Job loss and current unemployment I lost my job on: __________. I was: laid off terminated Other: ___________________________. I have been looking for work since I lost my job. A list of my job contacts is attached or will be provided at the hearing. I am receiving unemployment benefits and ask that the court base my child support on my unemployment benefits. I am not eligible for unemployment benefits and I ask that the court reduce my child support to zero until I find employment. 2. Change of employment and decrease in earnings a.

I am no longer working for the same employer as I was when the last order was made. I have not worked there since __________. The reason I am not working there is because ______________________________________. I currently work at ______________________________________. My occupation is _______________________. I earn $ _______ per hour and usually work ____ hours per week. My average gross monthly income is $_______. This is a decrease in my gross monthly earnings of $ __________ from the time of the last order. I tried to find work at my previous rate of pay but was unable to. b.

I am still employed at the same place I was when the last order was made, but my earnings have decreased. I now earn $ __________ per hour and usually work _____ hours per week. This is a decrease in my gross monthly earnings of $ _____________. My earnings decreased because ________________________________________ ___________________________________________________________________________________________. 3. Change in child custody and/or timeshare with children in this case a. I now have primary custody substantial increased timeshare with the children in this case.

The children are now with me as follows: _____________________________________________________________________ ___________________________________________________________________________________________ . Timeshare is estimated to be: _____% to me and _____% to the other parent. Timeshare was calculated by Family Court Services the court me. b. My child, ______________________________, is now emancipated as a result of attaining the age and not in high school attaining the age married in the military judicial decree. I request that support for that child be terminated.

Adopted for Optional Use L-1400 [New 02/17] DECLARATION IN SUPPORT OF MODIFICATION OF CHILD SUPPORT PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: OTHER PARENT: CASE NUMBER: 4. Disability and decrease in earnings and/or loss of income I am currently disabled. My disability began on _______________ and consists of the following medical/psychological problems: ___________________________________________________________________________________. I will be disabled until ________________ . I have attached a Verification of Disability from my treating doctor. (Select one) a.

I do not receive disability benefits at this time but I have applied for benefits. I expect to receive disability benefits from the state government federal government private insurance Other: ______________. I expect to start receiving benefits on or about _______________ in the amount of $ __________ monthly. Until I start to receive these benefits, I ask the court to reduce my child support to zero. b. I do not expect to receive disability benefits in the future because: ___________________________________ ___________________________________________________________________________________________ .

I ask the court to reduce my child support to zero. c. I receive disability benefits from state government federal government private policy. The amount I receive monthly is $ __________. From this disability income the sum of $ __________ is deducted for child support every month. I ask that child support be suspended and/or reduced during the period of my disability. I request any derivative benefits due my children from Social Security as a result of my disability be offset against my child support order entered, pursuant to Family Code

section 4504. d. I receive SSI/SSP benefits and have received SSI/SSP benefits since _______________. Thus, child support should be set at zero for so long as I continue to receive these benefits. 5. Change in income or ability to earn of the other parent Since the last order for child support was made, the other parent: a. has become employed, earning $ __________ per hour, working __________ hours per week. b. has received an increase in earnings and now earns $ __________ per month. c. now has the ability to obtain employment and earn at least $ __________ per month. 6.

Financial hardship Since the last order was made, I have sustained the following financial hardship(s): a. Statutory hardship – 1. Expenses of natural or adopted children in the home (FC § 4071(a)(2)). I provide support for the following natural or adopted minor children who reside in my home: __________________________________________. 2. Extraordinary health expenses and uninsured catastrophic losses (FC § 4071(a)(1)): ________________________________________________________________________________________. b.

Low income adjustment - I request that the court order a low income adjustment in this case because I net less than $1,500 per month, taking into consideration all allowable deductions and hardships. c. Court discretion - I request that the court use its discretion and deviate from the guideline amount because application of the guideline formula would be unjust or inappropriate due to the special circumstances in my case.

The facts supporting the special circumstances in my case are: _________________________________________ ____________________________________________________________ _______________________________. Adopted for Optional Use L-1400 [New 02/17] DECLARATION IN SUPPORT OF MODIFICATION OF CHILD SUPPORT PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: OTHER PARENT: CASE NUMBER: 7. Recent release from incarceration and decrease in earnings and/or current unemployment I was released from incarceration on __________. I was incarcerated from __________ to __________.

I am currently unemployed as a result of my incarceration and am actively looking for work. A list of my job contacts is attached or will be provided at the hearing. I have no current income. I am asking the court to reduce my child support to zero until I find employment. I am willing to return to court for review hearings as necessary. I am in a recovery program called _____________________________________ and have been there since __________. The program requirements are ________________________________________________________________________. I am not allowed to work for the first ________ weeks/months.

Thereafter I can work as follows: ________________________ ______________________________________________________________________________________________. I have attached verification of my enrollment and participation in this program. I am asking the court to reduce my child support to zero until I find employment. I am willing to return to court for review hearings as necessary. 8.

Other change of circumstance: ______________________________________________________________ __ ______________________________________________________________________________________________ __________________________________________________________________ ____________________________ _____________________________________________________________________ _________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ 9.

I request child support be modified and set at zero for any full calendar months in which the parent ordered to pay support is incarcerated or receiving SSI, and has no other assets or income. For all other periods, I request current support remain in effect until modified by court order. 10.

Other information I want the court to know concerning child support in my case that supports my request as set forth above: ________________________________________________________________________________ ________________________________________________________________________________________ ______ ______________________________________________________________________________________________ ______________________________________________________________________________________________ _________________________________________________________________________________ _____________ ______________________________________________________________________________________________ _________________________________________________________________________________ _____________ _________________________________________________________________________ _____________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ _________________________________________________________________________________ _____________ _________________________________________________________________________ _____________________ I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Date: ______________________ _________________________________________________ ________________________________________ (TYPE OR PRINT NAME) (SIGNATURE OF DECLARANT)