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Affidavit In Support Of Responsive Motion To Modify Child Support And Or Spousal Maintenance CSD-303 - Minnesota
| Affidavit In Support Of Responsive Motion To Modify Child Support And Or Spousal Maintenance Form. This is a Minnesota form and can be used in Child Support District Court Statewide . |
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State of Minnesota County District Court Judicial District: Court File Number: Case Type: In Re the Marriage of: Plaintiff / Petitioner vs. Defendant / Respondent Intervenor STATE OF MINNESOTA ) COUNTY OF _____________________ ) SS (County where Affidavit Signed) Affidavit in Support of Responsive Motion to Modify Child Support and/or Spousal Maintenance My name is (check one) (Petitioner/Plaintiff) . I am the (Respondent/Defendant) in this case, and I state under oath the following information: Reasons Why The Existing Support Order Should or Should Not Be Changed: 1. (Check only one of the following): I request that the existing support/maintenance order not be changed because there has not been a change of circumstances for me or the other party since the order was issued. OR I request a change in the existing support/maintenance order because of (check all that apply): Substantially increased or decreased earnings of the party (check one) Obligee (receiving support/maintenance) Obligor (paying support/maintenance) Substantially increased or decreased needs of the (check at least one) child(ren) Obligee Obligor Receipt of public assistance by the (check one) Obligee Obligor A change in the cost-of-living for (check one) Obligee Obligor Extraordinary medical and/or dental expenses of the child(ren). A change in the availability of health or dental insurance coverage. A substantial increase or decrease in existing work-related or education-related CSD303 State ENG Rev 9/05-D www.courts.state.mn.us/forms Page 1 of 5 American LegalNet, Inc. www.FormsWorkflow.com child care expenses of the (check one) Obligee Obligor Receipt of social security benefits by the Obligee Obligor child(ren) A change in the residence of the child(ren) Emancipation of a child (name of child): _________________________. 2. I make the following other comments in support of my request for a change to the existing support/maintenance order: Information From Existing Support Order: (Answer only those questions that apply) (Skip this question if motion is for spousal maintenance only) 3. I am the parent of the following children involved in this case (list only children involved in this case, and for each child check if you are the obligee or obligor): Child's Name Date of birth Obligee / Obligor ________________________________________________ Obligee Obligor ________________________________________________ Obligee Obligor ________________________________________________ Obligee Obligor ________________________________________________ Obligee Obligor 4. The existing support/maintenance order was issued by the court in ________________ County and is dated ________________________________. In that Order, I am the (check one) Obligor (making payments) Obligee (receiving payments) At the time the existing order was issued, I was (check one): Unemployed. Employed at (company or occupation) and per hour week month with a monthly net income of earned $ $ and had other monthly income totaling $_________________ (list all sources, such as from employment, public assistance, social security, or other source). At the time the existing order was issued, to the best of my knowledge, the other parent was (check one): Unemployed. Employed at (company or occupation) and earned $ per hour week month with a monthly net income of and had other monthly income totaling $_________________ $ from (list all sources, such as employment, public assistance, social security, or other source). At the time the existing order was issued, the child(ren) received monthly benefits in the amount of $ from (list all sources such as social security benefits) 5. 6. 7. Current Information: CSD303 State ENG Rev 9/05-D www.courts.state.mn.us/forms Page 2 of 5 American LegalNet, Inc. www.FormsWorkflow.com 8. I am currently (check one) employed unemployed (if employed, answer the following): a. Employer: b. Address: c. Work telephone number: d. Occupation: e. Length of employment: f. Supervisor: g. Gross Pay: $__________________ Net Pay: $ ____________________ h. Paid: Weekly Every other week Twice a month Monthly i. Number of withholding exemptions: __________________ j. Previously employed by for ___________ years prior to the above employment. k. Cost of monthly medical insurance for self: $ l. Cost of monthly medical insurance for dependents: $ m. Cost of monthly dental insurance for self: $ n. Cost of monthly dental insurance for dependents: $ o. If insurance coverage is in place, list the names of who the insurance covers: To the best of my knowledge, the other parent is currently: (check one employed unemployed (if employed, answer the following): a. Employer: b. Address: c. Work telephone number: d. Occupation: e. Length of employment: f. Supervisor: g. Gross Pay: $__________________ Net Pay: $ ____________________ h. Paid: Weekly Every other week Twice a month Monthly Unknown i. Number of withholding exemptions: __________________ j. Previously employed by for ___________ years prior to the above employment. k. Cost of monthly medical insurance for self: $ l. Cost of monthly medical insurance for dependents: $ m. Cost of monthly dental insurance for self: $ n. Cost of monthly dental insurance for dependents: $ o. If insurance coverage is in place, list the names of who the insurance covers: I have the following additional sources of income: (for example, public assistance, social security, Supplemental Security Income, pensions, Retirement and Survivors Disability Income, renters income, child support for other children): Source: _____________________________________________ $____________ month Source: _____________________________________________ $____________ month Source: _____________________________________________ $____________ month The value of the property I currently own by myself or with someone else is: Home $____________________ 9 10. 11. CSD303 State ENG Rev 9/05-D www.courts.state.mn.us/forms Page 3 of 5 American LegalNet, Inc. www.FormsWorkflow.com Household goods $____________________ Purchase price of my home $_________________ Balanced owed on my home $____________________ Other real estate $____________________ Checking/savings $____________________ Automobiles $____________________ (year and make) Recreational vehicles $____________________ (year and make) Personal property $____________________ Stocks/bonds/etc. $____________________ 12. I am currently (check all that apply): Married Separated Divorced Living with a
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