3224EN – Rev. 5/2016

Filing a Petition to Modify Your Child Support

Court Order

Instructions and Forms May 2016

3224EN – Rev. 5/2016

Table of Contents | Page - 1

Table of Contents Section 1: Introduction - Important Questions and Answers ....................................... 1

A. What is a Petition to Modify Child Support Order? ............................................... 1

B. When should I file this Petition? ........................................................................... 1

C. Should I use this packet? ..................................................................................... 1

D. Where may I file my Petition? .............................................................................. 2

E. How much will this cost? ...................................................................................... 2

F. What if I have questions that this packet does not answer? ................................ 2

Section 2: Words and Expressions You Should Know ................................................. 2

Section 3: How to File your Petition ............................................................................... 5

Section 4: What is in This Packet? ................................................................................. 7

A. Forms you will need in this packet: ...................................................................... 7

B. Forms you may also need in this packet: ............................................................. 7

Section 5: What Else Will I Need That is Not in This Packet? ...................................... 8

Section 6: Checklist of Forms and Documents You will Need ..................................... 9

A. Use these forms and documents if the other party will not agree: ........................ 9

B. What if the other parent and I agree on the change in child support? ................ 10

C. If you file certain confidential information any time during the case, use these forms to keep the private information out of the public court file ........................ 11

Section 7: Follow These General Instructions before Filling out the Forms ............ 11

Section 8: How to Fill out Each Form ........................................................................... 16

A. Washington State Child Support Worksheets .................................................... 16

B. Financial Declaration of: - FL All Family 131 ...................................................... 19

C. Sealed Financial Source Documents (Cover Sheet) – FL All Family 011 .......... 21

D. Confidential Information Form and Attachment - FL All Family 001 & 002 ......... 21

E. Petition to Modify Child Support Order – FL Modify 501 .................................... 22

F. Sealed Personal Health Care Records (Cover Sheet) – FL All Family 012 ....... 24

G. Summons: Notice about Petition to Modify Child Support Order - FL Modify 500 .................................................................................................................... 25

H. Domestic Case Cover Sheet .............................................................................. 25

I. Declaration re: Service Members Civil Relief Act – WPF All Cases 01.0200 ..... 26

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J. Notice re Military Dependent - FL All Family 103 ............................................... 28

Section 9: Filing and Serving Your Petition ................................................................. 28

A. Filing your Petition ............................................................................................. 28

B. Serving the Petition and filling out the Proof of Service by Mail ......................... 29

Section 10: How to fill out an Agreement to Join Petition (Joinder) if the Other Party Agrees with You .............................................................................. 31

Section 11: If the Other Party is in the Military or the Dependent of Someone in the Military ................................................................................................. 32

A. Instructions for the Waiver of Rights under Service Members Civil Relief Act form ................................................................................................................... 33

B. File the Waiver form ........................................................................................... 33

Section 12: Blank Forms ............................................................................................... 33

This publication provides general information concerning your rights and responsibilities. It is not intended as a substitute for specific legal advice.

This information is current as of May 2016.

© 2016 Northwest Justice Project — 1-888-201-1014.

(Permission for copying and distribution granted to the Alliance for Equal Justice and to individuals for non-commercial use only.)

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Section 1: Introduction - Important Questions and Answers

A. What is a Petition to Modify Child Support Order?

It asks the judge to change the amount of your child support. If you provide enough evidence to support a change, the judge will issue a new Child Support Order.

B. When should I file this Petition?

You may only do so in certain circumstances. Before filing, talk with a lawyer with family law expertise. (See resources below.) Our publication called Changing Your Child Support Court Order may also help. You can read it at www.washingtonlawhelp.org.

Also, check with your county's Superior Court. They may have a family law facilitator who can help you or refer you to free or low-cost clinics or lawyer referral services.

You will see footnotes in this packet. They tell the law or court case supporting the footnoted statement, or give special tips, links to websites, or other information. Use the footnotes to look up the law at your local law library, or to tell the court when you are trying to make a legal argument. CR is the Civil Rules of Washington. GR stands for General Rules. RCW stands for Revised Code of Washington, the law of Washington State. Court cases have names, such as In re Custody of Child. The references to the law are up to date as of the date we published this packet. The law sometimes changes before we can update the packet.

C. Should I use this packet?

This packet will help you start a Petition to Modify (change) a final Washington State Child Support Court Order in a divorce or parentage case. This packet does not describe how to change a temporary child support order, an order entered in a non-parent custody case, or court orders from other states. 1

Before using this packet (once you have decided you want to file a Petition to Modify Child Support Order), check with your county’s family law facilitator or court clerk. Your county may have its own Petition to Modify Child Support Order packet. If so, use theirs. It will have your county’s rules and forms.

1 The Uniform Interstate Family Support Act (RCW 26.21 et. seq.) is the law on registering and modifying child support orders from other states. If you need to modify an out-of-state order, talk with a lawyer or call the Division of Child Support (DCS).

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D. Where may I file my Petition?

