Fl 301 Request To Change Child Support Page 4

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15.
Other information: _____________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
E..
R
A
(You are the Applicant)
EQUEST OF THE
PPLICANT
16.
Applicant asks the court to (check all that apply):
a.
Raise the current child support payment.
b.
Lower the current child support payment.
c.
End the current child support payment.
d.
Set child support for the parent who does not have the children.
e.
Change who gets the tax deduction for the child or children.
f.
Change who pays for health care expenses for the child or children.
g.
Order that the other party pay the court fees.
h.
Order that the other party pay my attorney fees.
i.
Other request: ____________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
F..
A
H
TTORNEY
ELP
a.
An attorney did not help me prepare or fill in this paper.
(Check one)
b.
An attorney helped me prepare or fill in this paper.
(If you check b., you must fill in the following information):
_________________________________________ ___________________________________
(Name of attorney or organization, if any)
(Attorney’s P.I.N. # -- Ask the attorney)
_________________________________________________
_____________________ ________ ___________
(Business address of attorney or organization)
(City)
(State)
(Zip code)
(________)_______________________________
(________)__________________________
(Attorney’s phone number – required)
(Attorney’s fax number, if there is one)
G..
O
S
ATH AND
IGNATURE
I, ________________________________________, certify under penalty of perjury and pursuant to
the laws of the state of Iowa that the information I have provided in this Application is true and
correct.
(Your signature - Required):
______________________________________________________________
_________________________________
_______________________ ___________________
(Your mailing address – Required)
(City – Required)
(State, Zip code – Required)
(________)____________________
__________________________________________________________
(E-mail address - Optional)
(Fax number - Optional)
NOTICE TO APPLICANT: You must serve this form and an Original Notice (FL-304) on the other parties. If
the Child Support Recovery Unit (CSRU) is involved in this case (see item 6, above), you must also serve both
forms on the CSRU. See the instructions for forms
FL-301
and FL-304.
age
(9/6/07)
Form FL-301, p
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