motion to modify child support - minnesota...the court cannot modify an existing child support order...

Motion to Modify Child Support Expedited Process – Hmong CSX201 MN Rov kho tshiab 05/08 www.mncourts.gov/forms Nplooj 1 ntawm 32

MOTION TO MODIFY CHILD SUPPORT EXPEDITED PROCESS

NTAWV THOV HLOOV NQI YUG NOJ YUG HAUS RAU ME NYUAM COV KAUJ RUAM HAIS CEEV NROOJ

ATTENTION: CEEB TOOM:

STARTING JANUARY 1, 2007 NEW CHILD SUPPORT OBLIGATIONS WILL

BE CALCULATED UNDER THE INCOME SHARES GUIDELINES. PIB TXIJ LUB IB HLIS HNUB TIM 1, 2007 COV NQI YUG NOJ YUG HAUS

TSHIAB RAU ME NYUAM YUAV RAUG NTSUAM RAWS COV KEV CAI NTSUAS NYIAJ HLI SIB KOOM.

MODIFICATIONS TO EXISTING CHILD SUPPORT ORDERS SHALL NOT

BE GRANTED BY THE COURT UNTIL JANUARY 1, 2008 UNLESS CERTAIN LIMITED EXCEPTIONS APPLY.

LUB TSEV HAIS PLAUB YUAV TSIS TSO CAI HLOOV COV NQI YUG NOJ YUG HAUS RAU ME NYUAM UAS TWB YEEJ MUAJ TXOJ KEV YUAM LAWM KOM TXOG THAUM LUB IB HLIS HNUB TIM 1, 2008 TSHWJ YOG MUAJ LWM YAM

TSIM NYOG HLOOV.

The limited exceptions are as follows: Tej cov kev tsim nyog hloov yog muaj xws li cov nram no:

• A 20% change in the gross income of the obligor; • Tus them nqi yug noj yug haus qhov nyiaj hli hloov txog 20% feem pua; • A change in the number of joint children for whom the obligor is legally responsible and actually

supporting; • Kev hloov ntawm cov me nyuam uas tus them nqi yug noj yug haus muaj txoj cai xyuas thiab yeej

them nqi yug noj yug haus lawm; • Receipt of public assistance by a parent or caregiver of a child who is supported by an existing

child support order; • Tus niam txiv los yog tus saib xyuas tus me nyuam uas tam sim no yeej tau nqi yug noj yug haus

ho tau txais kev pab los ntawm tsoom fwv; • Additional work-related or education-related child care expenses of the obligee or a substantial

increase or decrease in existing work-related or education-related child care expenses; • Nuj nqis zov me nyuam muaj ntau ntxiv vim yog txoj hauj lwm los yog kev kawm ntawv los yog

cov nqi zov me nyuam nce ntau heev los yog nqis ntau heev vim yog txoj kev ua hauj lwm los yog kev kawm ntawv;

• A change in the availability of health care coverage or a substantial increase or decrease in the

http://www.mncourts.gov/ctforms


cost of existing health care coverage; • Ib yam hloov ntawm txoj kev pab them nqi kho mob los yog nqi kho hniav los yog nqi kho mob

nce ntau heev los nqis ntau heev; • The joint child becomes disabled; or • Tus me nyuam uas ob leeg muaj cai saib xyuas sib npaug cia li muaj kev tsis taus lawm; los yog

• Both parents agree to modification using the income shares guidelines • Ob tog niam txiv pom zoo hloov txoj kev yug noj yug haus rau me nyuam raws li cov kev cai

ntsuas nyiaj hli sib koom

THESE LIMITED EXCEPTIONS EXPIRE JANUARY 1, 2008 COV TSIM NYOG HLOOV YUAV TAG SIJ HAWM RAU LUB IB HLIS HNUB TIM 1, 2008

New terms: Joint child – is the dependent child of both parents in the support action. Nonjoint child – is the legal child of one, but not both parents in the support action. Cov ntsiab lus tshiab: Tus me nyuam ob leeg xyuas sib npaug zos (Joint child)– yog tus me nyuam uas ob leeg niam txiv muaj cai saib xyuas sib npaug. Tus me nyuam ob leeg tsis tau xyuas sib npaug(Nonjoint child) – yog tus me nyuam raws kev cai, tab sis tsis yog ob tug niam txiv muaj cai sib npaug saib xyuas tau. Note: The filing of this motion will require court fees to be paid. Court fees are nonrefundable even if the court dismisses. Check to be certain one of the limited exceptions applies before filing this motion. Faj seeb: Txoj kev ua tsab ntawv thov hloov no yuav tau them nqi hais plaub. Cov nqi no yuav tsis thim rov txawm tias lub tsev hais plaub tsis muab coj los hais. Xyuas cov kev hloov tsim nyog kom paub tseeb tias muaj ib yam tsim nyog tiag ua ntej thov hloov.



EXPEDITED CHILD SUPPORT PROCESS MOTION TO MODIFY CHILD SUPPORT

COV KAUJ RUAM HAIS CEEV NROOJ TXOG NQI YUG NOJ YUG HAUS RAU ME NYUAM

TSAB NTAWV THOV HLOOV NQI YUG NOJ YUG HAUS RAU ME NYUAM

USE CHILD SUPPORT FORMS FOR EXPEDITED PROCESS ONLY IF: SIV COV NTAWV THOV HAIS CEEV NROOJ TXOG NQI YUG NOJ YUG HAUS RAU ME

NYUAM YOG TIAS:

(1) There is already an existing court order setting or reserving child support; (1) Tsev hais plaub twb yeej yuam kom them los yog twb yeej pib txiav nyiaj hlis tseg yug noj yug haus rau me nyuam lawm; (2) You are asking the court to change child support, medical support, and/or child care, and (2) Koj xav hais kom lub tsev hais plaub hloov cov nqi yug noj yug haus rau me nyuam, kev pab them nqi kho mob thiab/los yog nyiaj zov me nyuam, thiab (3) You and/or the other party receive public assistance or child support enforcement services

(Title IV-D services) from the local child support enforcement agency. (3) Koj thiab/los yog tog txij nkawm tod tau nyiaj pab los ntawm tsoom fwv los yog tau kev pab tswj kom them nqi yug noj yug haus rau me nyuam (Title IV-D cov kev pab) los ntawm ib lub chaw khiav dej num tswj xyuas kev yug noj yug haus rau me nyuam.

You cannot use child support forms for the expedited process to change spousal maintenance,

parenting time, (visitation) or custody Koj siv tsis tau cov ntawv thov hais ceev nrooj txog hloov nqi yug noj yug haus rau txij nkawm, sij

hawm saib me nyuam, (kev sib xyuas) los yog kev tau me nyuam THE COURT CANNOT MODIFY AN EXISTING CHILD SUPPORT ORDER USING THE INCOME SHARES GUIDELINES UNLESS AN EXCEPTION UNDER MINN. STAT. § 518A.39 APPLIES. A CHANGE IN THE LAW ALONE IS NOT A REASON FOR THE COURT TO CHANGE YOUR ORDER. CONTACT AN ATTORNEY OR OTHER LEGAL SERVICES PROVIDER FOR MORE INFORMATION. LUB TSEV HAIS PLAUB SIV TSIS TAU COV KEV CAI NTSUAS NYIAJ HLI SIB KOOM LOS HLOOV TXOJ KEV YUAM YUG NOJ YUG HAUS RAU ME NYUAM UAS TWB YEEJ MUAJ LOS LAWM TSHWJ TSIS YOG MUAJ LWM YAM TSIM NYOG RAWS LI MINNESOTA TXOJ CAI § 518A.39. TXOJ CAI XWB TSIS YOG IB TXOJ KEV RAU LUB TSEV HAIS PLAUB HLOOV KOJ TXOJ KEV YUAM THEM. HU RAU IB TUG KWS LIJ CHOJ LOS YOG LWM COV CHAW PAB KEV CAI LIJ CHOJ KOM PAUB MEEJ NTXIV.

• Court personnel, the county attorney's office, and the child support enforcement agency cannot

help you fill out these forms. • Cov neeg ua hauj lwm hauv lub tsev hais plaub, hauv cheeb nroog kws lij choj chaw khiav dej num,

thiab hauv lub chaw khiav dej num tswj kev yug noj yug haus rau me nyuam pab tsis tau koj ua cov ntaub ntawv no.

• You may need to speak with a lawyer if you do not know how to answer the questions on the forms.

• Koj yuav tau nrog ib tug kws lij choj tham yog koj tsis paub teb tej cov nqe lus nug twg hauv cov ntaub ntawv no.

• You must fill out all forms listed in these instructions (the motion, the affidavit in support of motion, the financial affidavit for child support, the affidavit of service, Form 11.1 (if necessary), and Form 11.2).

• Koj yuav tsum ua kom tiav txhua daim ntawv uas sau muaj nyob ntawm cov lus qhia no (tsab ntawv thov, tsab ntawv pov thawj txhawb tsab ntawv thov, ntawv pov thawj nqi yug noj yug haus



rau me nyuam, ntawv pov thawj xa ntaub ntawv, Tsab Ntawv 11.1 (yog tias tsim nyog), thiab Tsab Ntawv 11.2).

• Type your answers or print neatly using dark ink. • Xuas tshuab ntaus koj cov lus teb los yog sau ib tug ntawv zus kom dub dub zoo zoo.



