Fill and Sign the Circuit Court for Form

Page 1 of 2 Plaintiff Defendant I, , representing myself, state that: 1. I am the mother father or Relationship (for example, aunt, grandfather, guardian, etc.) Date of Birth Name Name Name Name Date of Birth Date of Birth Date of Birth MOTION TO MODIFY CHILD SUPPORT Date of Birth Name Name Date of Birth 2. On the Circuit Court for issued an order in case number , ordering to pay $ weekly biweekly monthly toward the support of the child(ren). Date City or County Name Amount (Check One) 3. Since that Order, circumstances have changed (check all that apply): CC-DR-006 (Rev. 07/2018) City, State, Zip TelephoneCity, State, Zip Telephone vs. Name Address NameCIRCUIT COURT FOR , MARYLAND Case No. City/County Located at Expenses for the child(ren) have substantially increased (explain): Expenses for the child(ren) have substantially decreased (explain): Father's Mother's income has substantially increased (explain): Father's Mother's income has substantially decreased (explain): Child(ren) is no longer entitled to receive child support because (check all that apply): the child died; the child is married; the child is emancipated; the child has graduated from or is no longer in high school; the child has reached the age of 19. Other changes have occurred (explain): Address I solemnly affirm under the penalties of perjury that the contents of the foregoing paper are true to the best of my knowledge, information, and belief. Date Signature FOR THESE REASONS, I request the court (check all that apply): Order an increase in child support. Order a decrease in child support. Order child support to be paid (check one): Through the local support enforcement agency. Directly to the person who has custody. Order to provide health insurance for the child(ren). Order any other appropriate relief.  Page 2 of 2 CC-DR-006 (Rev. 07/2018) Name X X IMPORTANT: YOU MUST COMPLETE A FINANCIAL STATEMENT WITH THIS FORM (Use Financial Statement (Child Support Guidelines) (CC-DR-030) or Financial Statement (General) (CC-DR-031).)