Fill and Sign the Form 803

STATE OF VERMONT SUPERIOR COURT FAMILY DIVISION ______________ Unit Docket No.______________ Plaintiff Defendant Name D OB v . Name D OB NOTICE OF APPEARANCE and INTENT TO REPRESENT MYSELF I intend to represent myself and hereby enter my appearance with the court. No attorney will represent me in this case unless an attorney or I notify the court otherwise. I understand that IT IS MY RESPONSIBILITY TO: 1. Notify the Court in writing if I change my address or phone number; and 2. Send copies of any papers I file with the Court to the other party in this case. All court papers may be mailed to me by first class mail at the address listed below. M y Street Address My Mailing Address (if different): Town/City State Zip Town/City State Zip Phone Number (day) ( ) Phone Number (evening) ( ) E Mail Address MOTION TO MODIFY CHILD SUPPORT, MAINTENANCE SUPPLEMENT and/or SPOUSAL SUPPORT 1. I am the
Plaintiff
Defendant
Office of Child Support 2 . The other party is:
Plaintiff
Defendant 3 . I request that the court modify a child support order issued on ______________ Date of order



By this court




By another court: ____________________________________________. Name and address of Court 4. The children for whom support was ordered are: Name DOB Name DOB 5. I am the child(ren)’s: (check the applicable box)



Parent or guardian.



Support assignee.



Other (describe):__________________________________________ 6. The other party is the child(ren)’s (check the applicable box)



Parent or guardian.



Support assignee.



Other (describe):__________________________________________ 7. The obligation under the current order is. I am required to pay: (fill in all lines that apply)



$__________ per _____________ in Child Support.



$__________ per _____________ in Maintenance Supplement.



$__________ per _____________ in Spousal Support (Spousal Maintenance or Alimony). The other party is required to pay: (fill in all lines that apply)



$__________ per _____________ in Child Support.



$__________ per _____________ in Maintenance Supplement.



$__________ per _____________ in Spousal Support (Spousal Maintenance or Alimony). 8. I am requesting that the Court modify the child support and/or spousal support order by:



Increasing the monthly support amount.



Decreasing the monthly support amount 9. There has been a real, substantial and unanticipated change in circumstances because: (check all that apply)



My income has decreased.



My income has increased.



Other party’s income has increased.



Other party’s income has decreased.



I am unemployed.



Other party is unemployed.



The number of children subject to the order has changed.



It has been more than 3 years since child support was modified.



I am disabled because: _________________________________



The child support order was issued more than three years ago. 10. If child support were calculated today under the Child Support Guidelines, the existing monthly support amount would:



Increase by more than 10%.



Decrease by more than 10%



I do not know what the current support obligation would be under the Child S upport Guidelines. 11. In support of this motion, I have attached an Affidavit of Income and Expenses (Form 813A). REQUEST TO THE COURT I request that the court:
Modify the monthly child support obligation using the Child Support Guidelines.
Increase the child support obligation to $______________ per month.
Decrease the child support obligation to $______________ per month.
Increase maintenance supplement obligation $______________ per month.
Decrease maintenance supplement obligation $______________ per month.
Increase spousal support (alimony) obligation $______________ per month.
Decrease spousal support (alimony) obligation $______________ per month.
Grant any other relief this Court determines is appropriate. I hereby swear or affirm that the information above is true to the best of my knowledge and belief. Signed and sworn to before me: Signature Date Date Signature of Notary Public Expiration Date