Request For An Administrative Review Of The Support Order printable pdf download

Instructions for completing a JFS form 01849, Request for Administrative Review

of the Child Support Order and

Information regarding the Administrative Adjustment Review Process

You have made an inquiry to the Montgomery County Child Support Enforcement Agency about an

Administrative Adjustment Review of your order. This instruction and information sheet will assist you

in understanding this process.

Administrative Adjustment Review is a two-step process.

STEP 1

of the process is to complete the JFS 01849 that accompanies this. The 1849 is your

request for a Review. If it is not pre-printed, the top of the form will need to include your name and

address, the SETS Number, the Order Number (also called the Case Number), the names of the

support Obligor (support payer) and the support Obligee (support recipient).

If your order is dated 36 months (three years) prior to today’s date or older, you may have a Review

automatically and you should check the first block on the form.

If your order is dated less than 36 months prior, you may still be entitled to a Review if your situation

fits within one of the 14 criteria for a review within 36 months. Read these criteria carefully. You

must select the reason or reasons that best fits your situation. Please note that many of these

criteria require that you submit documentation to show that you are entitled to an early review.

Be sure to sign the 1849 and if you have a new, current address different from the address on the

top of the form, be sure to give us your new address. Only return the three pages of the 1849.

Keep this page to help guide you through the Review Process.

****Failure to provide supporting documentation or failure to sign the 1849 will probably result

in your request for an Administrative Adjustment Review being denied.****

****Do not send original documents to the CSEA. If you want copies, you should make them

before submitting them to us. ****

STEP 2

begins after a Review is scheduled. You will receive a document entitled Administrative

Adjustment Review Notification (JFS 07606) consisting of a 2-page letter and a 3-page questionnaire.

To get the best results from the Review process, you need to answer each question fully, even if the

answer is “$0.00” or “not applicable”, and provide as much supporting documentation as you have.

Documentation should be current and may include a statement from a child care provider about the

cost of child care for this child/ren; a statement from your employer about the cost of health insurance

for yourself only and the cost to add a family or the child/ren; a copy of your health insurance card

that names the child/ren as insured; birth certificates showing other child/ren born to you and living in

your home; current pay stubs; award letters from the Social Security Administration to include awards

of derivative benefits paid to your child/ren; award letters of workers or unemployment compensation;

if your are self-employed, in addition to complete tax returns for the past three years (1040 and all

schedules), include a current profit and loss statement; if you cannot work, a statement from a

physician that you are medically incapable of employment and a statement of when you can return to

work; and any other documentation to support the information contained in the Notification. Do not

send copies of your household bills or medical bills.

Return the Notification to the Agency on or before the date this Review is scheduled to be conducted.

****Be sure to sign the Notification. If you do not sign, it will not be accepted and the Review

will be dismissed.****

Request For An Administrative Review Of The Support Order