Fill and Sign the Mississippi Child Support Form

IN THE CHANCERY COURT OF _________________ (Name of County), MISSISSIPPI _____________________ PETITIONER (Name of Petitioner) VS.CASE NUMBER _________ _____________________ RESPONDENT (Name of Respondent) Petition to Modify Divorce Decree by Terminating Child Support Comes now ___________________ (Name of Father) , and petitions the court for an order modifying the Decree filed in this action on ________________________ (Date of Divorce and/or Support Decree) , by terminating the child-support and medical expense payments presently being paid on behalf of my child _________________ (Name of Child) , (hereafter referred to as Child ) and in support of this Petition would show unto this Honorable Court the following matters and facts, to-wit: 1. ______________________ (Name of Child) , the minor child of the former marriage of Petitioner, is _____ (age) ; his date of birth being _________________ (date) . Child is not going to school and no longer lives at home in ___________________________ (Name of County and State ), with his Mother nor does he live with Petitioner. He recently moved to ______________________________ (Name of City and State )and lives on his on. WHEREFORE, PREMISES CONSIDERED, Petitioner prays that on hearing of this Petition, that this Honorable Court would enter an Order terminating the responsibility of Petitioner _______________________ (Name of Father) to pay child support, maintain a major medical insurance policy covering Child , and/or be responsible for or required to pay Child’s dental, hospital and/or prescription drugs. And if Petitioner has prayed for wrong and improper relief, then he prays for such other, further and general relief as he may be entitled to in the premises, and as in duty bound, he will ever pray. Respectfully submitted, _________________________ (Printed Name of Father) _________________________ (Signature of Father) Of Counsel: _________________________ (Name of Attorney) MSB No. __________ _____________________________ (Street Address or Post Office No.) _____________________________ (City, State, Zip Code) Phone: _________________ Fax: ___________________ STATE OF MISSISSIPPI COUNTY OF ______________ Personally appeared before me, the undersigned authority in and for the aforesaid jurisdiction, the within named ___________________ (Name of Father) , who, after having been first duly sworn, stated on oath that the matters and facts set forth in the above and foregoing Petition are true and correct as therein stated. ___________________________ (Printed Name of Father) ___________________________ (Signature of Father) SWORN to and subscribed before me, this the ________ day of ______________, _________. (date) ____________________________ Notary Public My Commission Expires: ________________________ CERTIFICATE OF SERVICE I, _________________________ (Name of Attorney for Father) , do hereby certify that a true and correct copy of the above and foregoing Petition to Modify Divorce Decree by Terminating Child Support has been served, via US mail, postage prepaid, to the following: ____________________________ (Name of Attorney for Mother) _________________________________ (Street Address or Post Office No.) ___________________________________ (City, State, Zip Code) This the _______________________ (date) . Respectfully submitted, ____________________________ (Name of Attorney) ____________________________ (Signature of Attorney)