Settlement Agreement On Application To Modify Child Support {Form 328}

Rule 17.300--Form 328: Settlement Agreement on an Application to Modify Child Support Use this form only if: · You and the other party both agree to the terms of a Settlement Agreement. · There is a current Iowa child support order in effect. · You would like to increase, decrease, or stop child support · There is on file an Application to Modify Child Support. Caution: This form may require you to provide protected or sensitive information. If filing electronically and you include protected information on this form, fill out or update the Protected Information Disclosure (311) if you have not already done so. If filing in paper, you may use form 311 to provide any protected information in full. If you do not understand how to use this form, or if you should use this form, talk to an attorney. In the Iowa District Court for County where Application was filed County Upon the Petition of Equity case no. Petitioner Full name of Petitioner as it is in the Application Settlement Agreement on an Application to Modify Child Support and concerning Respondent Full name of Respondent as it is in the Application 1. Applicant's Information Fill in all information that you know. If you have been assaulted by your spouse and you fear for your safety, you may leave your street address, phone number, and email blank. A. Applicant's information: Birth year Applicant's present street address City State ZIP code ( County ) Email address Phone number B. Other parent's information: Birth year Other parent's present street address City State ZIP code ( County ) Email address Phone number February 2014 Rule 17.300--Form 328 Page 1 of 6 American LegalNet, Inc. www.FormsWorkFlow.com Rule 17.300--Form 328: Settlement Agreement on an Application to Modify Child Support, continued C. Other person (non-parent) who receives child support: Full name: first, middle, last Present street address County City State ZIP code ( ) Email address Phone number 2. Agreement A. Child support Check each that is true, and fill in the blanks for the items you check. (1) Child support should be raised from $ per month beginning Month First, middle, & last initials of each child a. b. c. Birth year per month to $ , 20 Day Year First, middle, & last initials of each child d. e. f. for: Birth year Check this box if you have attached a separate sheet listing additional children. (2) Child support should be lowered from $ per month beginning Month First, middle, & last initials of each child a. b. c. Birth year per month to $ , 20 Day Year First, middle, & last initials of each child d. e. f. for: Birth year Check this box if you have attached a separate sheet listing additional children. (3) Check here if you want child support to be higher or lower than the Child Support Guidelines amount. If you check this, write the amount you want and explain why in (b). a. Amount requested: $ per month Show Lines Hide Lines b. Child support should be different than the Guidelines amount because: February 2014 Rule 17.300--Form 328 Page 2 of 6 American LegalNet, Inc. www.FormsWorkFlow.com Rule 17.300--Form 328: Settlement Agreement on an Application to Modify Child Support, continued (4) Child support should be stopped beginning on the day of Day Month First, middle, & last initials of each child a. b. c. , 20 Year Birth year for: First, middle, & last initials of each child d. e. f. Birth year Check this box if you have attached a separate sheet listing additional children. B. Tax deduction for the children Check (1) or (2). (1) (2) There is no court order at this time on tax deductions. There is a court order at this time on tax deductions. If you check (2), check a or b: a. b. A court order currently says who gets the tax deduction for the child or children and it should stay the same. A court order currently says who gets the tax deduction for the child or children and it should be changed as set forth in the table below. Explain Show Lines Hide Lines First, middle, & last initials of each child i. ii. iii. iv. v. Birth year Person who should now claim child for tax deduction. Check this box if you have attached a separate sheet listing additional children. C. Health insurance or cash medical support Check (1) or (2) (1) (2) There is no court order at this time on who pays health insurance or cash medical support. There is a court order at this time on who pays health insurance or cash medical support. If you check (2), check a or b February 2014 Rule 17.300--Form 328 Page 3 of 6 American LegalNet, Inc. www.FormsWorkFlow.com Rule 17.300--Form 328: Settlement Agreement on an Application to Modify Child Support, continued a. b. A court order currently says who pays for health care expenses for the child or children and it should stay the same. A court order currently says who pays for health care expenses and it should be changed as set forth in the table below. Explain Show Lines Hide Lines First, middle, & last initials of each child i. ii. iii. iv. v. Birth year Person who should now provide health insurance or cash medical support Check this box if you are attaching a separate sheet listing additional children. (3) Applicant should pay % (4) The other parent should pay % expenses. (5) Applicant should pay % (6) The other parent should pay % of the out-of-pocket health care expenses. of the out-of-pocket health care in cash medical support. in cash medical support. D. Court Fees Check one (1) (2) (3) (4) All court fees should be paid by Applicant. All court fees should be paid by the other parent. The other parent and Applicant should pay one-half of the remaining court fees. The other parent and Applicant should pay one-half of the total court fees. Continued on next page February 2014 Rule 17.300--Form 328 Page 4 of 6 American LegalNet, Inc. www.FormsWorkFlow.com Rule 17.300--Form 328: Settlement Agreement on an Application to Modify Child Support, continued E. Attorney's Fees Check one (1) Applicant's attorney's fees a. b. c. Applicant has no attorney's fees. Applicant will pay Applicant's own attorney's fees. Applicant asks that the other party pay $ for Applicant's attorney's fees. (2) The other party's attorney's fees a. b. c. The other party has no attorney's fees. The other party will pay his or her own attorney's fees. The other party asks that Applicant pay $ fees. for the other party's attorney's 3. Necessary Documents We ask that the court require each of us to sign and deliver to each other any papers that may be needed