If you have a valid Washington State court order, you may file your Petition in the county:

• Where your current child support order was filed OR

• Where the child lives OR

• Where the person with custody of the child lives2

E. How much will this cost?

The costs involved include a filing fee of about $56 if you are modifying your order in the same county where it was entered, $220-$250 if you are filing in a new county,3 copying fees, and (possibly) fees for service (delivering the papers to the other parties in your case). If you cannot afford the filing fee, you can file a motion asking the judge to waive (cancel) the filing fee. Our publication called Filing Fee Waiver has more info. Our packet called Filing for Waiver of Your Filing Fee has forms and instructions.

F. What if I have questions that this packet does not answer?

Talk to a lawyer familiar with family law before filing anything with the court. Many counties have family law facilitators who can help you fill out forms or free legal clinics where you may get legal advice about your case.

• Do you live in King County? Call 211. 211 is open Monday through Friday between 8:00 a.m. and 6:00 p.m. From a pay/public phone, call 1-800-621-4636. 211 will identify and refer you to the appropriate legal aid provider.

• Apply online with CLEAR*Online - https://nwjustice.org/get-legal-help

• Call the CLEAR Legal Hotline at 1-888-201-1014.

Section 2: Words and Expressions You Should Know Appearance: Informing the court and parties where you can get notice and that you plan to take part in your case. You can do this in person at a Court hearing, or in writing, usually by filing and serving a Notice of Appearance. Certain informal actions, such as negotiating, phoning about the case, or writing a letter, that show a knowledge of the claims in the case and an intent to defend, might also be considered an appearance.

Attachment: A document stapled to a court form and referred to in the form. Attachments should follow any format rules for court forms. (Basic information about the format rules is in the General Instructions section of this packet.)

2 RCW 26.09.280. Our publication called Changing Your Washington Child Support Court Order has more information. 3 RCW 26.09.175(1).

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Bailiff: A member of the judge’s staff, in charge of courtroom procedure and security. The bailiff and clerk may be the same person.

Calendar: The court’s schedule of cases to be heard. Also called a Docket.

Caption: The heading of each legal document, which has the name of the court, the names of the parties, the case number, the name of the document itself, and, sometimes, the type of case.

Case Schedule: A printed schedule issued by the court in some counties showing major dates and deadlines in your case

Certified Copy: A copy of a document from the court file made by the court clerk that has an official stamp on it stating it is a true copy. Usually, you pay for a certified copy.

Clerk of the Court: An officer of the court who handles matters like keeping records, entering judgments and providing certified copies. Each courthouse has a Superior Court Clerk’s Office. Someone from the clerk’s staff is also usually in the courtroom during hearings.

Commissioner/Court Commissioner: Like a judge, but only makes decisions relating to a specific subject matter. Many counties have family law commissioners who decide only family law cases4.

Confirm a Hearing or Trial: Notifying the court that you still plan to have the hearing/trial scheduled in your case. The way to confirm your hearing or trial differs by county. Not all counties require it. Often a phone call to the court a few days before the hearing/trial is required. Local rules explain each county’s requirements. If notice is required and not given, the hearing/trial may be cancelled.

Conformed Copy: A copy of any court document that has been filed with the clerk. It must be stamped with the date filed. If the document is an order, it must also have the name of the judge who signed it written or stamped on it.

Contested Case: A case in which opposing parties actively disagree about the case’s outcome.

Continuance: Delaying your court hearing to a later date. In some counties, the judge must approve any request for a continuance.

Custodian: The person the children live with most of the time.

DCS: Division of Child Support: The state office (part of DSHS) that establishes, enforces and changes child support obligations in many cases. DCS used to be CSD, OSE and SED.

Declaration: A written statement made to the court under oath.

Default: When you do not respond to court papers within the legal deadline.

Ex Parte: Going before the court without notifying the other party. Sometimes also refers to the courtroom where you see a judge without notifying the other party.

4 Many decisions in family law cases are made by commissioners, not judges. To make this packet simpler, in most places we use “judge.”

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Exhibit: Documents, records, and photographs introduced into evidence at trial or hearing. Attachments to legal forms might also be called exhibits. If so, they should follow any format rules for court forms. (Basic information about the format rules is in the General Instructions section of this packet.)

Filing: Giving court papers to the Court Clerk to place in the case file.

Hearing: Going before a judge to ask for a court order or to defend against another party’s request. Hearings usually take place before the trial and are about specific issues. Example: temporary relief. Hearings on important issues (example: motions to dismiss) may end the case. In many counties the court does not allow live witness testimony at hearings. Instead, the parties are expected to file and serve materials in advance in writing. In some counties, the court may decide certain types of child support cases by hearing rather than by trial.

Jurisdiction: The court’s authority to make decisions. If a court does not have jurisdiction, it does not have the authority to make orders over the person or subject affected.

Motion: A formal request to the court for an order.

Motion Docket: The court’s schedule of motions it will hear.

Moving Party: The person who files the Petition to Modify Child Support Order. The moving party can be either a Petitioner or a Respondent in the original case.