GENERAL INFORMATION NCAUJ LUS QHIA

When filling out the forms be as accurate and as detailed as possible. This will help the court to clearly understand your circumstances. The hearing will be held before a child support magistrate or a district court judge. During the year of 2007, a court order for child support may only be changed if one of the following circumstances apply: • There has been at least a 20% change in the gross income of the obligor; • A change in the number of joint children for whom the obligor is legally responsible and actually

supporting; • A party is receiving some form of public assistance; • There are additional work-related or education-related child care expenses of the obligee or a

substantial increase or decrease in existing work-related or education-related child care expenses; • There has been a change in the availability of health care coverage or a substantial increase or

decrease in the cost of existing health care coverage; • The joint child has become disabled; or • Both parents agree to modify the existing child support order using the income shares guidelines. Thaum sau cov ntaub ntawv, sau kom raug thiab muaj paus muaj ntsis txaus txaus. Qhov no yuav pab kom lub tsev hais plaub to taub koj cov teeb meem zoo. Yuav mus sib hais rooj plaub no ntawm ib tug kws txiav txim kev yug noj yug haus rau me nyuam los yog ib tug kws txiav txim plaub ntug hauv cheeb tsam. Rau xyoo 2007, tsuas hloov tau txoj kev yuam them nqi yug noj yug haus rau me nyuam yog tias muaj ib yam tsim nyog nram no tshwm sim xwb: • Tus them nqi yug noj yug haus qhov nyiaj hli hloov txog 20% feem pua; • Kev hloov ntawm cov me nyuam uas tus them nqi yug noj yug haus muaj txoj cai xyuas thiab yeej

them nqi yug noj yug haus lawm; • Tus niam txiv los yog tus saib xyuas tus me nyuam uas tam sim no yeej tau nqi yug noj yug haus

ho tau txais kev pab los ntawm tsoom fwv; • Nuj nqis zov me nyuam muaj ntau ntxiv vim yog txoj hauj lwm los yog kev kawm ntawv los yog

cov nqi zov me nyuam nce ntau heev los yog nqis ntau heev vim yog txoj kev ua hauj lwm los yog kev kawm ntawv;

• Ib yam hloov ntawm txoj kev pab them nqi kho mob los yog nqi kho hniav los yog nqi kho mob nce ntau heev los nqis ntau heev;

• Tus me nyuam uas ob leeg muaj cai saib xyuas sib npaug cia li muaj kev tsis taus lawm; los yog • Ob tog niam txiv pom zoo hloov txoj kev yug noj yug haus rau me nyuam raws li cov kev cai

ntsuas nyiaj hli sib koom.

If you are now ordered to pay child support and are requesting support to be suspended because the child(ren) is/are living with you, you must provide proof. Examples of things that you can file with the court as proof are: • a signed and notarized statement from the other party stating the child(ren) has changed residence • school records • day care records or medical records Yog tias tam sim no koj yeej raug yuam them nqi yug noj yug haus rau me nyuam es koj xav thov kom tsis txhob yuam koj them nqi yug noj yug haus rau me nyuam lawm vim yog tus (cov) me nyuam yeej nrog koj nyob, koj yuav tsum muaj pov thawj. Tej qauv uas koj xa tau rau lub tsev hais plaub ua pov thawj yog: • tsab ntawv kos npe thiab muaj tus neeg muaj cai ua pov thawj (notary) kos npe lees paub tias tsab

ntawv yog tog neeg tod teev qhia tias tus (cov) me nyuam hloov chaw nyob lawm • cov ntaub ntawv hauv tsev kawm ntawv • ntaub ntawv hauv chaw zov me nyuam los yog ntaub ntawv them nqi kho mob



INSTRUCTIONS COV NCAUJ LUS QHIA

The information to fill in the boxes and blanks at the top of the form can be found at the top of your current child support order or your divorce or paternity decree, including: • The county where your case is located (which may be different from the county where you live). • The number of the judicial district. • The court file number. • The name of the Petitioner/Plaintiff. • The name of the Respondent/Defendant. Cov lus uas yuav tau sau rau cov chaw thiab rau cov kab tsis muaj dab tsi saum toj ntawm tsab ntawv no muaj nyob rau hauv koj tsab ntawv yuam them nqi yug noj yug haus rau me nyuam los yog nyob rau ntawm koj tsab ntawv sib nrauj los yog tsab ntawv lees tias yog leej txiv, nrog rau lwm qhov chaw xws li: • Lub cheeb nroog uas koj rooj plaub teev nyob rau (tej zaum yuav txawv koj qhov chaw nyob). • Tus zauv cim tsab ntawv rooj plaub. • Lub tsev hais plaub tus zauv teev cim rooj plaub. • Tus Neeg Thov Kev Sib Hais/Neeg Foob lub npe. • Tus Neeg Teb Lus/Neeg Raug Liam lub npe. If you are the Petitioner/Plaintiff in the current order or decree you will be the Petitioner/Plaintiff in this motion. If you are the Respondent/Defendant in the current order or decree you will be the Respondent/Defendant in this motion. Yog tias koj yog tus Neeg Thov Kev Sib Hais/Neeg Foob rau txoj kev yuam los yog kev tswj tam sim no ces koj yog tus Neeg Thov Kev Sib Hais/Neeg Foob hauv tsab ntawv thov no. Yog koj yog tus Neeg Teb Lus/Neeg Raug Liam rau txoj kev yuam los yog kev tswj tam sim no ces koj yog tus Neeg Teb Lus/Neeg Raug Liam rau tsab ntawv thov hloov no.

Fill in the name and last known address of the other party and the name and address of the county attorney where your case is located. DO NOT fill in the date, time, and location of the hearing. You will fill in this information as part of Step 4 below. Sau tus neeg tog tod lub npe thiab qhov chaw nyob uas paub zaum kawg kiag thiab lub npe thiab qhov chaw nyob ntawm cheeb nroog tus kws lij choj uas koj rooj plaub ntug teev nrog. TSIS TXHOB sau lub hnub, sij hawm thiab qhov chaw mus sib hais. Koj yuav sau cov lus no rau Kauj Ruam 4 nram qab no. In the area marked “Motion”, check off only the boxes that list the changes you are asking the court to make -- you do not need to check off every box. Only the choices listed can be considered by the court in 2007. You may check off as many changes as you wish, but it will be up to the court to decide what changes will actually be ordered. Ntawm qhov chaw sau tias “Tsab Ntawv Thov”, kos cov uas koj xav thov lub tsev hais plaub hloov – tsis tag koj yuav kos txhua yam. Lub tsev hais plaub tsuas xam cov teev muaj no rau xyoo 2007. Koj

STEP 1 FILL OUT THE “NOTICE OF MOTION AND MOTION

TO MODIFY CHILD SUPPORT” FORM KAUJ RUAM 1

SAU “TSAB NTAWV THOV THIAB KEV THOV HLOOV NQI YUG NOJ YUG HAUS RAU ME NYUAM”



kos tau ntau yam npaum li ntau tau, tiam sis nws yog lub tsev hais plaub ua tus txiav txim seb qhov kev hloov twg thiaj li yog qhov yuav yuam tau. Fill in the name and phone number of the person to contact to settle this matter. Sau lub npe thiab xov tooj ntawm tus neeg hu mus sib tham kom haum txog rooj plaub ntug no.

STEP 2 FILL OUT THE “AFFIDAVIT IN SUPPORT OF MOTION TO MODIFY CHILD

SUPPORT” AND THE “FINANCIAL AFFIDAVIT FOR CHILD SUPPORT” FORM KAUJ RUAM 2

SAU “TSAB NTAWV POV THAWJ TXHAWB TSAB NTAWV THOV HLOOV NQI YUG NOJ YUG HAUS RAU ME NYUAM” THIAB “TSAB NTAWV POV THAWJ NQI YUG

NOJ YUG HAUS RAU ME NYUAM” Fill in the top of the form the same way you did on your “Notice of Motion and Motion” form. Sau saum toj kom zoo tib yam li koj sau rau koj “Tsab Ntawv Thov Thiab Kev Thov”. Fill in the information on the “Affidavit in Support of Motion”. Sau cov lus rau “Tsab Ntawv Pov Thawj Txhawb Tsab Ntawv Thov”. Fill in the information on the “Financial Affidavit for Child Support”. Sau cov lus rau “Tsab Ntawv Pov Thawj Nqi Yug Noj Yug Haus Rau Me Nyuam”. ONLY DATE AND SIGN YOUR “AFFIDAVIT IN SUPPORT OF MOTION” AND YOUR “FINANCIAL AFFIDAVIT FOR CHILD SUPPORT” FORMS WHEN YOU ARE IN FRONT OF A NOTARY PUBLIC OR THE COURT CLERK. MAKE SURE TO BRING PICTURE IDENTIFICATION TO SHOW TO THE NOTARY PUBLIC OR CLERK. A Notary Public can usually be found at a bank and sometimes at the courthouse. TSUAS TEEV HNUB THIAB KOS NPE RAU KOJ “TSAB NTAWV POV THAWJ TXHAWB TSAB NTAWV THOV” THIAB “TSAB NTAWV POV THAWJ NQI YUG NOJ YUG HAUS RAU ME NYUAM” THAUM MUAJ TUS NEEG POV THAWJ LOS YOG KWS CEEV XWM NTAUB NTAWV NYOB NROG KOJ UA POV THAWJ POM KOJ KOS. NCO NTSOOV NQA DUAB CIM KOJ TUS KHEEJ QHIA RAU TUS NEEG MUAJ CAI NIAS NPE LOS YOG KWS CEEV XWM NTAUB NTAWV. Tus Neeg Muaj Cai Nias Npe muaj nyob rau hauv tej txhab cia nyiaj thiab tej thaum hauv lub tsev hais plaub. Gather documents that support your reasons why the child support order should be changed. Examples of these documents include the following: • Proof of your gross income (recent pay stubs, employer statements, or statements of receipts and

expenses if you are self-employed. Other documentation may include W-2 forms or copies of your tax returns for the most recent year

• Proof of unemployment/disability (lay-off notice, doctor’s statement, etc.) • Verification for status of unemployment compensation claim or worker’s compensation claim • Verification of receipt and amount of social security income • Verification of child care expenses • Verification of the cost of health care and/or dental insurance coverage Npaj cov ntaub ntawv txhawb seb ua li cas thiaj yuav hloov txoj kev yuam yug noj yug haus rau me nyuam. Cov qauv ntaub ntawv txhawb muaj xws li cov nram no: • Ntawv pov thawj qhia koj cov nyiaj hlis (daim tw nyiaj hlis them, cov nqe lus lub chaw hauj lwm



sau qhia, los yog cov ntawv pov thawj txais nyiaj thiab them nuj nqis yog koj ua hauj lwm rov rau koj tus kheej. Lwm cov ntaub ntawv kuj yog cov ntawv teev nyiaj xyoo W-2 los yog luam koj cov ntaub ntawv ua se rau xyoo tag los

• Ntawv pov thawj koj txoj kev poob hauj lwm/kev tsis taus (ntawv sau rho tawm hauj lwm, kws kho mob tsab ntawv, thiab tej li ntawd) • Pov thawj qhia seb poob hauj lwm li cas lawm los yog pov thawj tau nyiaj poob hauj lwm • Pov thawj txais tau nyiaj npaum li cas los ntawm cov nyiaj laus • Pov thawj them nqi zov me nyuam • Pov thawj them pab nqi kho mob thiab/los yog nqi pab them kho hniav

STEP 3 FILL OUT THE “SEALED FINANCIAL SOURCE DOCUMENTS” FORM 11.2.

