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					                  OFFICE OF CHILD SUPPORT ENFORCEMENT
                  «FIELD82» «FIELD83» «FIELD84» «FIELD85», «FIELD86» «FIELD87»
                  Telephone: «FIELD111»



                                                                DATE: «FIELD68»

«FIELD14» «FIELD15» «FIELD16» «FIELD17»
«FIELD18»
«FIELD19»
«FIELD20», «FIELD21» «FIELD22»


RE:     Child Support Case No: «FIELD52»
        Non-custodial Parent: «FIELD14» «FIELD15» «FIELD16» «FIELD17»
        Custodial Parent: «FIELD1» «FIELD2» «FIELD3» «FIELD4»
        Children: «FIELD150» «FIELD156» «FIELD162» «FIELD168»
        Support Order Date: «FIELD57» Date of Last Review: «FIELD230»

                      NON-CUSTODIAL PARENT REQUEST TO MODIFY AN ORDER
                   THAT HAS BEEN OBTAINED OR REVIEWED IN THE PAST 36 MONTHS
We received your written request for a review of your order for a possible recommendation of modification, in accordance
with O.C.G.A. §19-11-12. Our records show that your order is less than 36 months old, or has been reviewed within the past
three years.
Generally, to justify a "less than 36 month old order" review:
*  You must prove there has been a substantial change in your circumstances affecting your ability to earn a living
   or pay child support, which has occurred since the last order or the last review was completed.
    * A "substantial change" may be:
          Diagnosis of a serious illness or an accident that occurred since the last order or since the last review was
             completed. The effects must be expected to last for over a year and not expected to be relieved for at least
             another year.
          Requesting party is now receiving Welfare benefits (TANF).
          Unanticipated windfall of money, such as a party winning a large sum from the lottery, inheritance of money.
    * A "substantial change" is NOT:
          Unemployment or under-employment, depending on the facts surrounding each, a job change or a decision to
             become self-employed;
          Working at a new job paying less than before. The NCP must show why s/he lost the previous higher paying job
             and that it was not because of their actions or choice and why s/he cannot obtain a comparable job/income as
             before. If the NCP works part-time, s/he must show why they cannot or do not work full-time.
          New obligations, i.e., having other children, going into debt unnecessarily, or quitting work to return to school.
          Changes in either parent's income, depending on the facts surrounding each, marital status, or acquiring
             possessions (such as a new home or vehicle).
          Jail or Prison.
Your PROOF of your alleged "SUBSTANTIAL CHANGE" must be received within 15 days from the date of this letter; and be
strong enough to convince a Judge that your circumstances justify a "less than 36 month review". This means there MUST
be documentation, not just your statements, PROVING that your circumstances meet the description of a "substantial
change". (Note: OCSE is not responsible for proving your allegations. You must obtain this proof.)
Complete the enclosed form to show WHAT change(s) in circumstance has happened since the last order or the last review,
and attach proof (such as doctors' statements.) Please use MAIL instead of FAX. We need legible documents.
If the agency finds there is proof of a substantial change in circumstances, you will be notified of additional information that
will be needed, and a FULL Review will be scheduled. But, if the agency finds that your situation does not meet the
requirements of a substantial change in circumstances, you will be notified your request for review is being denied. As an
alternative to the OCSE process for review and/or modification, you have the right to hire a private attorney and seek
modification of your support order under the provisions of O.C.G.A. §19-6-19.
If you have any questions, call «FIELD111»

«FIELD88» «FIELD90» «FIELD89»
OFFICE CHILD SUPPORT ENFORCEMENT

FormRRF/1                                                                                                   Revised 1/31/2012
                      OFFICE OF CHILD SUPPORT ENFORCEMENT
                      «FIELD82» «FIELD83» «FIELD84» «FIELD85», «FIELD86» «FIELD87»
                      Telephone: «FIELD111»




                                                                 DATE: «FIELD68»

«FIELD1» «FIELD2» «FIELD3» «FIELD4»
«FIELD5»
«FIELD6»
«FIELD7», «FIELD8» «FIELD9»


RE:       Child Support Case No: «FIELD52»
          Non-custodial Parent: «FIELD14» «FIELD15» «FIELD16» «FIELD17»
          Custodial Parent: «FIELD1» «FIELD2» «FIELD3» «FIELD4»
          Children: «FIELD150» «FIELD156» «FIELD162» «FIELD168»
          Support Order Date: «FIELD57» Date of Last Review: «FIELD230»