Note/Notice of Hearing/Note for Motion Docket: A form which lets the clerk know to schedule a hearing and tells the other parties the subject of the hearing and when/where the hearing will be.

Order: A court document signed by a judge ordering someone to do or not do something. Restraining orders, orders re adequate cause, Residential Schedules or decrees, are all examples of orders, if the judge has signed them. If you disobey a court order, you may be held in contempt. Look to see if an order you are served with is only a proposed order or if the judge has actually signed it. An order is not in effect until a judge has signed it. (See “proposed order” definition.)

Other party: Every party to the case, other than yourself. In court forms, the “other party” can also mean one party. Example: when the Motion for Default says “other party,” it means the party you believe is in default.

Party: Any Petitioner or Respondent. GALs and the State of Washington may also be parties.

Petitioner: The person who first files a legal case. The petitioner in the caption of a form does not change, even after the other party files motions.

Pro Se: Acting without the aid of a lawyer. Representing yourself in court.

Proposed Order: A document one party asks the judge to sign. It will not yet have the judge’s signature on it. In many counties, you must file and serve your proposed order with your motion or response to a motion to show how you want the court to decide the motion. Even if your county does not require it, you should prepare and serve a proposed order and deliver copies to the court anyway. A proposed order becomes an order if the judge signs it.

Respondent(s): The party/parties against whom the case was originally filed.

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Response: A formal written answer to a court Petition. The term may also refer to the papers someone files in response to a motion. It can be confusing. We use the word “Response” with a capital “R” to refer to the Response form. We say “response” with a small “r” to refer to all types of responses (example: responses to motions AND petitions).

Ruling: A decision by the court.

Service: Giving court papers to the other party in a legally correct way.

Transfer Payment: The amount of money the court orders one parent to pay as that parent’s share of child support.

Trial: Usually, the final proceeding in a case. The judge considers properly introduced evidence, hears argument, and decides the case’s outcome. Courts often decide petition to modify child support order cases without a full trial. See “hearing” and “trial by affidavit.”

Trial by Affidavit: The kind of trial where the court hears no live testimony. Instead, the court reads the parties’ “affidavits” or written declarations, considers documentary evidence, hears argument, and decides the case’s outcome. In some counties, court commissioners preside over these trials. In other counties, they are held before judges.

Venue: The county where the case should be filed. Proper venue depends upon the type of case.

Waiver: Asking to be excused from something. When you file a motion for a fee waiver, you are asking the court’s permission to not have to pay the fee.

Working papers/working copies: Local court rules may require you to deliver an extra copy of all of papers (including proposed orders) for your hearing for the judge to read. We call this set of copies Working Papers. To learn the rules for working papers and confirming the hearing in your county, read local court rules, and check with the family law facilitator or court clerk.

Section 3: How to File your Petition We explain many of the steps below in more detail later in this packet.

Many counties have case schedules you must follow. Some counties require arbitration before a judge will sign final orders. Ask the court clerk or family law facilitator, if your county has one, about case schedules and local court rules for petition to modify child support order cases.

1. Learn About the Law on Child Support. Read our publications called Changing Your Child Support Order and Understanding the Washington State Child Support Schedule and How Child Support is Set in Washington. Try to talk with a family law attorney. Make sure this is the right procedure for you.

2. Check for Special Local Rules and Forms. Ask the court clerk or family law facilitator if your county has its own Petition to Modify Child Support Order packet. If

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so, use that packet. If you use ours, get any other forms you will need. Make sure you know any special deadlines for filing a petition to modify your child support order in your county.

3. Gather Needed Financial Documents and other forms that are not in this packet.

4. Make Sure you know the Other Party’s Address. You need the address for each party you must serve. The other parent may be the only other party. The State may be a party. There may be still other parties besides them.

5. Follow the General Instructions.

6. Fill out the Forms You Plan to Use.

7. Make One Copy of Each of the Finished Forms and the financial documents you are filing with the court.

8. File Your Papers with the Court Clerk’s Office in the Superior Courthouse of the county where the petition was filed.

9. Make the Necessary Extra Copies of the Forms. Have the Papers Served on the Other Parties.

10. Fill Out and File the Proof of Service by Mail.

11. File a Motion for Temporary Family Law Orders or Immediate Restraining Orders, if you want. If you want a court order that will change child support temporarily until your trial by affidavit, you can file a Motion for Temporary Family Law Orders. If you can schedule your final hearing anywhere from within a month to three months after you serve the papers, do not file a motion for Temporary Family Law Orders. Your trial is set fairly soon. Ask the family law facilitator or court clerk for more information about your county’s local practice. If you do need to file a motion for Temporary Family Law Orders, our packet called Filing for Temporary Family Law Orders: Divorce Cases and Petition to Change Parenting Plan Cases has the forms and instructions to do this.

12. Ask for Discovery, if you want it. The rules require the other parties to give the court and you certain financial information. If they do not, or you need more information, see your family law facilitator or talk with a lawyer about asking for discovery.

