PETITION TO MODIFY CHILD SUPPORT ORDER

(Ohio Rev. Code Ann. §§ 3119.02 et seq.; 3119.79; 3121.03)

TABLE OF CONTENTS

1. Document Header
2. Definitions
3. Operative Provisions
   3.1 Modification Request
   3.2 Calculation of Proposed Support
   3.3 Health Insurance Provisions
   3.4 Payment Method & Wage Withholding
   3.5 Tax Exemption Allocation
4. Representations & Warranties
5. Covenants & Continuing Obligations
6. Default & Remedies
7. Risk Allocation
8. Dispute Resolution
9. General Provisions
10. Execution Block
11. Verification/Affidavit
12. Certificate of Service

1. DOCUMENT HEADER

IN THE COURT OF COMMON PLEAS, [COUNTY] COUNTY, OHIO
DOMESTIC RELATIONS / JUVENILE DIVISION

Case No.: [CASE NO.]
Judge: [NAME]

[NAME OF PETITIONER],
 Petitioner/Obligee ☐  Petitioner/Obligor ☐

v.

[NAME OF RESPONDENT],
 Respondent/Obligor ☐  Respondent/Obligee ☐

PETITION TO MODIFY CHILD SUPPORT ORDER
(Ohio Rev. Code Ann. § 3119.79)

Date Filed: [DATE]
Jurisdiction: State of Ohio – Family Court

Recitals:
A. An existing child support order (“Existing Order”) was entered on [DATE OF EXISTING ORDER] in the above-captioned matter.
B. Pursuant to Ohio Rev. Code Ann. § 3119.79, a recalculation of support that varies by ten percent (10 %) or more constitutes a substantial change of circumstances warranting modification.
C. Petitioner asserts that such a change has occurred and seeks adjustment in accordance with Ohio’s Child Support Guidelines.

2. DEFINITIONS

For purposes of this Petition, the following capitalized terms have the meanings set forth below:

“Existing Order” – The child support order issued on [DATE] under Case No. [CASE NO.].

“Guideline Amount” – The monthly child support figure calculated pursuant to Ohio Rev. Code Ann. §§ 3119.02 et seq., as reflected on the attached Child Support Computation Worksheet.

“Minor Child(ren)” – [FULL NAME(S) AND DATE(S) OF BIRTH].

“Obligee” – The parent or guardian entitled to receive child support under the Existing Order or as modified herein.

“Obligor” – The parent obligated to pay child support under the Existing Order or as modified herein.

“Substantial Change” – A change in circumstances that produces a difference of at least ten percent (10 %) between the Existing Order and the recalculated Guideline Amount, or any other statutorily-recognized basis for modification under Ohio Rev. Code Ann. § 3119.79(A).

3. OPERATIVE PROVISIONS

3.1 Modification Request

1. Petitioner requests that the Court recalculate child support pursuant to the attached Child Support Computation Worksheet (Sole Residential Parent—Form DR-CSEA 805 or successor form).
2. The recalculation reflects a Substantial Change based upon:
   a. Change in income of Obligor and/or Obligee;
   b. Change in child-care or health-care costs;
   c. Change in parenting time/overnight allocation; and/or
   d. [OTHER BASIS—e.g., emancipation of a child].
   [// GUIDANCE: Insert each factual basis with supporting figures and documentation references.]

3.2 Calculation of Proposed Support

1. The proposed monthly Guideline Amount is $[AMOUNT], representing a [PERCENTAGE]% increase ☐ / decrease ☐ from the Existing Order.
2. If the Court deviates from the Guidelines, Petitioner requests written findings pursuant to Ohio Rev. Code Ann. § 3119.23.

3.3 Health Insurance Provisions

1. Obligor ☐ / Obligee ☐ has accessible, reasonable-cost health insurance available for the Minor Child(ren).
2. Petitioner requests an order obligating the parent with available insurance to enroll the child(ren) and to provide proof of coverage within thirty (30) days of journalization.
3. Unreimbursed medical expenses shall be allocated [PERCENTAGE]% to Obligor and [PERCENTAGE]% to Obligee.

3.4 Payment Method & Wage Withholding

1. Consistent with Ohio Rev. Code Ann. § 3121.03, any modified support shall be collected through immediate wage withholding.
2. Payments shall be directed to the Ohio Child Support Payment Central (“CSPC”) as required by statute.

3.5 Tax Exemption Allocation

Petitioner requests allocation of the federal and state income-tax dependency exemption(s) as follows: [SPECIFY ROTATING OR ALTERNATE YEARS / CONDITIONS].