                    CUSTODIAL PARENT / CUSTODIAN REQUEST TO MODIFY AN ORDER
                    THAT HAS BEEN OBTAINED OR REVIEWED IN THE PAST 36 MONTHS
We received your written request for a review of your order for a possible recommendation of modification, in accordance
with O.C.G.A. §19-11-12. Your order is less than 36 months old, or has been reviewed within the past three years
To justify a "less than 36 month old order" review:
*   You must prove there has been a substantial change in your circumstances increasing the child(ren)'s needs,
    which has occurred since the last order or the last review was completed.
     * A "substantial change" may be:
             CP or child diagnosed with a serious illness or an accident that occurred since the last order or since the last
                review was completed, which will have a lasting effect on the child(ren)'s needs.
             The applicant for a review and modification is now receiving welfare benefits (TANF).
             The non-requesting party has had an unanticipated windfall of money, such as a party winning a large sum
                from the lottery, inheritance of money.
      *   A "substantial change" is NOT:
             Changes in either parent's income, depending on the facts surrounding each, marital status, or acquiring new
               possessions (such as a new home or vehicle).
             The applicant taking on new obligations, such as other children, going into debt unnecessarily, or quitting work
               to return to school.
             Jail or Prison.
Your PROOF of your alleged "SUBSTANTIAL CHANGE" must be received within 15 days from the date of this letter; and be
strong enough to convince a Judge that your circumstances justify a "less than 36 month review". This means there MUST
be documentation, not just your statements, PROVING that your circumstances meet the description of a "substantial
change". (Note: OCSE is not responsible for proving your allegations. Even if your allegations involve the NCP’s income,
you are still responsible for obtaining proof of your allegations.)
Complete the enclosed form to show WHAT change(s) in circumstance has happened since the last order or the last review,
and attach proof (such as doctors' statements.) Please use MAIL instead of FAX. We need legible documents.
If the agency finds there is proof of a substantial change in circumstances, you will be notified of additional information that
will be needed, and a FULL Review will be scheduled. But if the agency finds that your situation does not meet the
requirements of a substantial change in circumstances, you will be notified your request for review is being denied. As an
alternative to the OCSE process for review and/or modification, you have the right to hire a private attorney and seek
modification of your support order under the provisions of O.C.G.A. §19-6-19.

If you have any questions, call «FIELD111»

«FIELD88» «FIELD90» «FIELD89»
OFFICE CHILD SUPPORT ENFORCEMENT



FormRRF/2                                                                                                   Revised 1/31/2012
                                          INFORMATION AFFIDAVIT
RE:     «FIELD52», Child Support Case No
        «FIELD14» «FIELD15» «FIELD16» «FIELD17», Noncustodian
        «FIELD1» «FIELD2» «FIELD3» «FIELD4», Custodian
        Children: «FIELD150» «FIELD156» «FIELD162» «FIELD168»


You may submit this form by mail with attached EVIDENCE, but you MUST show that Substantial
Changes have occurred since the original Support Amount was set by court order.


Please consider the following facts in determining if this child support amount should go up, down, or remain the same:

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________


Were the parents of the case child(ren) divorced from one another? [__]No, [__] Never married
[__]Yes, County:__________________, State:__________ Year:________ [__]Still married, not yet divorced

Please indicate the number of Documents attached to PROVE the above statements: ______


I understand the criminal penalties for making false statements and false swearing under O.C.G.A.
§16-10-71 and do hereby attest to the truthfulness of the information provided.

So sworn and affirmed,

Your Signature:________________________________________ SSN _____-____-_____                   Date: ____/____/____



Notary Public Signature: _________________________________ Commission Expiration Date: _____/_____/_____

NOTARY SEAL:




FormRRF/3                                                                                          Revised 1/31/2012
                                                STATEMENT OF MEDICAL NEED\COST
   (Use to show SPECIAL MEDICAL CONDITIONS that have occurred since the last support amount was ordered)

   RE:        «FIELD52», Child Support Case No
              «FIELD14» «FIELD15» «FIELD16» «FIELD17», Noncustodian
              «FIELD1» «FIELD2» «FIELD3» «FIELD4», Custodian
              Children: «FIELD150» «FIELD156» «FIELD162» «FIELD168»


