Free DISTRICT COURT TRUSTEE - Kansas

MIAMI COUNTY DISTRICT COURT
SIXTH JUDICIAL DISTRICT
PO BOX 187 PAOLA, KS 66071 913-294-4374 FAX: 913-294-2535

Pro Se Motion for Modification of Child Support
1. 2. Make a copy of the blank Domestic Relations Affidavit.

Fill out completely using typewriter or printed in ink:
a) Motion b) Notice of hearing (date will be given at the time of filing) c) Certificate of mailing d) Domestic Relations Affidavit e) Copies of your most recent paycheck stub which includes year-to-date totals and a copy of last year's income tax return f) Child support worksheet Note: Further explanations may be found on the next page.

3. File the original and 3 copies of the Motion with the notice of hearing and certificate of mailing sections completed, b) completed domestic relations affidavit, c) proof of income attachments, and d) child support worksheet to the Clerk of the District Court. Write "Chamber Copy" on the top of one of your copies.

Pursuant to K.S.A. 60-1621, a $52.00 filing fee must be paid when filing your motion.
4. The Clerk of the District Court will "file stamp" all copies, keep the originals and the Chamber Copy, and give you back the additional copies.

For Certified Mail Service: You must now serve a "file-stamped" copy of the motion, notice of hearing, domestic relations affidavit, proof of income attachments, child support worksheet AND a BLANK Domestic Relations Affidavit on the petitioner/respondent and his/her attorney of record by Certified Mail (Return Receipt Requested). After Service of Certified Mail (after the green card is returned to you): You must now fill out the form entitled, "Return of Service for Certified Mail." Fill out the form and file it with the Clerk of the District Court. 5. IT IS UP TO YOU to get the correct papers filed and proper service completed in order for your case to go forward on its assigned hearing date and time.

Child Support Modification Procedure
The following information is provided to assist you in obtaining a modification of your child support. The office of the Court Trustee does not represent any party to this case. The Court Trustee operates independently to ensure that the child support orders are enforced and to see that the Child Support Guidelines are followed. The Kansas Child Support Guidelines are the rules which must be followed in setting the amount of child support to be paid. There are specific rules which must be followed under these guidelines. The following information is designed to assist you in following these guidelines. If you can afford to hire an attorney to represent you in modifying your support obligation, you should seriously consider retaining an attorney to represent you. The following documents must be filed with the court when seeking a child support modification: 1. Motion to Modify Support. For your convenience, a standard motion is included with the information which you may complete. Please note that you must mail a copy of your motion to the parties involved in your case -- specifically, the District Court Trustee or SRS if you have an open case with either agency, the person to whom you pay support, and his/her attorney if she/he has an attorney. The original motion must be filed in District Court. A hearing cannot be held until your motion has been filed in District Court. Promptness is very important, as your child support cannot be modified until a formal motion has been filed. The Court cannot reduce/increase child support which has already become due prior to the filing of your motion. 2. Domestic Relations Affidavit. The Kansas Child Support Guidelines require this form be completed and filed with your motion. Failure to include this form with your motion could result in your motion being dismissed. The Domestic Relations Affidavit must be signed in the presence of a notary public. You must complete all information in the affidavit as it pertains to you. In other words, if you are the Respondent in this case, you must complete all information in the affidavit in the sections for Respondent. A Domestic Relations Affidavit is attached. This affidavit complies with the Kansas Child Support Guidelines. 3. Child Support Worksheet. Another document which must be included with your motion is the worksheet. This form shows the amount to which your child support should be modified. A worksheet which complies with the Kansas Child Support Guidelines is attached. In order to complete the worksheet, your present earnings information and the earnings of the other party must be provided. Proof of earnings may include copies of your pay stubs, unemployment, retirement, social security, and worker's compensation benefits, and income tax returns. You may review a copy of the Kansas Child Support Guidelines to assist you in preparing your child support worksheet at the office of the Court Trustee. The Court Trustee, however, cannot help you complete your worksheet. If you provide health insurance for the child(ren) in this matter, you should also provide proof of the insurance costs. Failure to complete the forms and present them to the Court may prevent you from obtaining a hearing before the District Judge Pro Tem. All documents must be completed and filed with the Court before a hearing can be scheduled.

