Fillable Printable Request to Modify a Child Support Order - Iowa

Request to Modify a Child Support Order - Iowa

470-2749 (Rev. 3/01)

Request to Modify a Child Support Order

The Child Support Recovery Unit (CSRU) has three processes available for modifying child support obligations.

These are Review a nd Adjustment, Administrative Modification and Cost-of-Living Alterations. To ask for a

modification complete the attached Request to Modify a Child Support Order form. For additional information

about these processes, see the enclosed Procedures for Modifying Child Support Obligations.

• If you would like a review and adjustment, it must be more than 24 months since your order was entered, child

support was modified, or determined not appropriate for adjustment, whichever occurred last.

• If it has been less than 24 months, you may qualify for an administrative modification.

• You may request a cost-of-living alteration. Both parties must agree and sign in the cost-of-living alteration

box on the last page of this document.

Complete the request form and sign one of the request boxes on the last page of this document. To avoid delays in

processing, sign your request.

Important Information about Modifications

• The person asking for a change may have to pay fees for completing this process.

• If CSRU accepts the request, CSRU sends each parent a financial statement to complete and return with proof of

income. CSRU determines the support amount using Iowa’s support guidelines.

• To verify financial information, CSRU may use the records of various state and federal agencies.

• Child support, dependent health insurance, and uncovered medical expenses will be addressed. The amount of

current support may go up, go down, or stay the same as a result of the modification process. Dependent

health insurance will be added to the order if it is not currently ordered and the custodial parent is receiving

medical support services. If the order is modified, the parent ordered to pay support will also be ordered to pay

a proportionate share of uncovered medical expenses.

• CSRU cannot assist either parent with issues such as custody and visitation rights.

• Orders entered in Iowa or other states may not be under the jurisdiction of the Iowa courts for the purpose of

modification. CSRU may have to forward your request to the child support office of the state that has the

authority to modify your order.

• If CSRU decides an adjustment can be done and no one challenges or asks for a court hearing, CSRU prepares

the order and asks the court to approve it. Once the order is approved and filed with the court, it is final. The

order has the same effect as if there had been a court hearing.

• If you ask to withdraw from the process, you may not be allowed to request another modification for two years.

However, CSRU may be required to co mplete the process or the other party may ask CSRU to continue.

Please return the form and any required documents to your local CSRU. The child support offices are listed on the

last page of the Procedures for Modifying Child Support Obligations. If you have any questions, please call the

Specialized Customer Service Unit at 515-242-5530 (local calls) or 1-888-229-9223 (toll free within United States).

Thank you.

Request to Modify a Child Support Order (Page 2)

470-2749 (Rev. 3/01)

Person Requesting Change

CSC Ca se Number: Teleph o ne Number :

First Name Middle Last Social Security Number

Street Address City State Zip Code

Children for Whom Support Was Ordered

Name (First, Middle, Last) Name (First, Mid dle, Last) Name (First, Middle, Last) Name (First, Mid dle, Last)

Other Parent Subj ect t o the Support Order

First Name Middle Last Social Security Number

Street Address City State Zip Code

Name and Address of Current Employer Employer Telephone Number

Order You Want Changed

Court Order Number Date Order Entered State County

Other Court Orders Involving the Same Parent

Court Order Number Date Order Entered State County

Health Insurance

Do you carry health insurance (other than Title 19 Medicaid) on the children covered under the orders listed above?

Yes

❑

If no, and you are the custodial parent on your case and the children are not covered at this time, do you want

medical provisions added to the court order? Yes

❑

If yes, ask your CSRU worker for form 470-2744, NPA Medical Support Questionnaire.

Please check any of the following special circumstances that apply to your situation:

❑

It has been MORE than 24 months since my order was entered, last modified or last reviewed.

❑

50% Change in my net income. * (Proof required. See next page.)

❑

50% Change in the other parent's net income. * (Proof required. See next page.)

* It has been LESS than 24 months since the order was entered, last modified or last reviewed. There has

been a change of 50% or more in a parent's net income. The change in financial circumstances has lasted

for at least three months and is expected to last for at least three more months.

Request to Modify a Child Support Order (Page 3)

470-2749 (Rev. 3/01)

Please explain how and why the financial circumstances have changed.

__________________________________________________________________________________________

YOU MU ST ATTACH PROOF of the income that was used to det ermine the child support obligation and

the present income of the parent with the 50% change in net income. FAILURE TO DO SO MAY

RESULT IN DENIAL OF YOUR REQUEST.

3. !

! Additional Child(ren) to be Added to the Current Order: (If more than two, attach another sheet.)

Last First M. Birth Date Social Security No .

Place of Birth Does Child Live in your Home?

❑

YES

❑

Has Pa ter nity Be en Established?

❑

YES

❑

Method U se d to Es tablis h Legal Resp onsibility ( You mus t attach verification)

❑

Court Order

❑

In Cou rt Statement & Consent

❑

Paternity Affidavit

❑

Child Born During Marriage

❑

Court Ordered Support

Obligation

Last First M. Birth Date Social Security No .

Place of Birth Does Child Live in your Home?

❑

YES

❑

Has Pa ter nity Be en Established?

❑

YES

❑

Method U se d to Es tablis h Legal Resp onsibility ( You mus t attach verification)

❑

Court Order

❑

In Cou rt Statement & Consent

❑

Paternity Affidavit

❑

Child Born During Marriage

❑

Court Ordered Support

Obligation

4. ❑

Other Circumstances:

My order set child support at zero or reserved setting a dollar-amount of support. This should be changed because:

__________________________________________________________________________________________

There is an error in the child support amount and/or medical support provisions of the order that was made when it

was prepared or filed. The error is:

__________________________________________________________________________________________

The non-custodial parent was a minor, so child support was reduced or waived. The non-custodial parent is no

longer a minor, is no l onger i n school or has not attended parent i ng classes. Please explain:

__________________________________________________________________________________________

You may attach a separate sheet to provide additional information.

Request to Modify a Child Support Order (Page 4)

470-2749 (Rev. 3/01)

Sign only one o f the request boxes listed below in order fo r CSRU t o act upon y our request.

REQUEST FOR A REVIEW AND ADJUSTMENT

ADMINISTRATIVE MODIFICATION

Sign this section to request a Review and Adjustment or Administrative Modification. CSRU will determine

which modification process fits your situation.

I take full responsibility for the information that I have provided o n this request form.

_______________________________________ _____________________________________

Signature of Person Making Request Date

_______________________________________

Relationship to Child(ren)

REQUEST FOR A COST-OF-LIVING ALTERATION (COLA)

To request a COLA, both parents subject to the order must sign this section. The new child suppo rt amount

reflects increases in the cost of living since the order was entered or last modified.

I request CSRU to do a cost-of-living alteration of my child support amount and agree to accept all service of papers

for the alteration process by first class mail.

I take full responsibility for the information that I have provided o n this request form.

__________________________________ ________________________________

Signature of custodial parent Signature of noncustodial par ent

__________________________________ ________________________________

Date