THIS INFORMATION IS REQUIRED:
Medical Insurance provided for the children : (CHECK all known sources of medical insurance for these children )
[_]NCP provides: [_]Medical; [_]Dental; [_]Vision; Insurance Co:___________________________________________ Does CP have card [_]N\[_]Yes
[_]CP provides: [_]Medical; [_]Dental; [_]Vision; Insurance Co:______________________ _________________________ [_]Medicaid\[_]PEACHCare
[_]YOUR Spouse provides [_]Medical; [_]Dental; [_]Vision; Insurance Co:______________________ Ins cost per pay period: $_______
RE   Military Medical Benefits for the case child(ren), based on current, reserves, or retired status:
Military Medical Benefits [_] ARE \ [_]ARE NOT available for the named child(ren)    As provided by [_]NCP\ [_]CP ‘s \ [_] Your Spouse’s military benefits

If Spouse provides insurance; Spouse's Name:_______________________ Spouse's employer:_______________________ Wk. Phone:_________________


   This form is to help you show special or unusual medical needs of yourself or child. Please attach copies of Doctors' Statements
   showing WHAT the conditions is, HOW long it is expected to continue, How much YOUR portion of the cost of treatment is after all
   insurance has been paid, etc.... The more documentation you provide, the more weight this will carry with the Judge.
   COMPLETE A NEW SECTION FOR EACH MEDICAL PROBLEM, EVEN IF IT IS FOR THE SAME PERSON.
   Make additional copies of form as needed.

   Patient's Name: ___________________________________________ Relationship to You: __________________________
   Medical Condition: _________________________________________ Date of (injury\first treatment): __________________
   How long is this expected to last: ______________________________________________________________________________
   How does this condition affect the patient's ability to function normally: ________________________________________________
   What kind of continued treatment is included: ____________________________________________________________________
   ________________________________________________________________________________________________________
   Name all REGULAR monthly office visits, medications, and treatments which this condition require _________________________
   ________________________________________________________________________________________________________
   What is the TOTAL monthly cost: $___________________                       How much of this cost is YOUR portion: $____________________
   Name of primary Physician: ___________________________________________ Doctor’s #: (________)__________________



   Patient's Name: __________________________________________                            Relationship to You:_____________________________
   Medical Condition:_________________________________________                           Date of (injury\first treatment):______________________
   How long is this expected to last:_____________________________________________________________________________
   How does this condition effect the patient's ability to function normally: _______________________________________________
   What kind of continued treatment is included: ___________________________________________________________________
   _______________________________________________________________________________________________________
   Name all REGULAR monthly office visits, medications, and treatments which this condition require ________________________
   _______________________________________________________________________________________________________
   What is the TOTAL monthly cost: $_____________________ How much of this cost is YOUR portion: $___________________
   Name of primary Physician: __________________________________________ Doctor’s #: (________)__________________


   Signed: __________________________________, [__] NCP [__] CP                          Date: ______/______/______


               ATTACH PROOF OF THE MEDICAL EXPENSES, SHOW PORTION NOT COVERED BY INSURANCE.
            ATTACH A DOCTOR'S STATEMENT DIAGNOSIS, PROGNOSIS, & LENGTH OF EXPECTED TREATMENT



   FormRRF/4                                                                                                                         Revised 1/31/2012
            NONCUSTODIAN'S STATEMENT OF EMPLOYMENT AND INCOME HISTORY
               (Use to show how your income has changed since the last support amount was ordered)

RE:     «FIELD52», Child Support Case No
        «FIELD14» «FIELD15» «FIELD16» «FIELD17», Noncustodian

Instructions:
An NCP who is seeking a review for possible recommendation of modification or objecting to an increase in support,
must show that changes in income are not due to his\her own actions and are expected to last over a year. This form
is to help you to show this.
     1. Attach copies of Separation Notices, Doctors' Statements (if you left due to an injury), etc... The more
         documentation you provide, the more weight this will carry with the Judge.
     2. Complete addresses are mandatory.
     3. PROOF is required, or a Less-than-36-Month Review will not be justified.

Employer:________________________________            Address:_____________________________________________________
Phone:(____)____________ Job Title:______________________ Period of employment: From ____/____/___ to ____/____/___
Paid: $_________ per [_]Hr [_]Wk [_]Biwkly [_]Yrly   Total of all bonuses, commissions, per diem, etc...rec’d Yrly: $____________
Describe actual job duties: __________________________________________________________________________________
Reason for job termination: [_]Quit [_] Fired [_] Laid Off [_]Other Details: ____________________________________________
________________________________________________________________________________________________________
Did you receive: [_]Unemployment [_] Disability [_] Settlement   Amount: $__________ From: ____/____/___ to ____/____/___
Proof of Income for this job: [_] W2’s, 1099’s, Tax Returns; [_] pay stubs; [_] Other:______________________________________
Proof of why I left this job: [_] Separation Notice; [_] Doctor’s or Medical Statements; [_] Other:_____________________________