IN THE DISTRICT COURT OF MIAMI COUNTY, KANSAS In the Matter of _____________________________, Petitioner, vs. _____________________________, Respondent. ) ) ) ) ) ) ) )

Case No. _________________

MOTION FOR MODIFICATION OF CHILD SUPPORT COMES NOW the (Petitioner/Respondent) and moves the Court to modify the current Order of Support for the following reasons: ____________________________________________________________________________________ ____________________________________________________________________________________ _______________________________________________________________ I have attached a completed copy of my Domestic Relations Affidavit, along with a copy of the most recent paycheck stub with year-to-date totals, a copy of last year's income tax return, and a completed Child Support Worksheet. WHEREFORE, the (Petitioner/Respondent) moves the Court for a modification of the current Support Order of the Court.

NOTICE OF HEARING Please take notice that the above Motion for Modification of Child Support has been set for hearing in the Miami Co District Court, (913) 294-4374, 120 S Pearl, Paola, Kansas, on : NOTE: Both parties are required by Kansas law to fill out and file a Domestic Relations Affidavit with attached copy of the most recent paycheck stub with year-to-date totals and a copy of last year's income tax return with the Clerk of the District Court no later than five (5) days prior to the hearing. ________________________________ Your signature Pro se Address ________________________ ________________________________ Phone___________________________

CERTIFICATE OF MAILING A copy of this Motion for Modification of Support has been sent by Certified Mail/Return Receipt Requested to (Petitioner/Respondent) and their attorney of record at the following addresses: ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Date________________________________________________________________________________
(Your signature again here)

IN THE DISTRICT COURT OF MIAMI COUNTY, KANSAS IN THE MATTER OF ___________________________________, Petitioner, and ___________________________________, Respondent. ) ) ) ) ) ) ) ) )

Case No. ___________________

RETURN OF SERVICE FOR CERTIFIED MAIL State of Kansas County of Miami ) ) ) ss.

The undersigned, being duly sworn, states: I have served a Motion for_______________ on the Petitioner/Respondent, and the following Return for Receipt of Service was served on the litigant by certified mail on _______________________ , 20____ , at the time and place as listed on the enclosed card.

(When you receive the signed green card back from the other party, tape it here.)

_________ Check here if service by certified mail was refused. (If refused, I certify that I sent a true copy of the motion by first-class mail after the certified letter was refused.) ______________________________________ Your signature Pro se Subscribed and sworn to before me on this ______day of _________________ , 20____. ______________________________________ Notary Public

IN THE

JUDICIAL DISTRICT COUNTY, KANSAS

IN THE MATTER OF

and

) ) ) ) ) ) ) ) ) )

Case No.

DOMESTIC RELATIONS AFFIDAVIT OF (name) 1. 2. 3. 4. Mother's Residence Father's Residence Date of Marriage: Number of Marriages: Mother 5. 6. Number of children of the relationship: Names, Social Security Numbers, birthdates, and ages of minor children of the relationship: Name Age Custodian Father

7.

Names, Social Security Numbers, and ages of minor children of previous relationships and facts as to custody and support payments paid or received, if any. Support Payment $ $ $ $ Paid or Rec'd

Name

Age

Custodian

8.

Mother is employed by

Father is employed by

(Name and address of employer) with monthly income as follows: A. Wage Earner 1. 2. 3. 4. 5. 6. 7. 8. 9. B. Gross Income Other Income Subtotal Gross Income Federal Withholding (Claiming _____ exemptions) Federal Income Tax OASDHI Kansas Withholding Subtotal Deductions Net Income $ $ $ $ $ $ $ $ $ Mother Mother $ $ $ $ $ $ $ $ $ Father Father

Self-Employed 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Gross Income from self-employment Other Income Subtotal Gross Income Reasonable Business Expenses (Itemize on attached exhibit) Self-Employment Tax Estimated Tax Payments (Claim _____ exemptions) Federal Income Tax Kansas Withholding Subtotal Deductions Net Income (Line B.3. minus Line B.9.)