FILL OUT “CONFIDENTIAL INFORMATION ” FORM 11.1 WHEN NECESSARY KAUJ RUAM 3

SAU KOM TIAV “COV NTAWV QHIA NYIAJ TXIAG UAS KAW CIA LAWM” TSAB NTAWV 11.2.

SAU KOM TIAV “NCAUJ LUS NPOG ZOO CIA ” TSAB NTAWV 11.1 THAUM TSIM NYOG

Certain information is considered confidential and not available to the public. To keep this information private and not available to the public, you must attach Form 11.2 to certain documents that contain confidential information. See Rule 11 of the Minnesota General Rules of Practice for more information. One Form 11.2 can be used for all documents containing confidential information. Examples of documents that have confidential information include: • Paycheck stubs, employer statements, W-2 forms, or business income and business expenses • Copies of your tax returns and schedules • Bank statements • Credit card statements • Check registers Tej cov ntaub ntawv yuav tau npog zoo cia thiab qhib tsis tau rau pej xeem pom. Kom npog zoo cia tau thiab tsis pub rau pej xeem pom koj yuav tsum tau ua Tsab Ntawv 11.2 rhais nrog rau cov ntaub ntawv uas yuav tau npog zoo cia. Saib Txoj Cai 11 hauv Minnesota Cov Kev Cai Khiav Dej Num rau cov ntaub ntawv yuav tau npog zoo cia. Cov ntaub ntawv ua qauv uas yuav tau npog zoo cia muaj xws li: • Tw nyiaj, cov nqe lus lub chaw hauj lwm sau qhia, cov ntawv teev nyiaj xyoo W-2, los yog cov

nyiaj ua lag luam tau thiab nqi them lag luam • Luam koj cov ntawv ua se thiab cov ntaub ntawv teev nuj nqi rhais nrog • Cov ntawv teev qhia nyiaj txiag hauv txhab cia nyiaj • Cov ntawv teev qhia nyiaj txiag rau cov credit card • Ntaub ntawv teev qhia sau nyiaj tawm To protect your privacy, the other parties, and your child(ren), all social security numbers, employer identification numbers, and financial account numbers listed on papers you file with the court must be blackened out (crossed out) completely. Failure to do this means these numbers could be available to the general public and you could be charged court costs for the failure to keep your and the other party’s social security number, employer identification number, and/or financial account numbers private. Use Form 11.1 to list any of these confidential numbers and file Form 11.1 with the court. If these numbers are already on file with the court, you do not need to submit another Form 11.1.



Kom tiv thaiv tau koj li ntiag tug, lwm cov neeg thiab koj tus (cov) me nyuam, tag nrho cov zauv social security, cov zauv cim lub hauj lwm, thiab cov txooj xwm hauv txhab cia nyiaj uas sau muaj nyob rau hauv ntawv uas koj muab xa tuaj rau lub tsev hais plaub yuav tsum muab kos kom dub dub (kos tawm) kom txhob pom kiag li. Yog tsis muab kos tawm li no ces pej xeem yuav pom tau cov zauv no thiab tej zaum koj tseem yuav raug them nqi rau txoj kev tsis ceev faj tiv thaiv npog zoo cia koj thiab lwm cov neeg cov zauv social security, zauv cim lub hauj lwm, thiab/los yog cov txooj xwm zauv hauv txhab cia nyiaj. Siv Tsab Ntawv 11.1 los sau cov zauv uas yuav tsum tau npog zoo cia no thiab sau Tsab Ntawv 11.1 no xa mus rau lub tsev hais plaub. Yog cov zauv no twb yeej muaj nyob hauv tsev hais plaub lawm, koj tsis tag xa dua ib Tsab Ntawv 11.1 ntxiv.

STEP 4

OBTAIN A HEARING DATE, TIME, AND LOCATION FROM COURT ADMINISTRATION

KAUJ RUAM 4 HAIS KOM TAU HNUB MUS SIB HAIS,

SIJ HAWM THIAB QHOV CHAW YUAV MUS SIB HAIS NTAWM TUS NEEG KHIAV DEJ NUM HAUV TSEV HAIS PLAUB

• Contact the court administrator's office in the county where your case is located. • Hu rau tus neeg khiav dej num rau tsev hais plaub lub chaw ua hauj lwm hauv lub nroog uas koj

rooj plaub ntug teev yuav mus hais.

• Ask for a hearing date, time, location of the hearing, and the name of the child support magistrate or judge who will hear the matter. The hearing date must be at least 23 days away from the date the motion papers are mailed to the other party and the county attorney’s office. Count the day after it is mailed as Day 1.

• Hais kom tau hnub yuav mus sib hais, sij hawm thiab qhov chaw yuav mus sib hais thiab tau tus kws pab txiav txim kev yug noj yug haus rau me nyuam los yog tus kws txiav txim plaub ntug kom nrog hnov cov lus. Hnub yuav mus sib hais yuav tsum ncua kom ntev txog 23 hnub tom qab hnub xa cov ntaub ntawv thov mus rau tog sab tod thiab mus rau cheeb nroog tus kws lij choj lub chaw khiav dej num. Suav hnub tom qab hnub xa ua Hnub 1.

• Fill in the date, time, and location of the hearing on the “Notice of Motion and Motion” form. • Sau lub hnub, sij hawm thiab qhov chaw yuav mus sib hais rau “Tsab Ntawv Thov Thiab Kev

Thov”.

STEP 5 MAKE COPIES OF FORMS

KAUJ RUAM 5 LUAM COV NTAUB NTAWV

• Make three copies of the completed “Notice of Motion and Motion” form, three copies of your

“Affidavit in Support of Motion” form, three copies of your “Financial Affidavit for Child Support”, and three copies of all other documents that support your motion (e.g. paycheck stubs, tax returns, proof of expenses). Do not make copies of Forms 11.2 or 11.1, unless you want copies for your own records.

• Luam peb daim “Tsab Ntawv Thov Thiab Kev Thov”, peb daim “



Tsab Ntawv Pov Thawj Txhawb Ntawv Thov”, peb daim “Tsab Ntawv Pov Thawj Nqi Yug Noj Yug Rau Me Nyuam” uas sau tiav lawm, thiab luam tag nrho lwm cov ntaub ntawv uas rhais txhawb koj txoj kev thov no (xws li tw nyiaj, ntaub ntawv ua se, ntawv pov thawj cov nuj nqis) kom muaj peb daim. Tsis txhob luam ntau daim Tsab Ntawv 11.2 los yog 11.1, tshwj tsis yog koj xav luam rau koj khaws cia.

• Keep one copy of each form and one copy of all supporting documents for yourself (remember to

bring your copies with you to court on the day of your hearing). • Luam cov ntaub ntawv rau koj khaws cia ib yam ib daim tag nrho (nco ntsoov nqa koj cov thaum

koj tuaj hauv tsev hais plaub rau hnub koj sib hais).

STEP 6 HAVE COPIES OF THE FORMS AND SUPPORTING DOCUMENTS

SERVED ON THE OTHER PARTY AND COUNTY ATTORNEY’S OFFICE KAUJ RUAM 6

YUAV TSUM XA COV NTAWV THIAB COV NTAWV TXHAWB UAS XA TAG RAU TOG TOD THIAB XA RAU

CHEEB NROOG TUS KWS LIJ CHOJ QHOV CHAW KHIAV DEJ NUM You must arrange for the other party and the county attorney’s office to receive complete copies of all forms and supporting documents you have prepared for the hearing. This is called “service of process.” A copy of the motion, affidavits, and any supporting documents must be served upon all parties, either personally or by mail. If a party is represented by an attorney, the forms and supporting documents must be served on the attorney instead of the party. Koj yuav tsum xyuas kom tog neeg tod thiab lub cheeb nroog tus kws lij choj lub chaw khiav dej num txais tau tag nrho cov ntaub ntawv thiab cov ntawv pov thawj uas koj npaj coj tuaj mus sib hais. Txoj kev xyuas no yog hu ua “kev xa ntawv.” Luam tsab ntawv thov, cov ntawv pov thawj, thiab tej ntaub ntawv txhawb nqa kiag mus los yog xa mus rau tag nrho cov tog neeg. Yog tog neeg twg muaj kws lij choj sawv cev rau, yuav tsum xav cov ntaub ntawv mus rau tus kws lij choj tsis yog rau tus neeg ntawd. Personal service: forms and supporting documents are hand delivered to the other party personally or by leaving them at that party’s place of residence with some person who is of suitable age or discretion who also lives at the same residence. Forms and supporting documents must be hand delivered at least 20 days before the hearing date. Kev nqa kiag mus rau: nqa kiag cov ntaub ntawv thiab cov ntawv txhawb mus cev kiag rau tog neeg tod los yog nqa mus cev rau ib tug neeg nyob hauv tog neeg ntawd lub tsev uas kom muaj hnub nyoog loj txaus los yog neeg paub tab txaus. Yuav tsum nqa cov ntaub ntawv thiab cov ntawv txhawb mus rau tog neeg ntawd tsawg kawg yog 20 hnub ua ntej hnub yuav mus sib hais. Mail service: forms and supporting documents are mailed by first class U.S. mail to the other party and the county attorney’s office at least 23 days before the hearing date. Kev xa ntawv: Xa cov ntaub ntawv thiab cov ntawv pov thawj raws qib Ib hauv Teb Chaws Asmeskas mus rau tog neeg tod thiab lub cheeb nroog tus kws lij choj lub chaw khiav dej num tsawg kawg yog 23 hnub ua ntej hnub yuav mus sib hais. If your forms and supporting documents are not timely served upon the other party (or his/her attorney) and the county attorney’s office your motion may not be heard by the court. Yog koj tsis xa cov ntawv thiab cov ntawv txhawb mus rau tog neeg tod kom raws sij hawm (los yog rau nws tus kws lij choj) thiab lub cheeb nroog tus kws lij choj qhov chaw khiav dej num raws sij



hawm ces tej zaum lub tsev hais plaub yuav tsis muab koj tsab ntawv thov coj los hais. NOTE! YOU CANNOT HAND DELIVER OR MAIL THE DOCUMENTS YOURSELF.

