Free F.C.A. §4511 Form 4-11b (Affidavit in Support of of Modification of Support) 9... - New York

F.C.A. §4511

Form 4-11b (Affidavit in Support of of Modification of Support) 9/2008

FAMILY COURT OF THE STATE OF NEW YORK COUNTY OF In the Matter of a Proceeding for Support under Article 4 of the Family Court Act

Petitioner, -againstAFFIDAVIT IN SUPPORT OF MODIFICATION OF SUPPORT Family File No.: Docket No. Respondent. STATE OF NEW YORK COUNTY OF ) )ss. )

________________________________, being duly sworn, deposes and states the following: 1. I am submitting this affidavit in support of the application for modification of a support order made in the Family Court Supreme Court [specify county]: , dated ___________________. I reside at [specify full address]:2 2. The support order sought to be modified is for the support of child(ren) spouse spouse and child(ren). 3 Upon information and belief, there have been the following changes in circumstances since the support order was made: Increased needs of the children [specify]:

1. Family Court Act §451 provides that "no hearing shall be required unless such application [to modify] shall be supported by affidavit and other evidentiary material sufficient to establish a prima facie case for the relief requested." 2. Unless the Court has ordered the address to be confidential on the ground that disclosure would pose an unreasonable health or safety risk. See Family Court Act §154-b; Form 21 (available at www.nycourts.gov).

Form 4-11b Needs of the children that are not being met [specify]:

Page 2



Change in the ability of the payor to pay support [specify]:



Other [specify]:

Dated: Signature of Petitioner Sworn to before me this ____ day of _______________________________ (Deputy) (Chief) Clerk of Court Notary Public/Commissioner of Deeds Print or type name

Signature of Attorney, if any Attorney's Name (Print or Type)

Attorney's Address and Telephone Number