13. Take part in locally required procedures. Find out and follow the procedures in your county. Example: some counties may require arbitration.

14. File a Motion for Oral Testimony if needed. Generally, the judge decides these cases by looking at papers you have filed (“trial by affidavit”). There is no testimony by “live” witnesses. If you want a trial with live testimony, where you or other witnesses will answer questions under oath, you must file a motion for oral testimony. Our packet called Finalizing a Modification of Your Child Support Order has more information.

15. Finalize Your Case. If all the parties agree about the final papers and sign them, you

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should ask the court to sign the agreed papers before your trial date. If the other party has not responded, file a motion for default. If the other party has responded, get ready for trial. You may need to ask for a trial date. Get our packet called Finalizing a Modification of Your Child Support Order.

Section 4: What is in This Packet? This packet has many of the forms you will need to file your Petition to Modify Child Support Order.

Read the next section to decide what else you will need.

A. Forms you will need in this packet:

Form Title Form Number Washington State Child Support Schedule & Instructions

WSCSS - Schedule

Child Support Worksheets WSCSS - Worksheets Financial Declaration of: FL All Family 131 Sealed Financial Source Documents (Cover Sheet)

FL All Family 011

Confidential Information Form & Attachment FL All Family 001 & 002 Petition to Modify Child Support Order FL Modify 501 Summons: Notice about Petition to Modify Child Support Order

FL Modify 500

Notice re Military Dependent FL All Family 103 Declaration re: Service Member’s Civil Relief Act

WPF ALL Cases 01.0200

Proof of Service by Mail FL All Family 107 Domestic Case Cover Sheet

B. Forms you may also need in this packet:

Form Title Form Number Sealed Personal Health Care Records (Cover Sheet)

FL All Family 012

Agreement to Join Petition (Joinder) FL All Family 119 Waiver of Rights Under the Service Members Civil Relief Act

No Form Number

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Section 5:What Else Will I Need That is Not in This Packet? You will need more than just this packet to file and finalize your case. Check the boxes by the documents and packets you need. Get those documents or packets before filling out your forms.

Your Current Child Support Order and Worksheets – Get a copy of your current Child Support Order and worksheets (the most recent final order and worksheets a judge signed). You can get a current copy at the Superior Court Clerk’s office in the county where the order was entered. Or call the Division of Child Support to ask them to send you one.

Filing for Waiver of Filing Fee - If you cannot afford to pay the filing fee, you can file a motion asking the court to waive (forgive) the filing fee. This packet explains how

Declaration about Public Assistance - FL All Family 132: This optional form is not in our packets. Our instructions tell you to serve the State in any case where TANF, Medicaid, or foster care is involved. We instruct you to get the state’s signature on all default and agreed orders where the state might have an interest in the child support obligation in your case. You may need the form if your county requires it, or if you need to verify that no public assistance has been paid or that the children are not in foster care or out-of-home placement. Get the form at http://www.courts.wa.gov/forms.

Serving Papers on the State - if any party is asking for an order regarding child support, and any of the children has gotten public assistance (TANF), or medical coupons/Medicaid or is in foster care or out-of-home placement, get this packet. You must include the state as a party and serve them with papers you file.

County Local Court Forms and Rules - Some counties have special forms you will need when filing a Petition to Modify Child Support Order. Those are not in this packet. Many counties have special local rules you will need to know about to file a Petition to Modify Child Support Order in that county. The court clerk’s office or family law facilitator has more information.

Example: Order Setting Domestic Case Schedule – Some counties use this form. If your county has a case schedule, the court clerk will give it to you when you file your case.

Your county’s local rules or forms may be available online. Check at the Access Washington web site: www.access.wa.gov/government/awco.asp.

Understanding the Washington State Child Support Schedule and How Child

Support is Set in Washington - basic information about the laws for setting child support in Washington State.

Changing Your Child Support Court Order - basic information about the laws that apply to changing a Washington State Child Support court order, or responding to a

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proposed change.

Sealed Records Cover Sheets. The Confidential Court Reports Cover Sheet is not in this packet. If you are filing the kinds of records that require this cover sheet (see Box #2 of the General Instructions section), it is in our packet Filing for Temporary Family Law Orders. Or download the form from http://www.courts.wa.gov/forms.

Declaration of Witness - to file statements from people familiar with any issues in your case, or to file your own detailed statement. This form is in our packet Finalizing a Modification of Your Child Support Order. Use it to get ready for your trial by affidavit. You will not use it at the start of the case.

Filing for Temporary Family Law Orders - to ask for a court order covering the time between the date you file for your petition and the date it is final.

Responding to a Motion for Temporary or Immediate Restraining Orders - if the other party files a motion for Temporary Family Law Orders and/or an immediate restraining order.

Subpoenaing Witnesses and Documents – to make sure important witnesses or documents are at trial. (Many courts decide these cases with declarations instead of live testimony.)

Finalizing a Modification of Your Child Support Order –to finalize your case, whether by agreement, default, or going to trial.

