(________)_______________________________ (________)__________________________

(Attorney’s phone number – Required) (Attorney’s fax number, if there is one)

G..

OATH AND SIGNATURE

I, ________________________________________, certify under penalty of perjury and pursuant to

the laws of the state of Iowa that the information I have provided in this Application is true and

correct.

(Your signature – Required)

______________________________________________________________

_________________________________ _______________________ ___________________

(Your mailing address – Required) (City – Required) (State, ZIP Code – Required)

__________________________________________________________

(________)____________________

(E-mail address – Optional) (Fax number– Optional)

NOTICE TO APPLICANT: You must serve this form and an Original Notice (FL-304) on the other parties. If

the Child Support Recovery Unit (CSRU) is involved in this case (see item 6, above), you must also serve both

forms on the CSRU. See the instructions for forms FL-301 and FL-304.