Employer:________________________________            Address:_____________________________________________________
Phone:(____)____________ Job Title:_____________________ Period of employment: From ____/____/___ to ____/____/___
Paid: $_________ per [_]Hr [_]Wk [_]Biwkly [_]Yrly   Total of all bonuses, commissions, per diem, etc...rec’d Yrly: $___________
Describe actual job duties: __________________________________________________________________________________
Reason for job termination: [_]Quit [_] Fired [_] Laid Off [_]Other Details: ____________________________________________
________________________________________________________________________________________________________
Did you receive: [_]Unemployment [_] Disability [_] Settlement   Amount: $___________ From: ____/____/___ to ____/____/___
Proof of Income for this job: [_] W2’s, 1099’s, Tax Returns; [_] pay stubs; [_] Other:______________________________________
Proof of why I left this job: [__] Separation Notice; [__] Doctor’s or Medical Statements; [__] Other:__________________________


Employer:_________________________________           Address:_____________________________________________________
Phone:(____)____________ Job Title:_____________________ Period of employment: From ____/____/___ to ____/____/___
Paid: $_________ per [_]Hr [_]Wk [_]Biwkly [_]Yrly Total of all bonuses, commissions, per diem, etc...rec’d Yrly: $___________
Describe actual job duties: __________________________________________________________________________________
Reason for job termination: [_]Quit [_] Fired [_] Laid Off [_]Other Details: ____________________________________________
________________________________________________________________________________________________________
Did you receive: [_]Unemployment [_] Disability [_] Settlement   Amount: $__________ From: ____/____/___ to ____/____/___
Proof of Income for this job: [_] W2’s, 1099’s, Tax Returns; [_] pay stubs; [_] Other:_____________________________________
Proof of why I left this job: [__] Separation Notice; [__] Doctor’s or Medical Statements; [__] Other:__________________________

Signed: ________________________________________,                     Date: _____/_____/_____

Please indicate the number of Documents attached to PROVE the above statements: ______


FormRRF/5                                                                                                  Revised 1/31/2012
                  OFFICE OF CHILD SUPPORT ENFORCEMENT
                  «FIELD82» «FIELD83» «FIELD84» «FIELD85», «FIELD86» «FIELD87»
                  Telephone: «FIELD111»




                                                          DATE: «FIELD68»


«FIELD14» «FIELD15» «FIELD16» «FIELD17»
«FIELD18»
«FIELD19»
«FIELD20», «FIELD21» «FIELD22»


RE:     Child Support Case No: «FIELD52»
        Non-custodial Parent: «FIELD14» «FIELD15» «FIELD16» «FIELD17»
        Custodial Parent: «FIELD1» «FIELD2» «FIELD3» «FIELD4»
        Children: «FIELD150» «FIELD156» «FIELD162» «FIELD168»
        Support Order Date: «FIELD57» Date of Last Review: «FIELD230»

                            NON-CUSTODIAL PARENT NOTICE OF FINDINGS
                             CLAIM OF CHANGE INSUFFICIENT TO JUSTIFY
                           LESS-THAN 36-MONTH REVIEW AND MODIFICATION

OCSE is authorized by O.C.G.A. §19-11-12, to review all support orders for a possible recommendation of modification
of the support amount. When Orders are LESS than 36 months old or were reviewed in the last 36 months, the
requesting person must prove there has been a significant change of circumstances since the last order.
We received a request from you, but after reviewing your submitted evidence, we determined that the order is not
eligible for a more frequent review for the following reason(s):
[_] You as the requesting party failed to provide testimony or evidence to PROVE A SUBSTANTIAL CHANGE that
    would justify a review.
       [_] The CP failed to prove there has been a SIGNIFICANT change in the needs of the child(ren) since the last
            order was filed.
       [_] You failed to provide proof of SIGNIFICANT change that was beyond your control or choice
       [_] Sufficient or conclusive financial information was not provided and\or evidence available to OCSE is
            insufficient to justify a modification of the support Order.
[_] Other obligations were voluntarily assumed by the NCP that have resulted in a change in financial circumstances.
    Pursuant to O.C.G.A. §19-11-12(e), an obligor shall not be relieved of the duty to provide support due to his\her
    own choices\decisions. (Examples: Changing from a high paying job to a lesser income; having another child;
    going into debt unnecessarily).
[_] Unemployment or underemployment are not reasons to modify the support Order.
       [_] You did not provide verification of inability to work.
       [_] You did not prove that changes were not due to the choices or actions of the Non-custodial parent.
       [_] You did not provide verification of disability, or inability to continue in historical form of employment.
[_] Your reduced income or medical disability is not expected to last more than a year.
[_] Medical Insurance is already ordered (although insurance may /may not be currently available at reasonable cost).
[_] Other: _____________________________________________________________________________________
THEREFORE, an OCSE modification review is not justified at this time. You may wish to hire an attorney to seek
modification of your support order under O.C.G.A. §19-6-19, or you may wish to request a review by our agency under
O.C.G.A. §19-11-12, once your order is more than 36 months old.
For your information: If you have access to the Internet, you may view your case information on the OCSE Portal at
https://services.georgia.gov/dhr/cspp/do/Logon. First time users are required to register to obtain a user ID and
password. Your IRN, «FIELD232», is required to register.