Financial Information - You must prove what your income is, and that you need a modification. If you do not provide enough financial information, the court can deny your request.

Notice of Address Change (FL All Family 120): If you move during or after your case, you must fill this form out, file it with the court, and get all other parties a copy. Download the form from http://www.courts.wa.gov/forms

Section 6: Checklist of Forms and Documents You will Need

A. Use these forms and documents if the other party will not agree:

Summons: Notice about Petition to Modify Child Support Order

Petition to Modify Child Support Order

Financial Declaration

Sealed Financial Source Documents Form

Child Support Worksheets

Confidential Information Form: & Attachment (Do not serve this form on the other

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party)

Civil Case Cover Sheet

Locally required forms

Proof of Service by Mail

A copy of your most recent final Child Support Order and worksheets.

Notice re Military Dependent

Declaration re: Service Member’s Civil Relief Act

Your last two years of federal and (if applicable) state income tax return forms, with your W2s and other attachments

If you have no copies of your income tax returns, request copies from the IRS for a fee. If you filed no federal income tax returns in the last two years, you must state that in your declaration, and explain why. You must provide the court with other proof of your income for the last two years, such as W2 or 1099 forms, paystubs, or a declaration from your employer.

Your pay stubs (provide at least one full month of paystubs, or more if possible. Some counties require more than a month of paystubs).

If you are self-employed, or you do not have paystubs or tax returns, you must get papers that prove what your income is. Examples include:

• Official letters from Social Security, L&I, Employment Security, or DSHS saying how much you receive in benefits

• Bank account statements

• Business tax returns or records, or 1099 forms

Some counties require other evidence, such as bank statements or check registers. Check your local court rules. See if you need to provide more financial information.

If the other party is in the military or is the dependent of a person in military service, include the Waiver of Rights under the Service Members’ Civil Relief Act in the papers served with the petition.

Use the Declaration of Witness to explain more about why you need the child support modification. Most people will need this form to get ready for their trial by affidavit. It is in our packet, Finalizing a Modification of Your Child Support Order.

B. What if the other parent and I agree on the change in child support?

If you agree on how much support should change, and all parties sign the papers to show your agreement, do not use all the forms listed above. You only need to fill out:

Petition to Modify Child Support Order

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Agreement to Join Petition (use this if the other parent does not sign the Petition, or if s/he does not sign the new Child Support Order, Final Order and Findings, and Child Support Worksheets)

Child Support Worksheets

Civil Case Cover Sheet

Locally required forms

Child Support Order

Final Order and Findings on Petition to Modify Child Support Order

Confidential Information Form: & Attachment (each party should fill out his/her own form. Do not give this completed form to the other party)

If the other party is in the military or is the dependent of a person in military service, the Waiver of Rights under the Service Members’ Civil Relief Act.

The Final Order and Findings on Petition to Modify Child Support Order, Child Support Order and Child Support Summary Report forms, and instructions for how to fill them out and enter final orders by agreement, are in our packet Finalizing a Modification of Your Child Support Order. Use that packet to finalize your case by agreement. You may also need to bring proof of both parties’ incomes to your final hearing.

You and the other parent must both sign all these forms after filling them out. If your children have ever gotten public assistance (TANF), or Medicaid, or if they are in foster care or out of-home-placement, the county prosecuting attorney’s office will need to sign all the final orders. Our packet called Serving Papers on the State has more information.

C. If you file certain confidential information any time during the case, use these forms to keep the private information out of the public court file

Sealed Personal Health Care Records (Cover Sheet)

Sealed Confidential Reports (Cover Sheet)

Sealed Financial Source Documents (Cover Sheet)

Section 7: Follow These General Instructions before Filling out the Forms

These general instructions apply to all the forms you fill out. The instructions cover all types of family law cases. Some of the information may not apply to your case. A Sample form at the end of this section may help you understand these instructions better.

The caption. The caption includes the name of your case, the case number, the name of the court, the title of the court paper, and, sometimes, the type of case. It appears at the top of

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the first page of every form. Put the name of the county where you are filing your case in the blank where the form reads "Superior Court of Washington County of ."

Case name. Look at your current Child Support Order (the one you are trying to change). Copy the names from the upper left-hand side of that form onto your blank form. Example: if the court entered your Order in a parentage action, you may see In re the Parentage of or State of Washington. List the petitioner and respondents just as they appear on your current child support order. These are the parties to your case. You must serve them with the papers you file. We explain how to later in this packet. If you have any questions about other potential parties, talk to a lawyer.

Case number. When Petitioner starts the case by filing the initial papers and paying the filing fee (or having the fee waived), the court clerk assigns a case number. All parties must put that case number on every paper they file with the court and serve on the other parties. Put the case number near the top on the right-hand section of the first page of every form after "No." (abbreviation for “number”)

You can print the case number OR you may be able to use a special stamp at the court clerk’s counter to stamp the case number on each paper. You must print or stamp the case number on the first page of every copy of every paper you file with the court and on the copies you make for other parties. If you do not, your papers may be lost, or the clerk may return them to you. Some courts will fine you for filing incorrect forms.

