Fill and Sign the Petition to Change Court Order New Hampshire Judicial Form

SU -W W W-0 08 ( 4 /9 8) THE STATE OF NEW HAMPSHIRE SUPERIOR COURT County Case No. In the matter of PETITION FOR MODIFICATION 1.Your NameDate of BirthResidence AddressTown/CityCountyState2.Other Party’s NameDate of BirthResidence AddressTown/CityCountyState3.What t y p e o f c ase r e su lte d i n t h e p re se n t c o urt o rd er ( d iv orc e, p ate rn ity a ctio n, e tc .) ? A nd, w hat c o urt i s su ed t h e order?4.W hat p re se n t o rd ers d o y ou w an t t h e c o urt t o c h an ge? ( B e s p ecif ic a n d i n clu de d ate o f o rd er i f p ossib le .)5.W hat d o y ou w an t t h e n ew o rd ers t o s a y ?6.W hy s h ou ld t h e c o urt c h an ge t h e p re se n t o rd ers ? ( L is t e ach r e aso n s e p ara te ly .)7.P le ase c h eck o ne o f t h e f o llo w in g r e g ard in g p ublic a ssis ta n ce: SU -W W W-0 08 ( 4 /9 8)N o p ublic a ssis ta n ce (A FD C/T A NF) is n ow b ein g o r h as w ith in th e la st 6 m onth s b een p ro vid ed , n or is me d ic al a ssis ta n ce ( M ed ic aid ) p re se n tly b ein g p ro vid ed , f o r t h e m in or c h ild re n o f t h e p artie s.T he N .H . D ep artm en t o f H ealth a n d H um an S erv ic es is p ro vid in g o r h as p ro vid ed w ith in th e la st 6 m onth s pu b lic a ssis ta n ce (A FD C/T A NF) a n d/o r m ed ic al a ssis ta n ce (M ed ic aid ) fo r a n y m in or c h ild o f th e p artie s. If th is i s c h eck ed , y o u m ust m ail c o pie s o f t h is p etitio n a n d t h e p ers o nal d ata s h eet t o t h e D ep artm en t a t: OCS Legal Office6 Hazen Drive Concord, NH 033018.By filing this petition, you are asking that the court:A. Modify the present orders as listed above.B. Other (list):C. G ra n t a n y o th er o rd ers w hic h m ay b e a p pro pria te ._ __ ____ _______ ______________ _____ _________________________________________D ate Sig natu re ( S ig n i n f ro nt o f N ota ry P ublic o r J u stic e o f t h e P eace) _ _________________________________________A tto rn ey ( if a n y)___________________________________________A tto rn ey ’s A ddre ss S ta te o f N ew H am psh ir e_ __ ____ _______ _________ C oun ty T he p ers o n s ig nin g th is p etitio n a p peare d a n d s ig ned it b efo re m e a n d to ok o ath th at th e s ta te m en ts in th is p etitio n a re tr u e, to th e b est o f h is o r h er k now le d ge a n d b elie f, a n d t h at h e/s h e h as m aile d c o pie s o f t h e p etitio n a n d p ers o nal d ata s h eet t o O CS ( if re q u ir e d u nder p ara g ra p h 7 ). ________________________________________D ate Nota ry P ublic /J u stic e o f t h e P eace