Child Support Modification
PREPARATION WORKSHEET — DO NOT FILE OR SIGN UNDER OATH
Transfer verified information only into the current official forms accepted or
required by the tribunal with authority over the support order.
CONNECTICUT CHILD-SUPPORT MODIFICATION ROUTING WORKSHEET
1. Existing Order and Case Control
| Item | Information | Source document |
|---|---|---|
| Petitioner / requesting party | [________________________________] | [____] |
| Respondent / other party | [________________________________] | [____] |
| Child name(s) and date(s) of birth | [________________________________] | [____] |
| Current obligor and obligee | [________________________________] | [____] |
| Issuing tribunal and case number | [________________________________] | [____] |
| Current order date | [__/__/____] | [____] |
| Later amendment / review / enforcement order | [________________________________] | [____] |
| Current periodic amount and frequency | $[________________] | [____] |
| Medical, dental, child-care, arrears, and other terms | [________________________________] | [____] |
| Income withholding or payment registry | [________________________________] | [____] |
| Current arrears / credit dispute | [________________________________] | [____] |
Attach every operative order. Do not rely on a private agreement, payment
history, agency screen, docket summary, or memory as the current order.
2. Tribunal, Route, and Interstate Gate
| Question | Facts | Current authority / official instruction | Counsel conclusion |
|---|---|---|---|
| Which tribunal issued the controlling order? | [____] | [____] | [____] |
| Does that tribunal retain authority to modify? | [____] | [____] | [____] |
| Where do each party and child reside? | [____] | [____] | [____] |
| Is another state, tribe, country, military, or agency involved? | [____] | [____] | [____] |
| Court petition, agency review, agreed order, interstate request, or other route? | [____] | [____] | [____] |
| Is parentage, custody, placement, emancipation, or dependency disputed? | [____] | [____] | [____] |
| Is enforcement or arrears relief also requested? | [____] | [____] | [____] |
| Is emergency or temporary relief requested? | [____] | [____] | [____] |
Do not assume that residence in Connecticut creates modification authority or
that an agency review and a judicial modification use the same trigger, form,
effective date, or remedy.
3. Current Authority, Guidelines, and Forms
Complete this table from sources current on the intended filing date.
| Control item | Current official source / URL | Version / effective date | Reviewed by / date |
|---|---|---|---|
| Modification standard for selected route | [____] | [____] | [____] |
| Agency review standard, if applicable | [____] | [____] | [____] |
| Child-support guidelines and instructions | [____] | [____] | [____] |
| Official petition / motion / request form | [____] | [____] | [____] |
| Financial statement and worksheet | [____] | [____] | [____] |
| Service, notice, waiver, and proof rules | [____] | [____] | [____] |
| Filing fee, waiver, e-filing, signature, and privacy rules | [____] | [____] | [____] |
| Income-withholding form / procedure | [____] | [____] | [____] |
| Health coverage and medical-expense rules | [____] | [____] | [____] |
| Retroactivity, arrears, credit, and effective-date rules | [____] | [____] | [____] |
4. Official Filing Set
| Document | Current official / local form | Required? | Signer / preparer | Status |
|---|---|---|---|---|
| Petition, motion, or agency request | [____] | [____] | [____] | [____] |
| Financial statement / affidavit | [____] | [____] | [____] | [____] |
| Guideline worksheet | [____] | [____] | [____] | [____] |
| Child-care / health-cost attachment | [____] | [____] | [____] | [____] |
| Summons, notice, service, or waiver | [____] | [____] | [____] | [____] |
| Income-withholding document | [____] | [____] | [____] | [____] |
| Proposed order | [____] | [____] | [____] | [____] |
| Confidential-information sheet | [____] | [____] | [____] | [____] |
| Interstate / agency transmittal | [____] | [____] | [____] | [____] |
| Other local or case-specific document | [____] | [____] | [____] | [____] |
This worksheet intentionally supplies no form number, docket format, county
division, oath, notary block, service method, or signature rule.
5. Modification Ground and Change Evidence
| Claimed change or review basis | Date began | Prior-order facts | Current facts | Evidence | Legal relevance |
|---|---|---|---|---|---|
| Income / employment | [____] | [____] | [____] | [____] | [____] |
| Child care | [____] | [____] | [____] | [____] | [____] |
| Health insurance / medical expense | [____] | [____] | [____] | [____] | [____] |
| Parenting / placement facts relevant to support | [____] | [____] | [____] | [____] | [____] |
| Child age, need, disability, education, or emancipation issue | [____] | [____] | [____] | [____] | [____] |
| Other dependent or household obligation | [____] | [____] | [____] | [____] | [____] |
| Time-based or agency review route | [____] | [____] | [____] | [____] | [____] |
| Other | [____] | [____] | [____] | [____] | [____] |
Do not use a private percentage, dollar, month, or “substantial change” formula.
Apply the current standard for the selected court or agency route and distinguish
a screening threshold from the tribunal's modification findings.
6. Income and Financial Record
| Income / adjustment item | Parent A | Parent B | Source and period | Guideline treatment confirmed? |
|---|---|---|---|---|
| Wages / salary / overtime / tips | $[____] | $[____] | [____] | [____] |
| Bonus / commission / incentive | $[____] | $[____] | [____] | [____] |
| Self-employment / business | $[____] | $[____] | [____] | [____] |
| Benefits / pension / support / other | $[____] | $[____] | [____] | [____] |
| Potential / attributed income issue | $[____] | $[____] | [____] | [____] |
| Required deduction or adjustment | $[____] | $[____] | [____] | [____] |
| Other child / dependent obligation | $[____] | $[____] | [____] | [____] |
Collect the current documents required by the official form and discovery
rules. Do not assume an annual exchange, thirty-day update, or ten-day
employment-notice duty unless current authority or the existing order supplies
it.