«FIELD88» «FIELD90» «FIELD89»
OFFICE CHILD SUPPORT ENFORCEMENT


FormRRF/6                                                                                        Revised 1/31/2012
                 OFFICE OF CHILD SUPPORT ENFORCEMENT
                 «FIELD82» «FIELD83» «FIELD84» «FIELD85», «FIELD86» «FIELD87»
                 Telephone: «FIELD111»




                                                 DATE: «FIELD68»


«FIELD1» «FIELD2» «FIELD3» «FIELD4»
«FIELD5»
«FIELD6»
«FIELD7», «FIELD8» «FIELD9»


RE:     Child Support Case No: «FIELD52»
        Non-custodial Parent: «FIELD14» «FIELD15» «FIELD16» «FIELD17»
        Custodial Parent: «FIELD1» «FIELD2» «FIELD3» «FIELD4»
        Children: «FIELD150» «FIELD156» «FIELD162» «FIELD168»
        Support Order Date: «FIELD57» Date of Last Review: «FIELD230»

                         CUSTODIAL PARENT/CUSTODIAN NOTICE OF FINDINGS
                            CLAIM OF CHANGE INSUFFICIENT TO JUSTIFY
                          LESS-THAN 36-MONTH REVIEW AND MODIFICATION

OCSE is authorized by O.C.G.A. §19-11-12, to review all support Orders for a possible recommendation of
modification of the support amount. When Orders are LESS than 36 months old or were reviewed in the last 36
months, the requesting person must prove there has been a significant change of circumstances since the last
Order.
We received a request from you, but after reviewing your submitted evidence, we determined that the order is not
eligible for a more frequent review for the following reason(s):
[_] You as the requesting party failed provide testimony or evidence to PROVE A SUBSTANTIAL CHANGE that
    would justify a review.
        [_] You failed to prove there has been a SIGNIFICANT change in the needs of the child(ren) since the last
             order was filed.
        [_] The NCP failed to provide proof of SIGNIFICANT change that was beyond his\her control or choice
        [_] Sufficient or conclusive financial information was not provided and\or evidence available to OCSE is
             insufficient to justify a modification of the support Order.
[_] Other obligations were voluntarily assumed by the NCP that have resulted in a change in financial circumstances.
    Pursuant to O.C.G.A. §19-11-12(e), an obligor shall not be relieved of the duty to provide support due to his\her
    own choices\decisions. (Examples: Changing from a high paying job to a lesser income; having another child;
    going into debt unnecessarily.)
[_] Unemployment or underemployment of the Non-custodial Parent are not reasons to modify the support Order.
        [_] You did not provide verification of inability to work.
        [_] You did not prove that changes were not due to the choices or actions of the Non-Custodial parent.
        [_] You did not provide verification of disability, or inability to continue in historical form of employment.
[_] The NCP's reduced income or medical disability is not expected to last more than a year.
[_] Medical Insurance is already ordered (although insurance may /may not be currently available at reasonable cost).
[_] Other:
THEREFORE, an OCSE modification review is not justified at this time. You may wish to hire an attorney to seek
modification of your support order under O.C.G.A. §19-6-19, or you may wish to request a review by our agency under
O.C.G.A. §19-11-12, once your order is more than 36 months old.
For your information: If you have access to the Internet, you may view your case information on the OCSE Portal at
https://services.georgia.gov/dhr/cspp/do/Logon. First time users are required to register to obtain a user ID and
password. Your IRN, «FIELD231», is required to register.

«FIELD88» «FIELD90» «FIELD89»
OFFICE CHILD SUPPORT ENFORCEMENT

FormRRF/7                                                                                         Revised 1/31/2012

				
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