Review and Adjustment Request (CSE102 4/22/2024)

Review and Adjustment Request Form
Requestor's Name*

First NameLast Name
Other Party's Name*

First NameLast Name
Household # or Court Case Number or Family Support Registry

Either parent may ask Child Support Services (CSS) to review their child support order for possible modification. If your order was reviewed or established in the last three (3) years, you must provide written evidence that a substantial change of circumstances has occurred.

I am requesting CSS to review and modify, if warranted, my current child support order because:*
If you are requesting a review because there has been a significant change in circumstances, please include documentation supporting the change – for example: pay stubs, daycare statements, medical documentation, etc.
- A review could result in an upward or a downward modification or may indicate that no change is warranted; or could result in a modification of medical coverage
- If the Court orders modification of the child support amount, the modification may be made effective by the Court on either a date agreed upon by the parties, the date of a custody change, the date the motion to modify was filed with the Court, or another date determined by the Court. For a modification review request where both parties live in Colorado it takes three to four months, on average, from the date we receive the review until the time we receive a court order granting or denying our motion. If the motion is set for hearing, this time is extended.
- If your order is to be modified or reviewed by another state your request could take up to two (2) years for processing.
- It is the responsibility of the parties to redact confidential information.
Signature*

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Print Name*
Date*

MonthDayYear
Date
E-mail Address*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home/Cell Phone Number*
Please enter a valid phone number.
Work Phone Number
Please enter a valid phone number.

Process and FAQs

Review and Adjustment/Modification of Child Support Orders
You have received this paperwork because either you, the other party, or the Department has requested a review of the child support order for a possible modification.

If you are the requesting party: complete the Review and Adjustment Form, a Financial Affidavit (signed and notarized) alongwith supporting financial documentation. Parties are responsible for redacting confidential info.

If you are the non-requesting party: complete a Financial Affidavit (signed and notarized), along with supporting financial documentation. You have twenty days to return the above documentation or a review will be conducted with the best information available. Parties are responsible for redacting confidential information.
THE PROCESS:
1. Within 20 days of the request for review, the Department sends the financial affidavit to the non-requesting party.
2. On or before the 50 th day of the request, a guideline calculation is completed and sent with a proposed stipulation to the parties and/or attorneys.
3. If in agreement, sign the proposed stipulation andreturn to the Department within 15 days. Or, if you disagree you have 15 days to submit a written challenge and proof that inaccurate documents were used or that there was a mathematical error. *
4. If there is no agreement, a Motion to Modify Child Support or Request for Hearing is filed with Court after the challenge period(s) have been exhausted. *
5. If an objection/response is filed with the Court you will be referred to Jefferson County Mediation Services.
6. The Court’s ruling or approval of an agreement marks the completion of the modification.
*We may send out multiple guideline calculations and proposed stipulations based on challenges from either party

THE PROCESS FOR REVIEWS / MODIFICATION IN OTHER STATES:
- Upon receipt of the Request for Review form, the Department will determine which state has jurisdiction to modify the order. We will coordinate with the other state to determine which documentsare necessary for them to conduct a review of the order.
- The Department works with the other state by sending any additional documentation they may require. We will notify the party requesting the review of the status.
- The Department stays in contact with the other state on a regular basis, requesting status information until the review/modification comes to its conclusion.
FREQUENTLY ASKED QUESTIONS:

Q: Who can request a review?
A: Either party can request a review of the support order so long as they provide a written request, financial affidavit and supporting documents. Under certain circumstances the Department can initiate areview of an order.

Q: How long does this process take?
A: This process largely depends on the parties, but on average it takes between 3 to 4 months; longer if the matter goes to hearing.

Q: Can the modification be retroactive?
A: The order can be retroactive to the date of change of custody, or the month the motion was filed, or at the discretion of the Court.

Q: Can you modify or terminate my maintenance/alimony?
A: We do not have the authority to modify maintenance or alimony.

Q: What if I don’t have tax returns?
A: Please call us so that we can discuss this with you.

Q: What if the other party isn’t exercising their courtordered visitation? Can you modify it?
A: If there is a disagreement between the parties as to the number of overnights, then we may use the number of overnights specified in the parenting time order. It is recommended that parties modify their parenting time orders to reflect the current situation. We can assist by referring your case to Mediation Services.

Resources:
www.courts.state.co.us

Jefferson County Court Self-Help Desk: 720-772-2501

Income and Expense Declaration
INSTRUCTIONS: Please print in ink. Complete each question with a check mark or an "X" in the space provided, or enter the information requested. DO NOT leave any questions unanswered, except as instructed. If you have no knowledge of the information requested, enter "Don't know." Attach documents and proof as requested. If any information changes after the declaration is complete, please notify the Child Support Services (CSS) unit of the changes.
Your Personal Data
Name*

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
E-mail Address*
example@example.com
Child(ren) born or adopted of this marriage/relationship

	First, Middle, Last Name	Date of Birth
Child 1
Child 2
Child 3
Child 4
Child 5
Child 6

	Monthly Amount	Effective Date
Maintenance (Spousal Support)
Pension Income (retirement)
Rental Property Income
Social Security Disability
Social Security Retirement
Social Security Survivors
Supplemental Security Income
Aid to the Needy and Disabled
Colorado Works (TANF)
Unemployment Compensation
Veterans Benefits
Workers Compensation
Private Disability Insurance
Other Income

Review and Adjustment Request Form

Process and FAQs

Income and Expense Declaration

Your Personal Data

Child(ren) born or adopted of this marriage/relationship

Your Primary Employment

If Self-Employed

Income from Other Sources

Parenting Time

Daycare

Health Insurance Information

Other Deductions

Other Children