Title. Each form has a title. It is directly under the case caption. Sometimes the full title is on the form. Sometimes you must add more information to finish it. (Example: On a declaration, you put the name of the person filling out the declaration.)

Format: Pleadings (legal forms) that you file with the court and attachments to those pleadings must follow the court rules about size and margins (GR 14(a)). You must use regular size (8 ½ x 11”) white paper. You may write on only one side of the paper. The first page of each paper that you file must have a three-inch margin (three inches of space) at the top. The other margins (left, right and bottom, and the top from the second page on) must be at least one-inch wide. Use black or dark blue ink. If your forms do not follow these rules, the court clerk may refuse to file them or may make you pay a fine.

The contents. Fill out each form according to the instructions for that form. In most counties, you may print or type the information. It must be readable. You must use BLACK OR DARK BLUE INK. In a few counties, you must type everything. After filling out each form, re-read it. Make sure you have correctly filled in all blanks you need to. Any corrections must be neat and readable.

Do not write in the margins of any page. The clerk may reject your form.

Dates. On the last page of most forms (not including orders), there is a space for the person who filled the form out to put the date they signed it. The judge will put dates in orders when s/he signs the order.

Signatures.

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• Your Signature: After you fill out a form, look for the place(s) to sign your name:

o Some forms have one signature line for “petitioner” or “respondent.” After you fill out a form such as the petition, sign at the place that applies to you. Look carefully. You may have to sign in more than one place. You may have to put the date and the place (city, state) you signed the form.

o When you prepare and file motions, you are the moving party. After you prepare a motion, look for each place marked person making this motion fills out below. You may have to sign in more than one place. You may have to put the date and the place (city, state) you signed the form.

o When you prepare an order and plan to present it for the judge to sign, look for the place at the end for your signature. Check is presented by me.

• Judge’s Signature: Leave the judge’s signature line and the date blank.

• Other party’s signature: Some forms have a place for other parties to sign. You cannot force another party to sign a court paper. S/he can choose (not) to sign. If you have prepared an order after a hearing, the other party may be willing to sign it if s/he agrees it accurately states the judge’s decisions (or the judge may require the other party to sign), even if the party is not happy with the decision itself.

o Agreed orders. If the other party agrees with the orders you have written, s/he should sign in the right place on each court order s/he agrees to.

o May be signed by the court without notice to me. If you are the respondent or nonmoving party, or if you did not prepare the order, the other party may ask you to check this box and sign underneath. If you do, you are agreeing the judge should sign the order as written AND the other party can give the order to the judge to sign without letting you know when they are going to do it.

• Other signatures: If someone else (a witness or the person serving papers) must sign a form, they must fill out all information correctly and sign in the right space.

Place signed. Declarations and Proofs of Service must include the place you signed them and the date. (Example: Signed this 10th day of October 2014 at Seattle, WA.)

Identifying Information. Court rules try to protect privacy but also allow for public access to some information in court files. The following three boxes discuss these rules: GR (General Rule) 15, GR 22 and GR 31.

Box #1 - Things to Not Put in Most Court Papers: Court General Rules 22 & 31 try to protect privacy in family law cases. Almost all pleadings, orders and other papers filed with the court are available to the public. They may also be available to the public online. Except where instructions about a specific form tell you otherwise (example: the forms in Box #3), use these rules for papers you file with the court.

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Address (Where you Live) and Phone Number: You must put an address where you can get mail from the court. (It does not have to be your home address.) You should also give the court a phone number where they can reach you.

Social Security/Driver’s License, ID Numbers of Adults and Children: If you put these in court papers, put only the last four digits, not the whole number.

Bank Account, Credit Card Numbers: Put the bank name, type of account (savings, checking, and so on), and only the last four digits of the account number.

Box #2 - Private Information You Should File With Sealed Cover Sheets: If you use a sealed cover sheet, this information is usually available to the other party and the court. It is not available to the public.

Financial Information: If you file paystubs, checks, loan applications, tax returns, credit card statements, check registers, W-2 forms, bank statements, or retirement plan orders, attach them to a Sealed Financial Source Documents form. Then the public cannot access them.

Medical or Mental Health Records or Information: If you file papers that have health or mental health information (information about someone’s past, present, or future physical or mental health, including insurance or payment records), you must attach the papers to a Sealed Personal Health Care Records form. Then the public cannot access them.

Confidential Reports: Reports intended for court use must have a public section and a private section. You should attach the private section of the report to a Sealed Confidential Reports Cover Sheet.

Retirement Plan Orders: Certain retirement information belongs in the public file. “Retirement Plan Orders” do not. Use the Sealed Financial Source Documents Cover Sheet for the Retirement Plan Order. See GR 22, or see a lawyer if this affects your case.