7. Child-Related Costs and Coverage
| Item | Provider / plan | Total cost | Child-specific amount | Paying party | Proposed allocation | Evidence |
|---|---|---|---|---|---|---|
| Child care | [____] | $[____] | $[____] | [____] | [____] | [____] |
| Health insurance | [____] | $[____] | $[____] | [____] | [____] | [____] |
| Dental / vision | [____] | $[____] | $[____] | [____] | [____] | [____] |
| Uninsured / unreimbursed expense | [____] | $[____] | $[____] | [____] | [____] | [____] |
| Education / special need / other | [____] | $[____] | $[____] | [____] | [____] | [____] |
Confirm eligibility, reasonableness, availability, tax treatment, subsidy,
reimbursement, notice, proof, and allocation under the current guidelines and
order. No percentage is supplied by this worksheet.
8. Guideline Calculation and Deviation Record
| Calculation item | Entry / source |
|---|---|
| Current official worksheet and version | [________________________________] |
| Number of children covered | [________________________________] |
| Parent A guideline inputs | [________________________________] |
| Parent B guideline inputs | [________________________________] |
| Parenting / placement input, if permitted | [________________________________] |
| Child-care and health inputs | [________________________________] |
| Presumptive amount and frequency | $[________________________________] |
| Proposed deviation | $[________________________________] |
| Deviation factor and evidence | [________________________________] |
| Required finding / explanation | [________________________________] |
Do not build a homemade calculator. Preserve the completed official worksheet,
source records, assumptions, rounding, and any departure explanation.
9. Effective Date, Arrears, Credit, and Withholding
| Issue | Requested treatment | Current authority / order | Calculation / evidence |
|---|---|---|---|
| Modification effective date | [____] | [____] | [____] |
| Retroactive period | [____] | [____] | [____] |
| Arrears balance | $[____] | [____] | [____] |
| Payment credit / overpayment | $[____] | [____] | [____] |
| Arrears payment | $[____] per [____] | [____] | [____] |
| Interest or fee | [____] | [____] | [____] |
| Income withholding | [____] | [____] | [____] |
| Payment registry / disbursement | [____] | [____] | [____] |
Keep modification, enforcement, contempt, arrears adjudication, credit,
withholding, tax intercept, license, and other remedies on their correct routes.
This worksheet does not make any sanction or fee automatic.
10. Notice and Service Plan
| Recipient | Address / location | Required method | Deadline / trigger | Service / waiver proof |
|---|---|---|---|---|
| Other parent / party | [____] | [____] | [____] | [____] |
| Child-support agency | [____] | [____] | [____] | [____] |
| Issuing / responding tribunal | [____] | [____] | [____] | [____] |
| Other required person or agency | [____] | [____] | [____] | [____] |
Actual knowledge, electronic delivery, prior participation, or consent does not
have a preset service or waiver effect in this worksheet.
11. Requested Relief and Proposed Order Control
| Relief requested | Amount / term | Factual support | Current authority / required finding |
|---|---|---|---|
| Current support | $[____] per [____] | [____] | [____] |
| Health / dental coverage | [____] | [____] | [____] |
| Child-care / medical allocation | [____] | [____] | [____] |
| Effective date | [____] | [____] | [____] |
| Arrears / credit / repayment | [____] | [____] | [____] |
| Income withholding | [____] | [____] | [____] |
| Fees / costs | [____] | [____] | [____] |
| Other | [____] | [____] | [____] |
Do not ask to “vacate” the entire prior order if only specified support terms
should change. The proposed order must state exactly what remains, changes,
begins, ends, accrues, is credited, or is administered.
12. Final Filing Review
- ☐ Controlling order and every later amendment attached
- ☐ Court, agency, interstate, agreed, or other route confirmed
- ☐ Modification and agency-review standards kept separate
- ☐ Current official forms and guideline worksheet downloaded on [__/__/____]
- ☐ Income, deductions, child costs, insurance, and parenting inputs supported
- ☐ Deviation request tied to evidence and required findings
- ☐ Effective date, retroactivity, arrears, credit, and withholding reviewed
- ☐ Enforcement and modification remedies kept on proper routes
-
☐ Notice, service, waiver, filing, fee, privacy, signature, and verification
requirements checked -
☐ Proposed order matches the requested relief and retains unaffected terms
- ☐ Connecticut counsel approved the final official filing set
Final official filing-set location: [________________________________]
Counsel approval: [NAME / DATE]
About this template
- Last updated
- August 27, 2026
- Citations checked
- August 27, 2026
- Jurisdiction
- Connecticut
- Category
- Family Law
Family law covers the paperwork that shapes divorce, custody, child support, adoption, guardianship, and other family matters. These filings are emotional and high-stakes, and they also have to meet strict procedural rules for service, financial disclosure, and parenting plans. Clean, accurate paperwork keeps the focus on getting a workable outcome for the family instead of getting derailed by technical problems that delay hearings or force amended filings.
Not legal advice
This template is provided for informational purposes. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.
Checked against the law it cites
A reviewer verified this template's legal citations against the official source on August 27, 2026.
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