YOU MUST HAVE SOMEONE ELSE OVER THE AGE OF 18 WHO IS NOT A PARTY TO THE CASE HAND DELIVER OR MAIL THE DOCUMENTS FOR YOU.

FAJ SEEB! KOJ NQA TSIS TAU LOS YOG XA TSIS TAU COV NTAUB NTAWV KOJ TUS KHEEJ. KOJ YUAV TSUM MUAB RAU LWM TUS NEEG MUAJ HNUB NYOOG TSHAJ 18 XYOO UAS TSIS MUAJ FEEM XYUAM NROG ROOJ PLAUB NO NQA KIAG MUS LOS YOG XA MUS.

STEP 7 COMPLETE THE “AFFIDAVIT OF SERVICE” FORM

KAUJ RUAM 7 SAU KOM TIAV TSAB “NTAWV UA POV THAWJ XA”

The person who hand delivers or mails the forms and supporting documents must fill out an “Affidavit of Service” form for each party served. Tus neeg uas nqa los yog xa cov ntaub ntawv thiab cov ntawv txhawb mus yuav tsum sau xa tsab ntawv “Ntawv Ua Pov Thawj Xa” mus rau txhua tog neeg. NOTE! THE PERSON WHO HAND DELIVERS OR MAILS THE FORMS AND

SUPPORTING DOCUMENTS MUST SIGN THE “AFFIDAVIT OF SERVICE” IN FRONT OF A NOTARY PUBLIC OR A COURT CLERK. MAKE SURE THE PERSON BRINGS PICTURE IDENTIFICATION TO SHOW TO THE NOTARY PUBLIC OR CLERK.

FAJ SEEB! TUS NEEG UAS NQA LOS YOG XA COV TSAB NTAWV THIAB COV NTAUB NTAWV TXHAWB YUAV TSUM KOS NPE RAU TSAB “NTAWV UA POV THAWJ XA” TIM NTSEJ MUAG NTAWM IB TUG NEEG MUAJ CAI NIAS NPE LOS YOG IB TUG KWS CEEV XWM NTAUB NTAWV HAUV TSEV HAIS PLAUB. XYUAS KOM TUS NEEG NO NQA NTAUB NTAWV CIM TUS KHEEJ MUS QHIA RAU TUS NEEG MUAJ CAI NIAS NPE LOS YOG TUS KWS CEEV XWM NTAUB NTAWV HAUV TSEV HAIS PLAUB.

STEP 8 FILE THE FORMS AND SUPPORTING DOCUMENTS WITH COURT

ADMINISTRATION AND PAY ANY REQUIRED COURT FEE KAUJ RUAM 8

MUAB COV TSAB NTAWV THIAB COV NTAWV TXHAWB MUS RAU LUB CHAW KHIAV DEJ NUM TSWJ TSEV HAIS PLAUB NTUG THIAB

THEM TEJ NQI HAIS PLAUB TSIM NYOG File the original forms and supporting documents with court administration in the county where your case is located as soon as practical but no later than 5 days before the scheduled hearing. Muab cov tsab ntawv tseem thiab cov ntawv txhawb tseem rau lub chaw khiav dej num tswj tsev hais plaub hauv lub cheeb nroog uas yuav mus hais koj cov plaub ntug rau kom sai li sai tiam sis tsis pub lig tshaj 5 hnub ua ntej hnub teem mus sib hais.



• The original “Notice of Motion and Motion to Modify Child Support” • “Tsab Ntawv Thov thiab Kev Thov Hloov Nqi Yug Noj Yug Haus Rau Me Nyuam” tseem • The original “Affidavit in Support of Motion to Modify Child Support” • “Tsab Ntawv Pov Thawj Txhawb Kev Thov Hloov Nqi Yug Noj Yug haus Rau Me Nyuam” tseem • The original “Financial Affidavit for Child Support” • “Tsab Ntawv Pov Thawj Nqi Yug Noj Yug Haus Rau Me Nyuam” tseem • The original “Affidavit of Service” • “Tsab Ntawv Pov Thawj Xa” tseem Filing by facsimile: Any paper may be filed with the court by facsimile (fax). If documents are filed by fax, the original documents must not be filed, but you must keep all original documents and make them available to the court or any party upon request. Xa raws xov tooj hluav taws xob: Xa rau txhua tsab ntawv raws hauv xov tooj fax mus rau lub tsev hais plaub. Yog twb xa raws xov tooj fax tag lawm ces tsis txhob xa cov tseem tuaj ntxiv lawm, tab sis khaws tag nrho cov tseem cia thiab muab rau lub tsev hais plaub los yog lwm tog neeg thaum twg nug txog. Form 11.2 Tsab Ntawv 11.2 You must file copies of all supporting documents (such pay stubs, employer statements, tax returns, verification of medical/dental insurance costs or expenses, child care expenses, disability payments) and attach one Form 11.2 to supporting documents that contain confidential information (see Step 3). Be certain to blacken out all social security numbers and financial account numbers that appear on any other document not under cover of Form 11.2. Check your documents to make sure all blanks are filled in, especially on the Affidavit of Service and the motion. All papers served must be identical copies of the original forms and supporting documents filed with the court. Koj yuav tsum luam xa tag nrho cov ntaub ntawv txhawb (xws li tw nyiaj, cov nqe lus lub chaw hauj lwm sau qhia, nqi them kho mob/kho hniav, nqi them zov me nyuam, them kev tsis taus) thiab rhais ib Tsab Ntawv 11.2 nrog cov ntaub ntawv txhawb uas muaj qee yam yuav tau npog zoo cia (saib Kauj Ruam 3). Muab kos tawm tej zauv social security thiab txooj xwm zauv hauv tej txhab cia nyiaj uas tshwm pom hauv ntaub ntawv uas tsis yog tshwm hauv Tsab Ntawv 11.2. Xyuas koj cov ntaub ntawv kom txhua kab muaj lus sau rau, xws li tsab Ntawv Pov Thawj Xa thiab tsab ntawv thov. Tag nrho cov ntaub ntawv xa mus rau hauv lub tsev hais plaub yuav tsum yog cov zoo tib yam li cov tseem. Court Fees Tsev Hais Plaub Cov Nqi Pay the $55 modification fee at the time you file this motion. If you did not pay an initial filing fee when this case first began, you will be asked by court administration to pay the initial filing fee and library fees as well as the $55 modification fee before your motion can be heard by the court. Court administration will be able to tell you if you have paid the initial filing fee. Them tus nqi hloov ntaub ntawv $55 thaum lub sij hawm koj ua tsab thov kev sib hais no. Yog koj tsis tau them thawj qhov nqi thaum rooj plaub ntug no pib, lub chaw tswj tsev hais plaub yuav hais kom koj them tus nqi pib ua ntaub ntawv thiab nqi tsev qiv ntawv nrog rau tus nqi hloov koj cov ntaub ntawv $55 ua ntej yuav muab koj rooj plaub coj los hais hauv tsev hais plaub. Lub chaw tswj tsev hais plaub yuav qhia rau koj seb koj twb them tag tus nqi thaum civ thawj los tsis tau. If you cannot afford to pay the fee, you may qualify to have the filing fee and motion fee waived by the court. You need to fill out an In Forma Pauperis application (available from court administration or



the court website) and file it with court administration. Your application will be reviewed by a child support magistrate or judge who will decide whether you must pay the fee. If the magistrate or judge does not sign an order that waives the fee, you must be prepared to pay the fee. Yog koj them tsis taus tus nqi, tej zaum lub tsev hais plaub yuav zam tus nqi ua ntaub ntawv thiab tus nqi hais plaub. Koj yuav tau sau tsab ntawv thov (Zam Nqi Hais Plaub) In Forma Pauperis (lub chaw tswj tsev hais plaub los yog hauv lub tsev hais plaub qhov website muaj tsab ntawv no) thiab muab sau cia rau lub chaw tswj tsev hais plaub. Ib tug kws pab txiav txim kev yug noj yug haus rau me nyuam los yog tus kws txiav txim plaub ntug yuav xyuas koj tsab ntawv thov thiab mam li txiav txim seb koj puas raug them qhov nqi. Yog tus kws txiav txim kev yug noj yug haus rau me nyuam los yog tus kws txiav txim plaub ntug tsis zam qhov nqi rau koj, koj yuav tsum npaj nyiaj them tus nqi.

STEP 9 APPEAR AT THE HEARING

KAUJ RUAM 9 TUAJ TSHWM THAUM SIB HAIS PLAUB

Come to court on the date and time scheduled for the hearing. Be sure to bring with you your copy of the “Motion to Modify Child Support”, “Affidavit in Support of Motion to Modify Child Support”, “Financial Affidavit for Child Support”, and all of your supporting documents. You must bring enough copies of any supporting documents not already filed with the court nor served on all the parties so that copies can be given to all parties and the court. Tuaj kom ncav rau hauv lub tsev hais plaub rau hnub thiab lub sij hawm uas tau teem tseg sib hais. Nco ntsoov nqa koj “Tsab Ntawv Thov Hloov Nqi Yug Noj Yug Haus Rau Me Nyuam”, “Tsab Ntawv Pov Thawj Txhawb Tsab Ntawv Thov Hloov Nqi Yug Noj Yug Haus Rau Me Nyuam”, “Tsab Ntawv Pov Thawj Nqi Yug Noj Yug Rau Me Nyuam”, thiab tag nrho koj cov ntaub ntawv txhawb tuaj kom tag. Koj yuav tsum nqa cov ntaub ntawv txhawb uas tsis tau xa rau lub tsev hais plaub los yog xa rau lwm tog neeg kom txhua rau txhua tog neeg thiab lub tsev hais plaub tib si.