4. REPRESENTATIONS & WARRANTIES

1. Each party represents that the financial data supplied on the attached Affidavit of Income and Expenses is true, complete, and accurate to the best of that party’s knowledge, information, and belief.
2. Each party warrants that all required disclosures under Ohio Civ. R. 75(I) and Local Rule [NUMBER] have been made or will be made within the prescribed time.
3. These representations survive the filing of this Petition and any subsequent hearing until a final order is entered.

5. COVENANTS & CONTINUING OBLIGATIONS

1. Each party shall timely supplement financial disclosures upon any material change in circumstances, including but not limited to change in employment, income, or health-insurance availability.
2. The parent providing health insurance shall furnish updated insurance cards and policy information to the other parent within seven (7) days of any change.
3. Both parties shall exchange year-end W-2s and/or IRS Form 1099s no later than February 1 of each calendar year.

6. DEFAULT & REMEDIES

1. Failure of the Obligor to comply with any support obligation may subject the Obligor to:
   a. Income interception, including tax refunds;
   b. Suspension of driver’s or professional licenses;
   c. Contempt proceedings punishable by fine, incarceration, or both; and
   d. Any other enforcement mechanism permitted under Ohio law.
2. Failure of either party to provide updated financial information may result in evidentiary sanctions or monetary penalties as the Court deems equitable.

7. RISK ALLOCATION

1. Child-support liability is statutorily limited to a percentage of the Obligor’s income as determined under Ohio’s Guidelines and any ordered deviations.
2. No indemnification provisions apply; statutory remedies govern.

8. DISPUTE RESOLUTION

1. Governing Law: This matter is governed exclusively by the laws of the State of Ohio, including Ohio Rev. Code Ann. Chapters 3119 and 3121.
2. Forum Selection: The Court of Common Pleas, [COUNTY] County, Ohio, Domestic Relations / Juvenile Division retains exclusive jurisdiction.
3. Arbitration: Not applicable; family-law matters are non-arbitrable under Ohio public policy.
4. Jury Waiver: By statute, child-support matters are heard and determined by the Court without a jury.
5. Injunctive Relief: Wage withholding constitutes mandatory statutory injunctive relief enforceable through CSPC.

9. GENERAL PROVISIONS

1. Amendment: This Petition may be amended only by leave of Court under Ohio Civ. R. 15.
2. Severability: If any provision herein is found unenforceable, the remaining provisions shall remain in full force and effect to the extent permitted by law.
3. Integration: This Petition, together with all statutorily-required worksheets and affidavits, constitutes the complete request for relief; no prior statements shall modify its terms.
4. Electronic Signatures: Facsimile or electronically transmitted signatures shall be deemed originals for filing purposes, subject to any local rule.

10. EXECUTION BLOCK

Respectfully submitted,

[NAME OF PETITIONER]
Address: [STREET, CITY, STATE, ZIP]
Phone: [PHONE]
E-Mail: [EMAIL]

☐ With Counsel  ☐ Pro Se

If represented:

[ATTORNEY NAME] (Bar No. [#####])
[LAW FIRM NAME]
Address: [STREET, CITY, STATE, ZIP]
Phone: [PHONE]
E-Mail: [EMAIL]
Counsel for Petitioner

[// GUIDANCE: Add Respondent signature block if filing jointly or by agreement.]

11. VERIFICATION / AFFIDAVIT

STATE OF OHIO )
       ) ss.
[COUNTY] COUNTY)

I, [NAME OF PETITIONER], being first duly sworn, depose and state that the facts set forth in the foregoing Petition are true and accurate to the best of my knowledge, information, and belief.

[NAME OF PETITIONER]

Sworn to before me and subscribed in my presence this _ day of ___ 20____.

Notary Public
My Commission Expires: ______

12. CERTIFICATE OF SERVICE

I certify that a true and accurate copy of the foregoing Petition to Modify Child Support Order was served upon [NAME OF RESPONDENT or RESPONDENT’S COUNSEL], at [ADDRESS OR E-MAIL], by ☐ ordinary U.S. mail ☐ hand delivery ☐ electronic service in accordance with Civ. R. 5(B) on this _ day of ___ 20____.

[NAME OF PETITIONER OR COUNSEL]

[// GUIDANCE: Attach the following mandatory forms as separate exhibits for filing:
• Child Support Computation Worksheet (appropriate form based on custody arrangement)
• Affidavit of Income and Expenses (Uniform Domestic Relations Form 1)
• Health Insurance Affidavit (Uniform Domestic Relations Form 4)
• Parenting Time Schedule or Deviation Justification, if applicable]