$ $ $ $ $ $ $ $ $ $

$ $ $ $ $ $ $ $ $ $

Pay period: Mother Father

9.

The liquid assets of the parties are (do not list more than the last four digits of any account number shown): Joint or Individual (Specify)

Item A. Checking Accounts: $ $ B. Savings Accounts: $ $ C. Cash Mother Father Other $ $ $ $ 10.

Amount

D.

The monthly expenses of each party are: (Please indicate with an asterisk all figures which are estimates rather than actual figures taken from records.) A. Item 1. 2. 3. Rent (if applicable)* Food Utilities: Trash Service Newspaper Telephone Gas Water Lights Other Insurance: Life Health Car House/Rental Other Medical and dental Prescriptions drugs Child care (work-related) Child care (non-work-related) Clothing School expenses Hair cuts and beauty Car repair Gas and oil Personal property tax Mother (Actual or Estimated) $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Father (Actual or Estimated) $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

4.

5. 6. 7. 8. 9. 10. 11. 12. 13. 14.

Item

Mother (Actual or Estimated)

Father (Actual or Estimated)

15.

Miscellaneous (Specify) $ $ $ $ $ $ $ $

16.

Debt Payments (Specify) $ $ $ $ Total $ $ $ $ $ $

*Show house payments, mortgage payments, etc., in Section 10.B. B. Monthly payments to banks, loan companies or on credit accounts: (Indicate actual or estimated, use asterisk for secured.) DO NOT LIST ANY PAYMENTS INCLUDED IN PART 10.A ABOVE. When Incurred Amount of Payment Date of Last Payment Responsibility Mother Father $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

Creditor

Balance

$ $ $ $ $ $ Subtotal of Payments Total C. Total Living Expenses

Mother (Actual or Estimated) 1. Total funds available to Mother and Father (from No. 8) 2. Total needed (from No. 10.A and B) 3. Net Balance 4. Projected child support $

Father (Actual or Estimated) $

$ $ $

$ $ $

D.

Payments or contributions received, or paid, for support of others. Specify source and amount. Source (+/-) (+/-) (+/-) (+/-) $ $ $ $ Mother $ $ $ $ Father

11.

How much does the party who provides health care pay for family coverage? per . $ How much does it cost the provider to furnish health insurance only on the provider? per . $

FURNISH THE FOLLOWING INFORMATION IF APPLICABLE. 12. Income and financial resources of children. Income/Resources $ $ $ $ 13. Child support adjustments requested. Mother Long Distance Visitation Costs Visitation Adjustments Income Tax Considerations Special Needs Agreement Past Minority Overall Financial Condition $ $ $ $ $ $ $ Father $ $ $ $ $ $ $ Amount

14. All other personal property including retirement benefits (including but not limited to qualified plans such as profit-sharing, pension, IRA, 401[k], or other savings-type employee benefits, nonqualified plans, and deferred income plans), and ownership thereof (joint or individual), including policies of insurance, identified as to nature or description, ownership (joint or individual), and actual or estimated value. Do not list more than the last four (4) digits of any account number shown. Joint or Individual (Specify)

Amount $ $ $ $

THE FOLLOWING NEED NOT BE FURNISHED IN POST JUDGMENT PROCEDURES.

15.

List real property identified as to description, ownership (joint or individual) and actual or estimated value. Property Description Ownership Actual/Estimated Value

16.

Identify the property, if any, acquired by each of the parties prior to marriage or acquired during marriage by a will or inheritance. Source of Ownership Actual/ Estimated Value

Property Description

Ownership

17.

List debt obligations, including maintenance, not listed in Section 10.A or 10.B above, identified as to name or names of obligor or obligors and obligees, balance due and rate at which payable; and, if secured, identify the encumbered property. Balance Due Payment Rate Encumbered Property

Debt Obligation

Obligor

Obligee

18.