State of Minnesota

District Court Xeev Minnesota

Cheeb Tsam Tsev Hais Plaub

County Judicial District: Cheeb Nroog Cheeb Tsam Ciaj

Ciam:

Court File Number: Zauv Cim Tsab

Ntawv Rooj Plaub:

Case Type: Hom Txooj Xwm:

□ In Re the Marriage of:

□ Hais Txog Kev Txij Nkawm ntawm: Plaintiff / Petitioner Neeg Thov Kev Sib Hais/Neeg Foob

Notice of Motion and Motion vs / and To Modify Child Support Tsab Ntawv Thov thiab Kev Thov Hloov vs / thiab Nqi Yug Noj Yug Haus Rau Me Nyuam Defendant / Respondent Neeg Teb Lus/Neeg Raug Liam Intervenor Tus Tshuam Lus

Notice Tsab Ntawv TO: Other Party: XA RAU: Lwm Tog Neeg: ________________________________________________________________________ First Middle Last Npe Npe Nruab Nrab Xeem ________________________________________________________________________ Street Address Apt. No. Chaw Nyob Chav Zauv ________________________________________________________________________ City State Zip Zos Xeev Zauv Zip



County Attorney’s Office: Cheeb Nroog Kws Lij Choj Chaw Khiav Dej Num: ________________________________________________________________________

Name of County Attorney Cheeb Nroog Kws Lij Choj Npe ________________________________________________________________________ Street Address Chaw Nyob ________________________________________________________________________ City State Zip Zos Xeev Zauv Zip PLEASE TAKE NOTICE that the undersigned will bring a motion before the Honorable , on (Name of Child Support Magistrate, Judge or Referee) (Date: Month, Day, Year) at o’clock at the County Courthouse (Time) (a.m./p.m.) (Name of building where hearing to be held)

or Government Center located at in the city of (Street address where hearing to be held)

Minnesota, (check the public calendar at the hearing location for (City where hearing to be held) the room number), and will ask the court to modify the existing child support order as requested in the following motion. THOV FAJ SEEB tias tus kos npe no yuav thov coj plaub ntug tuaj sib hais ntawm tus Muaj Hwj Chim Honorable , rau (Kws Txiav Txim KevYug Noj Yug Haus Rau Me Nyuam, Kws Txiav Txim Plaub Ntug los yog Tus Neeg Txiav Txim Nruab Nrab) (Hnub: Hli, Hnub, Xyoo) thaum teev rau hauv lub Cheeb Nroog Tsev Hais Plaub (Sij hawm) (sawv ntxov/tav su) (Lub tsev yuav mus sib hais plaub lub npe)

los yog Tsoom Fwv Chaw Khiav Dej Num ntawm hauv lub zos (Qhov chaw nyob yuav mus sib hais)

Minnesota, (xyuas cov sij hawm rau pej xeem ntawm lub chaw (Lub Zos uas yuav mus sib hais rau)

yuav mus sib hais kom paub chav sib hais), thiab hais kom lub tsev hais plaub hloov txoj kev yug noj yug haus rau me nyuam kom raws li tsab ntawv thov.



Motion Tsab Ntawv Thov

I request that the court modify the support order dated ________________________________

(Date of existing support order) by ordering the following (check all that apply): Kuv xav thov lub tsev hais plaub kom hloov txoj kev yug noj yug haus uas pib yuam them txij thaum _______________________________ rau cov nram no (kos txhua qhov yog): (Hnub pib yuam them kev yug noj yug haus uas muaj dhau los) Increasing basic child support Decreasing basic child support Nce nqi yug noj yug haus rau me nyuam Txo nqi yug noj yug haus rau me nyuam kom tsawg Increasing medical support Decreasing medical support Nce nyiaj them nqi kho mob Txo nyiaj them nqi kho mob kom tsawg Increasing child care support Decreasing child care support Nce nyiaj them nqi zov me nyuam Txo nyiaj them nqi zov me nyuam kom tsawg Increasing arrearage payment Decreasing arrearage payment Them cov nyiaj tsis tau duav kom ntau ntxiv Them cov nyiaj tsis tau them kom tsawg dua Establishing medical support Establishing child care support Pab kom muaj nyiaj them nqi kho mob Pab kom muaj nyiaj them nqi zov me nyuam Changing other medical terms (describe):

Hloov lwm cov kev them nqi kho mob (piav):

Other (describe):

Lwm Yam (piav):

The facts upon which I base my request are set forth in the attached Affidavit in Support of Motion to Modify Child Support. Cov ntsiab lus tseeb uas kuv siv los txhawb muaj raws li teev rhais nrog rau Tsab Ntawv Pov Thawj Txhawb Ntawv Thov Hloov Kev Yug Noj Yug Haus Rau Me Nyuam

Notice of Rights to Other Party

Ntawv Qhia Rau Lwm Tog Cov Cai • You have a right to a hearing, if a hearing is not already scheduled. • Koj muaj txoj cai mus sib hais, yog tias tseem tsis tau teem ib lub sij hawm mus sib hais. • You have the right to object or respond to the changes I am requesting. • Koj muaj txoj cai tsis pom zoo los yog teb rau cov kev hloov uas kuv xav kom muaj. • If you decide to respond or object to this motion, a packet entitled “Response to Motion to Modify

Child Support” is available from the court administrator. • Yog koj txiav txim teb cov lus los yog tsis pom zoo rau cov lus hauv tsab ntawv thov hloov no, muaj

ib pob ntawv hu ua “Lus Teb Rau Tsab Ntawv Thov Hloov Nqi Yug Noj Yug Haus Rau Me Nyuam” muaj nyob ntawm tus neeg khiav dej num hauv tsev hais plaub.

• You have 14 days from the date this motion is personally served or mailed to you to serve upon all parties a written response or counter motion, along with your financial affidavit for child support, objecting to the relief requested. A counter motion is where you can raise new child support issues, in addition to responding to the issues in this motion.



• Koj muaj 14 hnub txij li hnub uas tsab ntawv thov no nqa tuaj los yog xa tuaj txog koj uas koj yuav tsum xa koj cov lus teb nrog rau tej pov thawj los yog koj txoj kev pom zoo xav hloov rau koj tej nyiaj txiag mus rau txhua tog neeg mus qhia koj txoj kev tsis pom zoo. Txoj kev koj pom zoo kom hloov yog thaum koj hais txog ib hom nqi yug noj yug haus tshiab, ntxiv rau cov kev xav hloov muaj hauv tsab ntawv thov kev hloov no

• You must file a copy of your written response, financial affidavit for child support, and supporting documents at least 5 days before any scheduled hearing. The court may, in its discretion, choose not to consider any documents you file with the court if they are not filed on time.

• Koj yuav tsum luam koj tsab ntawv teb lus, cov ntawv pov thawj nqi yug noj yug haus rau me nyuam thiab cov ntaub ntawv txhawb kom mus txog ua ntej 5 hnub rau hnub teem yuav mus sib hais. Lub tsev hais plaub muaj cai tsis pom zoo, xaiv tsis yuav koj cov ntaub ntawv yog tias koj tsis xa tuaj raws sij hawm.

Settlement Kev Sib Hais Haum

This matter may be settled without a court hearing if all parties, including the county attorney, reach an agreement. To discuss a possible settlement, contact the following person at the phone number listed: at (Name of person to contact to discuss settlement) (_____________)________________________________. (Phone number of person to contact) Tej zaum tsis tag yuav mus sib hais hauv tsev hais plaub yeej muaj kev sib hais haum yog tias tag nrho cov tog neeg nrog rau cheeb nroog tus kws lij coj hais sib haum lawm. Xav sib tham txog seb puas hais sib haum, hu tus xov tooj rau tus neeg nram no: ntawm (Tus neeg hu mus sib tham kev sib hais haum lub npe) (_____________)________________________________. (Tus neeg tus xov tooj)



Acknowledgments by Party Making Motion: Cov Lus Lees Paub los ntawm Tus Ua Tsab Ntawv Thov: a. I am not serving or filing this document for any improper purpose, such as to harass or to cause

unnecessary delay or needless increase in the cost of litigation. a. Kuv tsis yog xa tsab ntawv no los yog rau cov lus no ua kev phem xws li kev zes los yog ua kom

muaj kev lig tsis tsim nyog los yog ua kom raug nqi plaub ntug ntau ntxiv. b. The claims, defenses, and other legal contentions therein are warranted by existing law or by a

nonfrivolous argument for the extension, modification, or reversal of existing law or the establishment of new law.

b. Cov lus aws, lus cam thiab lwm yam lus tseeb yeej hais raws li txoj cai los yog tsis yog lam hais dag kom muaj kev ncua sij hawm, hloov los yog tsis ua li txoj cai muaj los yog tsim txoj cai tshiab.

c. The allegations and other factual contentions have evidentiary support or, if specifically so

identified, are likely to have evidentiary support after a reasonable opportunity for further investigation or discovery.

c. Cov lus liam thiab lwm cov lus tseeb muaj pov thawj tseeb txhawb los yog yam uas nug txog los yeej muaj pov thawj txaus tom qab tsim nyog kev tshawb fawb los yog kev tshawb kom paub tseeb.

d. The denials of factual contentions are warranted on the evidence or, if specifically so identified,

are reasonably based on a lack of information or belief. d. Txoj kev tsis lees txais tej lus tseeb yuav tsum muaj pov thawj txhawb, los yog, yog nug txog

yeej tsim nyog raws li tsis muaj tej ncauj lus los yog tej kev ntseeg txaus. e. The court may impose an appropriate sanction upon the attorneys, law firms, or parties that

violate the above stated representations to the court, or are responsible for the violation. e. Tej zaum lub tsev hais plaub yuav nplua txim tsim nyog rau cov kws lij choj, cov lag luam lij

choj, los yog cov tog neeg uas ua txhaum cov lus teev rau hauv tsev hais plaub uas muaj saum no, los yog cov ua txhaum cov kev cai.

f. I understand that the existing order remains in full force and effect and I must continue to

comply with that order until a new order is issued. f. Kuv to taub tias txoj kev yuam them nqi qub yeej tseem ua hauj lwm raws nkaus li qub thiab

yeej ua hauj lwm mus thiab kuv yuav tsum ua raws li txoj kev yuam them nqi qub kom txog thaum muaj txoj kev txiav txim tshiab.