Other Kinds of Confidential or Embarrassing Information Not Mentioned Above. If the paper you want kept confidential is not in the above list, you may need to file a motion with the court to asking to have that paper, or part of it, sealed under General Rule (GR) 15. There is no packet for this. There are presently no mandatory forms for this type of motion. Talk to a lawyer.

Box #3 - When to Put Private Information in Court Forms These forms are not in the public file. Information in them is usually not available to the other party.

You must fill out your personal information completely (including your home address, social security number, and so on): Confidential Information Form, Vital Statistics Form, Domestic Violence Information Form, and Law Enforcement Information Sheet.

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Superior Court of Washington, County of In re the marriage of:

Petitioner (person who started this case):

Jane Brown

And Respondent (other spouse):

John Brown

No. Notice of Hearing (NTHG)

Clerk’s action required: 1

Sample Form - Notice of Hearing To the Court Clerk and all parties:

1. A court hearing has been scheduled: for: May 15, 2016 at: 9:30 a.m. p.m.

date time

at: 1234 Maple Street in 15 court’s address room or department Judge Anne Smith docket / calendar or judge / commissioner’s name

2. The purpose of this hearing is (specify):Temporary Family Law Orders regarding a parenting plan and child support.

Warning! If you do not go to the hearing, the court may sign orders without hearing your side. This hearing was requested by: Petitioner or his/her lawyer Respondent or his/her lawyer

Jane Brown Jane Brown 5/1/16 Person asking for this hearing signs here Print name (if lawyer, also list WSBA No.) Date

I agree to accept legal papers for this cas at:

5252 A Street address

Treelane WA 98888 city state zip

(Optional) email: jbrown@email.com

This does not have to be your home address. If this address changes before the case ends, you must notify all parties and the court clerk in writing. You may use the Notice of Address Change form (FL All Family 120). A party must also update his/her Confidential Information form (FL All Family 001) if this case involves parentage or child support.

This case type is for a divorce. Yours may be different.

Put the county where you are filing this form.

Put the case number. The court clerk assigns this number when the

Petitioner files the case.

This is the form’s title.

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Section 8: How to Fill out Each Form

A. Washington State Child Support Worksheets

Each party must fill out a set of child support worksheets, using the instructions and schedule that come with them. You may have to file and serve worksheets more than once during the course of your case:

• With the Petition and Response

• When there are motions and hearings involving child support (to update info in your first set of worksheets)

The judge will sign a set of worksheets s/he approves when entering a child support order. The judge may sign worksheets one party prepared. Or the judge may ask a party to fill out a new set of worksheets with the specific income, expense, and child support amounts the judge announced at hearing/trial.

The instructions in this packet only cover a few special issues.

The instructions and worksheets in this packet are current as of May 2016. Use them along with the Washington State Child Support Schedule published by the Administrative Office of the Courts. Get it from their website (http://www.courts.wa.gov/forms/), or call (360) 705-5328. Also, read our publication called Understanding the Washington State Child Support Schedule and How Child Support is Set in Washington.

These instructions are for filling out the worksheets based on the income, child support amounts, and expense figures you propose at the start of the case and/or before a hearing or trial.

If the parties all agree on the income, child support amounts, and expense figures, you must fill out the worksheets using the figures you agree to. You may still need to show the judge that those amounts are correct.

If you are filling out these worksheets after the judge has announced a decision, you must use the income, child support amounts, expenses, and other info the judge announced, even if you disagree with them and/or they are different from what you proposed.

Use the Division of Child Support’s (DCS) online Child Support Estimator, https://fortress.wa.gov/dshs/dcs/SSGen/Home/QuickEstimator for help

• estimating the amount of support the judge might order in your case

• preparing proposed child support worksheets

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• filling out your Worksheets online

The Estimator may not work if you are asking for a “deviation” from the standard child support calculation. (Examples of when you might ask for a deviation: the parents spend a lot of residential time with the children; there are children from other relationships; each parent has custody of one of the children.)

To fill out the worksheets, follow the instructions in the Washington State Child Support Schedule (WSCSS). They explain:

• the meaning of gross and net income

• how to list your income

• how/when to impute income to the other party

• how to fill out the rest of the financial info

Our instructions address gaps in the WSCSS instructions:

1. Above the caption, check the box to show whether these worksheets are proposed or an order signed by the judge. If they are proposed, check the box showing who is proposing them and put your name.

2. Caption your worksheets. At the top of worksheet page 1, put your county, the case number, the parents’ and children’s names, and the children’s ages in the appropriate spaces.

3. List your info on the Worksheet in Column 1 and the other parent’s in Column 2.

4. Put info for the other parent only if you know or can estimate their income and expenses. You should put on the form if you have used estimates. If you have any income information for the other parent, even an estimate, use that information. Explain in Other Factors for Consideration at Line 26 any income information or estimates you listed which you did not base on wage stubs or tax returns. The other parent will have a chance to correct any incorrect information.

5. If any party gets SSI, TANF, or Food Stamps, list that income on line 22(f), Income from Assistance Programs, and not line 1, Gross Monthly Income. You should list income from other common programs such as social security, worker’s compensation, unemployment benefits, and pension or retirement benefits on line 1(e), “Other Income.”

