Colorado Modify Child Form – Fill Out and Use This PDF

After "I am the", mark Petitioner or Respondent (or Co-Petitioner).

Fill in the County District/Juvenile Court, the Court Address, the Petitioner and, if there is one, the Respondent (or co-petitioner).

Under Attorney or Party Without Attorney (My name and address), enter your name and address, Phone Number, E-mail and FAX Number.

Case Number, Division and Courtroom sit under Court Use Only.

Under 1. Certificate of Conferral, you checked to see if the other parties agree with your request. Mark They: Agree, Disagree or Did Not Respond, or write what they did after Other.

Under 2. Information about Petitioner, enter the Date of Birth, Mailing Address, City & Zip, Cell Phone, Email, Home Phone and Work Phone.

Under 3. Information about Respondent, enter the Date of Birth, Mailing Address, City & Zip, Cell Phone, Email, Home Phone and Work Phone.

Under 4. The parties have ___ minor child(ren), enter the number of minor child(ren), then each Child's Name, Present Address, Sex and Date of Birth.

Under 5. Under the current support order, enter the overnights per year the Petitioner has with the child(ren) and, if there is one, the overnights per year the Respondent (or Co-Petitioner) has.

Under 6. Under the current support order, mark who pays child support, Petitioner or Respondent (or Co-Petitioner), and enter how much the child support obligation is. Mark how this is paid: weekly, bi-weekly, twice a month or monthly, or write Other.

Mark Yes or No: does the current support order contain a provision for medical insurance coverage? If yes, enter how much that coverage costs.

Mark Yes or No: have you attached a current Sworn Financial Statement (JDF 1111) to this Motion? If no, you must file one within 42 days.

Under 9. Reasons for the Change, mark each substantial and continuing change because of which the support order should be changed: day care costs, amount of income, parenting time, place of residence, child emancipation, medical insurance coverage or other. You believe these would cause the child support payment to change by at least 10%.

Fill in the lines after "I am requesting a change to the child support because:".

Mark Yes or No: have you attached a proposed child support worksheet to this Motion? If yes, enter the proposed child support payment and mark how it is to be paid: weekly, bi-weekly, twice a month, monthly or other.

Mark Yes or No: does either parent live in another state? If yes, enter which parent and in which state.

Mark Yes or No: is either party receiving child support enforcement services? If yes, enter in which county and in which state.

Mark Yes or No: is either party currently receiving public assistance? If yes, enter the Name of Person Receiving Benefit, Name of County or State and Case Number.

Check only if applicable: I request a change in the current tax exemption because of the reallocation of the costs of raising the dependent child(ren), pursuant to C.R.S. § 14-10-115(12).

Check one box: that you are filling in the blanks and not changing anything else on the form, or that you have made a change to the original content of this form.

Under 15. Signature & Date, enter the signature and the date.

Under 16. Certificate of Service, enter the date on which a true and accurate copy of this document was served on the other party by Hand Delivery, E-filed through Colorado Courts E-Filing, Faxed to this number, or Mail through the United States Postal Service, postage pre-paid, and addressed to the other party. Sign on the signature line.

Check here if you also sent a copy to the Child Support Enforcement Unit. You must send them a copy if they are involved in the case.

The Sworn Financial Statement (JDF 1111) and Certificate of Compliance (JDF 1104) for the Court and other Parties are due within 42 days of this motion's service date.