List health insurance coverage and the right, pursuant to ERISA §§ 601-608, 29 U.S.C. §§ 1161-1168 (1986), to continued coverage by the spouse who is not a member of the covered employee group. Health Insurance Yes COBRA Continuation No Unknown

AFFIANT /s/ VERIFICATION State of , County of ,

I swear or affirm under penalty of perjury that this affidavit and attached schedules are true and complete. /s/ Subscribed and sworn this day of /s/ Notary Public My Appointment Expires: , 20 .

IN THE

JUDICIAL DISTRICT COUNTY, KANSAS

IN THE MATTER OF:

and

CASE NO.

CHILD SUPPORT WORKSHEET OF (name) MOTHER A. INCOME COMPUTATION ­ WAGE EARNER 1. Domestic Gross Income (Insert on Line C.1. below)* INCOME COMPUTATION ­ SELF-EMPLOYED 1. 2. 3. Self-Employment Gross Income* Reasonable Business Expenses Domestic Gross Income (Insert on Line C.1. below) $ FATHER $

B.

(-)

C.

ADJUSTMENTS TO DOMESTIC GROSS INCOME 1. 2. 3. 4. 5. Domestic Gross Income Court-Ordered Child Support Paid Court-Ordered Maintenance Paid Court-Ordered Maintenance Received Child Support Income (Insert on Line D.1. below)

(-) (-) (+)

D.

COMPUTATION OF CHILD SUPPORT 1. 2. 3. Child Support Income Proportionate Shares of Combined Income (Each parent's income divided by combined income) Gross Child Support Obligation** (Using the combined income from Line D.1., % + = %

find the amount for each child and enter total for all children) Age of Children Number Per Age Category Total Amount * Interstate Pay Differential Adjustment? **Multiple Family Application? 0-6 + 7-15 + Yes Yes No No 16-18 = Total

MOTHER 4. 5. Health and Dental Insurance Premium Work-Related Child Care Costs Formula: Amt. ­ ((Amt. X %) + (.25 x (Amt. x %))) for each child care credit Example: 200 ­ ((200 x .30%) + (.25 x (200 x .30%))) Parents' Total Child Support Obligation (Line D.3. plus Lines D.4. & D.5.) Parental Child Support Obligation (Line D.2. times Line D.6. for each parent) Adjustment for Insurance and Child Care (Subtract for actual payment made for items D.4. and D.5.) Basic Parental Child Support Obligation (Line D.7. minus Line D.8.; Insert on Line F.1. below) $

FATHER + $ =

=

6.

7. 8.

(-)

9.

E.

CHILD SUPPORT ADJUSTMENTS N/A CATEGORY AMOUNT ALLOWED MOTHER FATHER (+/-) (+/-) (+/-) (+/-) (+/-) (+/-) (+/-) (+/-) (+/-) (+/-) (+/-) (+/-)

APPLICABLE 1. 2. 3. 4. 5. 6. 7. F.

Long Distance Parenting Time Costs Parenting Time Adjustment Income Tax Considerations Special Needs Agreement Past Majority Overall Financial Condition TOTAL (Insert on Line F.2. below)

DEVIATION(S) FROM REBUTTABLE PRESUMPTION AMOUNT AMOUNT ALLOWED MOTHER FATHER 1. 2. 3. Basic Parental Child Support Obligation (Line D.9. from above) Total Child Support Adjustments (Line E.7. from above) Adjusted Subtotal (Line F.1. +/- Line F.2.)

(+/-)

4.

5.

Enforcement Fee Allowance** Percentage (Applied only to Nonresidential Parent) Flat Fee $ ((Line F.3. x Collection Fee %) x .5) or (Monthly Flat Fee x .5) (+) Net Parental Child Support Obligation (Line F.3. + Line F.4.)

%

(+)

**Parent with nonprimary residency

Judge/Hearing Officer Signature

Date Signed

Prepared By

Date Approved