Dated: Hnub rau: Signature Kos Npe Print Name: Sau Lub Npe:

Address: Chaw nyob:

City/State/Zip: Zos/Xeev/Zauv Zip: Telephone: ( ) Xov Tooj:

Attorney for: Kws lij choj rau:



State of Minnesota



County Judicial District: Cheeb Nroog Cheeb Tsam Ciaj

Ciam :


Ntawv Rooj Plaub:



□ Hais Txog Kev Txij Nkawm ntawm: Plaintiff / Petitioner Neeg Thov Kev Sib Hais/Neeg Foob Affidavit in Support of Motion vs / and to Modify Child Support Ntawv Pov Thawj Txhawb Ntawv Kev Thov Hloov vs / thiab Nqi Yug Noj Yug Rau Me Nyuam Defendant / Respondent Neeg Teb Lus/Neeg Raug Liam Intervenor Tus Tshuam Lus STATE OF MINNESOTA ) COUNTY OF _____________________ ) SS (County where Affidavit Signed) XEEV MINNESOTA ) CHEEB NROOG _____________________ ) SS (Lub Cheeb Nroog Uas Kos Npe Rau Tsab Ntawv Pov Thawj) My name is . I state under oath the following information: Kuv lub npe yog . Kuv lees tseeb rau cov lus nram no: Reasons Why the Existing Order Should Be Changed Cov Laj Thawj Yuav Hloov Txoj Kev Yuam Tam Sim No 1. I request a change in the existing order because of (check all that apply):

A 20% change in the gross income of the obligor (person paying support)



A change in the number of joint children for whom the obligor is legally responsible and actually supporting

Receipt of public assistance by a parent or caregiver of a child who is supported by an existing child support order

Additional work-related or education-related child care expenses of the obligee or a substantial increase or decrease in existing work-related or education-related child care expenses

A change in the availability of health care coverage and/or dental insurance coverage or a substantial increase or decrease in the cost of existing health care coverage

The joint child has become disabled The other parent and I agree to modify the child support under the income shares

guidelines 1. Kuv thov kom muaj kev hloov hauv txoj kev yuam vim yog (kos txhua yam yog):

Tus them nqi yug noj yug haus (tus neeg them nyiaj yug noj yug haus) qhov nyiaj hli hloov txog 20% feem pua

Kev hloov ntawm cov me nyuam uas tus them nqi yug noj yug haus muaj txoj cai xyuas thiab yeej txhawb nqa

Tus niam txiv los yog tus saib xyuas tus me nyuam uas tam sim no yeej tau nqi yug noj yug haus ho tau txais kev pab los ntawm tsoom fwv

Nuj nqis zov me nyuam muaj ntau ntxiv vim yog txoj hauj lwm los yog kev kawm ntawv los yog cov nqi zov me nyuam nce ntau heev los yog nqis ntau heev vim yog txoj kev ua hauj lwm los yog kev kawm ntawv

Ib yam hloov ntawm txoj kev pab them nqi kho mob los yog nqi kho hniav los yog nqi kho mob nce ntau heev los nqis ntau heev

Tus me nyuam uas ob leeg muaj cai saib xyuas sib npaug cia li muaj kev tsis taus lawm Tus niam txiv tog tod thiab kuv pom zoo hloov txoj kev yug noj yug haus rau me nyuam

raws li cov kev cai ntsuas nyiaj hli sib koom. 2. I make the following other comments in support of my request for a change to the existing

support/maintenance order: 2. Kuv sau lwm cov lus nram no txhawb kuv txoj kev thov hloov nqi yug noj yug haus tam sim

no/kev yuam them nqi yug noj yug haus:

3. I am the parent of the following joint child(ren) involved in this case (list only joint child(ren)

involved in this case). 3. Kuv yog ib leej niam leej txiv muaj cai sib npaug saib tus (cov) me nyuam uas muaj npe hauv

rooj plaub no (tsuas sau tus (cov) me nyuam uas nyob hauv rooj plaub no xwb). Joint Child’s Name Date of birth Me Nyuam Rau Ob Leeg Saib Lub Npe Hnub Yug

Information From Existing Child Support Order (Answer only those questions that apply) Cov Lus Teev Hauv Txoj Kev Yuam Them Nqi Yug Noj Yug Haus Rau Me Nyuam Uas Yeej Muaj



Lawm (Tsuas teb cov nqe lus nug uas yog xwb) 4. The existing support order was issued by the court in ________________County and is dated

___________________________. In that Order, I am the (check one) Obligor (making payments) Obligee (receiving payments)

4. Lub tsev hais plaub pib txoj kev yuam them nqi yug noj yug haus hauv Cheeb Nroog ________________ thiab rau hnub thaum ___________________________. Hauv txoj kev Yuam them ntawd, Kuv yog (kos ib tug) Tus Raug Them (them cov nqi) Tus Tau Txais (txais cov nyiaj)

5. At the time the existing order was issued, I was (check all that apply): Unemployed Employed at (company or occupation) and earned

$ per hour week month with a monthly gross income of $ Other monthly gross income totaling $_________________ from (list all sources, such as unemployment compensation, workers’ compensation, social security, or other source).

5. Lub sij hawm thaum txoj kev yuam them nqi pib, Kuv (kos txhua yam yog): Tsis ua hauj lwm Ua hauj lwm ntawm (lub lag luam los yog txoj hauj

lwm) thiab khwv tau nyiaj$ rau ib teev twg ib lim piam twg ib hlis twg uas ib hlis twg khwv tau nyiaj $ ua ntej rho tej nqi tawm Lwm cov nyiaj hli khwv tau ua ntej rho tej nqi tawm muaj$_________________los ntawm (sau tag nrho cov hom nyiaj, xws li nyiaj poob hauj lwm, nyiaj raug mob, nyiaj laus social security los yog lwm hom nyiaj).

6. At the time the existing order was issued, to the best of my knowledge, the other parent was

(check one): Unemployed. Employed at (company or occupation) and earned

$ per hour week month with a monthly gross income of $ and had other monthly gross income totaling $_________________ from (list all sources, such as unemployment compensation, workers’ compensation, social security, or other source).

6. Thaum txoj kev yuam them nqi pib, raws li kuv muaj peev xwm paub, tus niam txiv sab tod (kos ib qho):

Tsis ua hauj lwm. Ua hauj lwm ntawm (lub lag luam los yog txoj hauj

lwm) thiab khwv tau nyiaj$ rau ib teev twg ib lim piam twg ib hlis twg uas ib hlis twg khwv tau nyiaj $ ua ntej rho tej nqi tawm thiab muaj lwm cov nyiaj hli khwv tau ua ntej rho tej nqi tawm muaj$_________________los ntawm (sau tag nrho cov hom nyiaj, xws li nyiaj poob hauj lwm, nyiaj raug mob, nyiaj laus social security los yog lwm hom nyiaj).

7. At the time the existing order was issued, the joint child(ren) received monthly social security

or veteran’s benefits in the amount of $ based on my disability other parent’s disability and is paid to me other parent

7. Lub sij hawm txoj kev yuam them nqi pib, tus (cov) me nyuam uas wb muaj cai sib npaug xyuas tau nyiaj hli hauv social security los yog nyiaj pab tub rog txog $ raws li kuv txoj kev tsis taus tus niam txiv sab tod txoj kev tsis taus thiab them nyiaj rau kuv tus niam txiv sab tod



Current Information About Me Cov Ncauj Lus Txog Kuv Tam Sim No 8. I am currently (check all that apply): Married Separated Divorced Living with a companion Single 8. Tam sim no kuv (kos txhua yam uas yog): Muaj txij nkawm Sib Faib Nyias Nyob Nyias Sib Nrauj Lawm

Nrog Ib Tug Hlub nyob Tsis Tau Muaj Txij Nkawm 9. I am currently (check one) employed unemployed (if employed, answer the following):

a. Employer: b. Address: c. Work telephone number: d. Occupation /Type of work: e. Length of employment: f. Supervisor: g. Gross Pay: $_________________ This does does not include overtime pay. h. Paid: Weekly Every other week Twice a month Monthly i. Previously employed by

for ___________ years prior to the above employment. 9. Tam sim no kuv (kos ib qho) ua hauj lwm tsis ua hauj lwm (yog ua hauj lwm, teb cov

nram no): a. Chaw Hauj Lwm: b. Chaw Nyob: c. Xov Tooj tom hauj lwm: d. Txoj Hauj Lwm/Hom hauj lwm: e. Ua hauj lwm ntev li cas lawm: f. Tus Thawj Saib Xyuas Neeg Ua Hauj Lwm: g. Them Nyiaj: $_________________ Qhov nyiaj no yog ntxiv tsis tau ntxiv qhov nyiaj them ua cov sij hawm tshaj. h. Them: Ib lim piam ib zaug Ib lim piam kem ib lim piam Ob zaug ib hlis Ib zaug ib hlis i. Ua hauj lwm rau lwm lub chaw

tau ___________ xyoos ua ntej txoj hauj lwm saum no. 10. I have the following additional sources of income: Commissions $ Pension Payments $ Annuity Payments $ Unemployment Benefits $ Military / Naval Retirement $ Workers’ Compensation $ Spousal Maintenance Received $ Disability Payments $ Self-Employment $ Other $ 10. Kuv muaj cov hom nyiaj nram no ntxiv: Cov nyiaj Rau nqi Dag Zog $ Nyiaj Laus Pension $ Nyiaj Laus Them Ib Xyoos Ib Zaug Nyiaj Poob Hauj Lwm $ Nyiaj Tub Rog / Nyiaj Tub Rog Laus So $ Nyiaj Raug Mob$ Nyiaj Yug Txij Nkawm $ Nyiaj Tsis Taus $ Nyiaj Khwv Tau Ua Hauj Lwm Rau Tus Kheej $ Lwm cov nyiaj $ 11. I receive (check only if it applies) MFIP Medical Assistance MinnesotaCare

General Assistance SSI Child Care Assistance 11. Kuv tau (tsuas kos yog muaj tiag) Nyiaj MFIP Kev Pab Them Nqi Kho Mob (Medical

Assistance) Kev Pab Them Nqi Kho Mob (MinnesotaCare) Nyiaj Pab Txhua Yam (General Assistance) Nyiaj SSI Nyiaj Pab Zov Me Nyuam



12. The joint child(ren) currently receives monthly social security or veteran’s benefits in the

amount of $ based on my disability the other parent’s disability and is paid to me other parent.

12. Tus (cov) me nyuam uas wb muaj cai xyuas sib npaug tau nyiaj hli hauv social security los yog nyiaj pab tub rog txog $ raws li kuv txoj kev tsis taus tus niam txiv sab tod txoj kev tsis taus thiab them nyiaj rau kuv tus niam txiv sab tod

13. I am court ordered to pay monthly spousal maintenance. (check one) YES NO If yes, how much? 13. Lub tsev hais plaub yuam kom kuv them nqi yug noj yug haus rau txij nkawm. (kos ib qho) YOG TSIS YOG Yog tias yog, them npaum li cas? 14. I support the following nonjoint child(ren):

Child's Name Date of Birth Relationship Child support Living in monthly amount my home $ Yes / No $ Yes / No $ Yes / No $ Yes / No $ Yes / No (If ordered to pay child support for any child listed above, provide copies of court orders) 14. Kuv yug noj yug haus rau tus (cov) me nyuam kuv tsis muaj cai xyuas nram no:

Me Nyuam Npe Hnub Yug Txheeb Li Cas Yug Noj Yug Haus Nyob hauv Nyiaj Hli kuv tsev $ Nyob / Tsis Nyob $ Nyob / Tsis Nyob $ Nyob / Tsis Nyob $ Nyob / Tsis Nyob $ Nyob / Tsis Nyob (Yog tsev hais plaub yuam kom yug noj yug haus rau tus me nyuam twg saum no, muab cov ntaub ntawv luam nrog) 15. My monthly expenses at the present time are as follows (if remarried, include total of

household expenses): 15. Kuv cov nuj nqis tam sim no yog muaj (yog rov sib yuav nrog lwm tus lawm, ntxiv tag nrho cov

nuj nqis rau tsev neeg): Monthly Payment at Present Time Cov Nuj Nqis Them Raws

Hli Tam Sim No a. House payment or

Rent $

a. Them nqi tsev muas los yog Nqi tsev xauj $

b. Real Estate Taxes, if not included in (a) $

b. Nqi Se rau Av,



yog tsis tau ntxiv rau nqe (a) $

c. Association Dues or Lot Rent (for property) $ c. Nqi Koom Zej Zog los yog Nqi Xauj Av (rau tsev) $ d. Insurance:

Homeowners, if not included in (a) $ Car $ Life $

d. Nqi Pov Hwm: Cov Tswv Tsev, yog tsis tau ntxiv rau nqe (a)$ Tsheb $ Txoj Sia $ e. Utilities: (Average Monthly Amount) Gas $ Electricity $ Telephone $ Water and garbage $ Cable TV $ e. Nqi Vaj Tse: (Qhov nqi nruab nrab uas them ib hlis twg) Roj $ Hluav taws xob $ Xov tooj $ Dej thiab Yam tsis siv $ Xov Tso TV $ f. Food $ f. Zaub Mov $ g. Clothing $ g. Khaub Ncaws $ h. Laundry/dry cleaning $ h. Ntxhua khaub ncaws/ntxhua qhuav $ i. Personal allowances and incidentals $ i. Nyiaj Faib Rau Tus Kheej thiab nyiaj rau them tej tshwm sim $ j. Magazine and newspapers $ j. Nqi them cov phau ntawv Magazine thiab ntawv xov xwm $ k. Uninsured / unreimbursed medical expenses $ k. Nqi kho mob uas tus kheej them /tsis thim nyiaj rov los $ l. Uninsured / unreimbursed dental expenses $ l. Nqi kho hniav uas tus kheej them/tsis thim nyiaj rov los $ m. Child care expenses $ m. Nqi zov me nyuam $

n. Transportation expenses: Car payment $ License $ Gasoline $ Repairs $

n. Nqi tsheb: Tus nqi muas tsheb $ Nqi muas Ntawv tsav tsheb (License) $ Roj sam tsheb $ Cov nqi kho tsheb $ o. Recreation/Entertainment $



o. Kev ua si/Kev lom zem $ p. Child(ren)'s needs (sports/school/hobbies) $ p. Cov yuav tsum muaj rau me nyuam (ntaus ncaws pob/kawm ntawv/kev txaus siab) $ q. Allowances $ q. Cov nyiaj rau siv $

r. Other (list) $ r. Lwm cov nqi (sau qhia) $

s. Charge accounts and loans (list): s. Nyiaj qiv thiab nyiaj txais (sau qhia): Name of Account Balance Owed Tus Neeg Tshuav Nqi Tshuav Nqi Npaum Cas 1. $ ____________________ 2. $ ____________________ 3. $ ____________________ 4. $ ____________________ 5. $ ____________________

TOTAL MONTHLY EXPENSES: $

TAG NRHO NUJ NQIS IB HLIS TWG: $

16. The following people help me pay my current monthly expenses listed in question 15: Spouse Companion Roommate(s) Relatives No One 16. Cov tib neeg nram no pab kuv them kuv cov nuj nqis uas sau muaj rau nqe lus nug 15: Tus txij nkawm Tus hlub Tus khub koom nyob ua ke Txheeb Ze Tsis Muaj 17. The value of the property I currently own by myself or with someone else is: Home $____________________ Household goods $____________________ Purchase price of my home $_________________

Balanced owed on my home $____________________ Other real estate $____________________ Checking/savings $____________________ Automobiles $____________________ (year and make) Recreational vehicles $____________________ (year and make) Personal property $____________________ Stocks/bonds/etc. $____________________ 17. Cov khoom uas kuv muas kuv los yog muas nrog lwm tus neeg muaj nuj nqis zoo: Lub Tsev $____________________ Khoom vaj khoom tsev $____________________ Nqi muas kuv lub tsev $_________________

Nuj Nqi Tshuav rau kuv lub tsev $____________________ Lwm cov tsev/av $____________________ Nyiaj Checking/saving $____________________ Cov tsheb $____________________ (xyoo thiab hom tsheb) Cov tsheb tsav ua si $_________________ (xyoo thiab hom tsheb) Khoom ntiag tug muaj nuj nqis zoo $____________________ Nyiaj lag luam (Stocks/bonds) thiab tej yam li $____________________



Current Information About Other Parent Cov Ncauj Lus Txog Tus Niam Txiv Tog Sab Tod Tam Sim No 18. To the best of my knowledge, the other parent is currently:

(check one) employed unemployed (if employed, answer the following): a. Employer: b. Address: c. Work telephone number: d. Occupation / Type of work: e. Length of employment: f. Supervisor: g. Gross Pay: $_________________ This does does not include overtime pay. h. Paid: Weekly Every other week Twice a month Monthly Unknown i. Previously employed by

for ___________ years prior to the above employment. 18. Raws li kuv muaj peev xwm paub, tam sim no tus niam txiv sab tod (kos ib qho) ua hauj lwm

tsis ua hauj lwm (yog ua hauj lwm, teb cov nram no): a. Chaw Hauj Lwm: b. Chaw Nyob: c. Xov Tooj tom hauj lwm: d. Txoj Hauj Lwm/Hom hauj lwm: e. Ua hauj lwm ntev li cas lawm: f. Tus Thawj Saib Xyuas Neeg Ua Hauj Lwm: g. Them Nyiaj: $_________________ Qhov nyiaj no yog ntxiv tsis tau ntxiv qhov nyiaj them ua cov sij hawm tshaj. h. Them: Ib lim piam ib zaug Ib lim piam kem ib lim piam Ob zaug ib hlis Ib zaug ib hlis i. Ua hauj lwm rau lwm lub chaw

tau ___________ xyoos ua ntej txoj hauj lwm saum no. 19. To the best of my knowledge, the other parent has the following additional sources of income: Commissions $ Pension Payments $ Annuity Payments $ Unemployment Benefits $ Military / Naval Retirement $ Workers’ Compensation $ Spousal Maintenance Received $ Disability Payments $ Self-Employment $ Other $ 19. Raws li kuv muaj peev xwm paub, tus niam txiv tod tau cov hom nyiaj nram no ntxiv: Cov nyiaj Rau nqi Dag Zog $ Nyiaj Laus Pension $ Nyiaj Laus Them Ib Xyoos Ib Zaug Nyiaj Poob Hauj Lwm $ Nyiaj Tub Rog / Nyiaj Tub Rog Laus So $ Nyiaj Raug Mob$ Nyiaj Yug Txij Nkawm $ Nyiaj Tsis Taus $ Nyiaj Khwv Tau Ua Hauj Lwm Rau Tus Kheej $ Lwm cov nyiaj $ 20. To the best of my knowledge, the other parent receives (check only if it applies) MFIP

Medical Assistance MinnesotaCare General Assistance SSI Child Care Assistance 20. Raws li kuv muaj peev xwm paub, tus niam txiv tod (tsuas kos yog muaj tiag) tau Nyiaj

MFIP Kev Pab Them Nqi Kho Mob (Medical Assistance) Kev Pab Them Nqi Kho Mob (MinnesotaCare) Nyiaj Pab Rau Txhua Yam (General Assistance) Nyiaj SSI Nyiaj Pab Zov Me Nyuam

21. To the best of my knowledge, the other parent is ordered to pay spousal maintenance. (check



one) YES NO If yes, how much? 21. Raws li kuv muaj peev xwm paub, lub tsev hais plaub yuam kom tus niam txiv tod them nqi yug

noj yug haus rau txij nkawm. (kos ib qho) YOG TSIS YOG Yog tias yog, them npaum li cas? 22. To the best of my knowledge, the other parent supports the following nonjoint child(ren):

Child's Name Date of Birth Relationship Child support Living in monthly amount the home $ Yes / No $ Yes / No $ Yes / No $ Yes / No $ Yes / No 22. Raws li kuv muaj peev xwm paub, tus niam txiv tod yug noj yug haus rau tus (cov) me nyuam

kuv tsis muaj cai xyuas nram no: Me Nyuam Npe Hnub Yug Txheeb Li Cas Yug Noj Yug Haus Nyob hauv

Nyiaj Hli lub tsev $ Nyob / Tsis Nyob $ Nyob / Tsis Nyob $ Nyob / Tsis Nyob $ Nyob / Tsis Nyob $ Nyob / Tsis Nyob Parents Health Care Coverage Information Ncauj Lus Txog Niam Txiv Kev Pab Them Nqi Kho Mob Only answer if you are asking for a change in health care coverage and/or dental coverage for the joint child(ren). Tsuas teb yog tias koj xav thov kom hloov kev pab them nqi kho mob thiab/los yog kev pab them nqi kho hniav rau tus(cov) me nyuam uas ob leeg muaj cai sib npaug xyuas. 23. About me: (check all that apply)

I am court ordered to carry health care coverage for the joint child(ren) I now have private health care coverage available for the joint child(ren) I do not have or no longer have private health care coverage available for the joint child(ren) I cannot afford to pay my proportionate share of health care coverage for the joint child(ren) My proportionate share of health care coverage for the joint child(ren) should be changed I am court ordered to maintain health care coverage for other nonjoint children and

coverage is in place for other nonjoint children. I have private health care coverage and/or dental insurance coverage in place for the following people: Cost of monthly health care coverage for self: $ Cost of monthly health care coverage for dependents: $ Cost of monthly dental insurance for self (if separate coverage from health care coverage): $ Cost of monthly dental insurance for dependents (if separate coverage from health care coverage): $

23. Hais txog kuv: (kos tag nrho cov yog) Tsev hais plaub yuam kom kuv yuav tsum muaj kev pab them nqi kho mob rau tus (cov) me

nyuam uas ob leeg muaj cai sib npaug xyuas



Tam sis no kuv muaj kev pab them nqi kho mob rau tus (cov) me nyuam uas ob leeg muaj cai sib npaub xyuas

Kuv yeej tsis muaj los yog tsis muaj kev pab them nqi kho mob rau tus (cov) me nyuam uas ob leej muaj cai sib npaug xyuas lawm

Kuv them tsis taus kuv qhov nqi muas kev pab them nqi kho mob rau tus (cov) me nyuam uas ob leeg muaj cai sib npaug xyuas

Yuav tsum hloov kuv qhov nqi muas kev pab them nqi kho mob rau tus (cov) me nyuam uas ob leeg muaj cai sib npaug xyuas

Lub tsev hais plaub yuam kom kuv yuav tsum muaj kev pab them nqi kho mob rau lwm cov me nyuam uas kuv tsis muaj cai xyuas thiab yeej muaj kev pab them nqi kho mob rau lawv lawm.

Kuv yeej muaj kev pab them nqi kho mob thiab/los yog kev pab them nqi kho hniav rau cov neeg nram no lawm: Tus nqi muas kev pab them nqi kho mob rau tus kheej yog: $ Tus nqi muas kev pab them nqi kh omob rau cov me nyuam: $ Tus nqi muas kev pab them nqi kho hniav rau tus kheej (yog muaj lwm qhov kev pab them nqi kho mob lawm): $ Tus nqi muas kev pab them nqi kho hniav rau cov me nyuam (yog muaj lwm qhov kev pab them nqi kho mob lawm): $

24. Currently, there is:

no court order that directs either parent to carry private health care coverage for the joint child(ren). a court order that directs me the other parent to carry private health care coverage for the joint child(ren). Medical Assistance MinnesotaCare currently in place for the joint child(ren).

24. Tam sim no, muaj: tsev hais plaub tsis tau yuam kom ib tog niam txiv twg yuav tsum muaj kev pab them nqi kho mob rau tus(cov) me nyuam uas ob leeg muaj cai sib npaug xyuas. tsev hais plaub twb yuam kom kuv tus niam txiv sab tod muaj kev pab them nqi kho mob rau cov me nyuam uas ob leeg muaj cai sib npaug xyuas. Kev pab them nqi kho mob (Medical Assistance) Yeej muaj kev pab them nqi kho mob (MinnesotaCare) rau tus(cov) me nyuam uas ob leeg muaj cai sib npaug xyuas.

25. About the other parent: (check all that apply)

The other parent is court ordered to carry health care coverage for the joint child(ren) The other parent has private health care coverage available for the joint child(ren) The other parent does not have or no longer has private health care coverage available for the joint child(ren) The other parent is court ordered to maintain health care coverage for other nonjoint children and coverage is in place for other nonjoint children. The other parent has private health care coverage and/or dental insurance coverage in place for the following people: Cost of monthly health care coverage for self: $ Cost of monthly health care coverage for dependents: $ Cost of monthly dental insurance for self (if separate coverage from health care coverage): $ Cost of monthly dental insurance for dependents (if separate coverage from health care coverage): $

25. Hais txog tus niam txiv sab tod: (kos tag nrho cov yog)



Tsev hais plaub yuam kom tus niam txiv sab tod yuav tsum muaj kev pab them nqi kho mob rau tus(cov) me nyuam uas ob leeg muaj cai sib npaug xyuas

Tam sis no tus niam txiv sab tod yeej muaj kev pab them nqi kho mob rau tus(cov) me nyuam uas ob leeg muaj cai sib npaub xyuas

Tus niam txiv sab tod yeej tsis muaj los yog tsis muaj kev pab them nqi kho mob rau tus(cov) me nyuam uas ob leej muaj cai sib npaug xyuas lawm

Lub tsev hais plaub yuam kom tus niam txiv sab tod yuav tsum muaj kev pab them nqi kho mob rau lwm cov me nyuam uas ib tug niam txiv twg tsis muaj cai xyuas thiab yeej muaj kev pab them nqi kho mob rau lawv lawm.

Tus niam txiv sab tod yeej muaj kev pab them nqi kho mob thiab/los yog kev pab them nqi kho hniav rau cov neeg nram no lawm: Tus nqi muas kev pab them nqi kho mob rau tus kheej yog: $ Tus nqi muas kev pab them nqi kh omob rau cov me nyuam: $ Tus nqi muas kev pab them nqi kho hniav rau tus kheej (yog muaj lwm qhov kev pab them nqi kho mob lawm): $ Tus nqi muas kev pab them nqi kho hniav rau cov me nyuam (yog muaj lwm qhov kev pab them nqi kho mob lawm): $

Child Care Obligation Kev Them Nqi Zov Me Nyuam Only answer if you are asking for a change in child care support for the joint child(ren). Tsuas teb yog tias koj thov kom hloov cov nyiaj zov tus(cov) me nyuam uas ob leeg muaj cai sib npaug xyuas. 26. I am court ordered to pay a proportionate share of child care support and the amount of

child care support has changed. There is no court ordered child care obligation and I have child care expenses. 26. Lub tsev hais plaub yuam kom kuv them ib feem nqi zov me nyuam thiab qhov nyiaj zov me

nyuam hloov lawm. Tsev hais plaub tsis tau yuam kom yug nyiaj zov me nyuam thiab kuv yeej muaj cov nuj nqis zov me nyuam lawm. 27. If there is an existing court order for monthly child care expenses, list the court ordered

amount: $ 27. Yog tsev hais plaub yuam kom them cov nqi zov me nyuam ib hlis zus, sau qhia qhov nqi: $

28. The current total monthly costs of child care are $ 28. Tus nqi them zov me nyuam tam sim no yog $ The information contained in this Affidavit is true and correct to the best of my knowledge. Cov lus sau muaj rau hauv tsab ntawv Affidavit no muaj tseeb thiab yog raws li kuv muaj peev xwm. Dated: Signature (Sign only in presence of Notary or Court Deputy)

Hnub: Kos Npe (Tsuas kos npe tim ntsej muag ntawm tus Neeg Pov Thawj

los yog Tus Sawv Cev Rau Tus Khiav Dej Num Hauv Tsev Hais Plaub)

Sworn / affirmed before me this Print Name:

day of , Address:



City/State/Zip:

Notary Public / Deputy Court Administrator Telephone: ( )

Lees /qhia tseeb rau kuv rau Sau Npe:

hnub , Chaw Nyob:

Zos/Xeev/Zauv Zip:

Neeg Muaj Cai Nias Npe / Tus Sawv Cev Rau Tus Khiav Dej Num Hauv Tsev Hais Plaub Xov tooj: ( )



State of Minnesota



County Judicial District: Cheeb Nroog Ciaj Ciam Cheeb

Tsam :


Ntawv Rooj Plaub:



□ Hais Txog Kev Txij Nkawm ntawm: Plaintiff / Petitioner Neeg Thov Kev Sib Hais/Neeg Foob Affidavit of Personal Service vs / and Affidavit of Service By Mail

Ntawv Ua Pov Thawj Nqa Rau vs / thiab Ntawv Ua Pov Thawj Xa Rau

Defendant / Respondent Neeg Teb Lus/Neeg Raug Liam Intervenor Tus Tshuam Lus

STATE OF MINNESOTA ) COUNTY OF ____________________ ) SS (County where Affidavit Signed) XEEV MINNESOTA ) CHEEB NROOG _____________________ ) SS (Lub Cheeb Nroog Uas Kos Npe Rau Tsab Ntawv Pov Thawj) I, , being duly sworn, upon oath, state that on (Name of person who served documents) __________________________, I served the attached documents, namely (Date service made) (Title of documents hand delivered or mailed) ____________________________________________ upon (check one): Plaintiff / Petitioner (Name) Defendant / Respondent (Name) County Agency (Name)



Other (Name)

Kuv, , lees, raws kev ncaj ncees tias (Tus neeg xa tsab ntawv no) __________________________, kuv xa cov ntaub ntawv rhais no, hu ua (Hnub xa) (Tsab ntawv nqa mus los yog xa mus lub npe) ____________________________________________ mus rau (kos ib tug): Neeg Thov Kev Sib Hais/Neeg Foob (Npe) Neeg Teb Lus/Neeg Raug Liam (Npe) Cheeb Nroog (Npe) Lwm tus (Npe) by (check method of service used): raws (kos hom kev xa): Personally handing a true and correct copy of the document(s) to named above at

____ o’clock ___.m. at (Address where documents delivered)

Nqa tsab(cov) ntaub ntawv tseem thiab yog mus rau uas muaj npe saum toj no thaum ____ teev ___ sawv ntxov/tav su rau

(Qhov chaw nyob uas nqa cov ntawv mus rau)

Mailing a true and correct copy of the document(s) to named above by placing the document(s) in an envelope with sufficient postage in the United States mail at the Post Office located in the City of , State of , at the person’s last known address of:

Xa tsab(cov) ntawv tseem thiab yog mus rau uas muaj npe saum toj no uas muab cov ntaub ntawv ntsaws rau hauv lub hnab ntawv them nyiaj xa tsim nyog los hauv Teb Chaws Asmeskas ib lub Chaw Xa Ntawv hauv lub Zos , hauv lub Xeev , mus rau tus neeg qhov chaw nyob uas paub zaum kawg kiag uas yog:

Dated: Signature ( Sign only in presence of notary or Court Deputy)

Hnub: Kos Npe (Tsuas kos npe tim ntsej muag ntawm tus Neeg Pov Thawj Notary los

yog Tus Sawv Cev Rau Tus Khiav Dej Num Hauv Tsev Hais Plaub)

Sworn / affirmed before me this Print Name:

_________day of , Address:

City/State/Zip: Notary Public/ Deputy Court Administrator Telephone: ( ) Lees / qhia tseeb rau kuv rau Sau Npe:

_________hnub , Chaw Nyob:

Zos/Xeev/Zauv Zip: Neeg Muaj Cai Nias Npe / Tus Sawv Cev Rau Tus Khiav Dej Num Hauv Tsev Hais Plaub Xov Tooj: ( )


motion to modify child support - minnesota...the court cannot modify an existing child support order...

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