6. If you cannot get accurate income information about the other parent or estimate their income based on what you know, or you believe s/he is voluntarily unemployed or underemployed, follow the instructions for imputing income to that parent. (See the WSCSS Definitions and Standards, INCOME STANDARD #6, on page 1.)

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7. Health Care Expenses (Part III): You should include here only expenses you pay regularly (example: monthly health insurance premium). Do not include doctor bills that may change over time. If you are listing health care expenses on lines 10a and 10b, you should also list monthly payments you actually made for those expenses on line 16a, Monthly Health Care Expenses Credit.

8. You can Include Daycare, Education & Travel Expenses: In section 11, put your daycare, tuition or other special childcare expense, and have that amount included in the transfer payment. Then mark the first box in section 21 of the Child Support Order under Other shared expenses: “Does not apply. The monthly amount covers all expenses, except health care expenses.” If you are listing day care or other special expenses in part III of the Worksheets, you must also list monthly payments that parent actually made for those expenses on line 16b, Day Care and Special Expenses Credit.

In most cases, you should not list your daycare, education and travel expenses here. Instead, you should list them in section 21 of the Child Support Order under Other shared expenses, after checking the parents will share the cost for the expenses listed below. This allows for changes in these expenses that may take place over time. Then you may not need to change your support order in the future. The downside of putting these expenses in the Order (instead of the Worksheets) is that it may be harder to collect payment from the other parent for these expenses. DCS will help compute and collect day care and other special expenses.

9. In the “Other Factors for Consideration” part of the Worksheet, you explain how you calculated income and expenses, and show factors that may allow “deviation” from the “standard calculation.” If there are special circumstances, you should list this information on the worksheet. See the “Limitation Standards” and the "Deviation Standards" on pages 3 - 4 of the Definitions and Standards section of the Washington State Child Support Schedule to decide what info to put.

You can also explain how you calculated the support amount. State how you calculated each parent’s income. If the income you put for someone is imputed or estimated, put how you figured out the income amount. If you believe support should be less than the standard calculation, state how much it should be and why.

If a parent gets disability benefits like Social Security and the child is eligible for them on the parent’s account, you must report both parent’s and child’s shares under “net income.” You should then explain in the Other factors for Consideration box the child’s share of the benefit, who is currently getting the child’s benefit, and that the parent should get credit against his/her support obligation as long as the child’s benefit continues.

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Fill out the Worksheet Completely. It takes time and patience. You must fill it out accurately as you can. The court decides the child support payment based on the info in this worksheet.

Signature. Sign where indicated on the last page. Put the date and place (city) you signed.

B. Financial Declaration of: - FL All Family 131

Attach the last two years of tax returns (or W2s and 1099s if you have not yet filed your income tax form), and at least six months of pay stubs or proof of income from other sources such as Social Security. Local court rules may require more documentation.

Caption. Fill out the caption, including your name.

1. Your personal information. Give the info requested. Check yes if you are currently working and put your hire date. Check no if you are not currently working and put the info provided.

2. Summary of your financial information. Skip this section. Come back to it after filling out the rest of the form.

3. Income.

If you do not know how much the other parent’s income is, give your best estimate, or use the support schedule’s instructions for imputing income.

Use the You column for your information and the Other Party column for the other parent. Put the income information and income deduction information requested. Make sure you use the correct column for each party.

Income from Benefits: If a parent gets Social Security Disability (SSDI) or workers’ compensation (L&I, or other disability benefits from an employer), put that amount in Other Income.

Work-Related Disability Benefits: If a parent gets SSDI, L&I and some employer-paid disability benefits or Social Security retirement, and the child/ren get dependent benefits as a result, the payments they get directly count as income to that parent even if the money actually goes to the other parent or custodian. You should add those amounts under 3A to income of the parent getting benefits. Those benefits should also be credited as child support paid by the parent. The paying parent’s support should go down dollar for dollar by the amount of dependent benefits his/her children get directly for current child support. See RCW 26.18.190.

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Deductions from Income: If you include any deductions from income other than income tax, FICA, and L&I payments, you must provide documents proving each deduction.5 Paystubs may show union and pension plan deductions. You must have extra documents (such as pages from a collective bargaining agreement or employee handbook, or a letter from the employer) showing these deductions are required. If pension deductions are voluntary, show documents proving you have had the deduction taken for at least two years, or the court may not allow it. If the other parent disputes your claims, be ready to present business records and receipts showing any business expenses you are claiming. Follow the instructions at the end of the Financial Declaration Form. You should attach private financial information to the Financial Source Documents Cover Sheet.

4. Other Income and Household Income.

A. Other income. Put the name and amount of any other income (including TANF, SSI, and/or food stamps) a parent gets regularly.

B. Household Income. List the gross monthly income of other adults in the household. That income is not included in calculating the basic child support obligation. The court might consider it if someone asks for a deviation from the standard child support amount.

5. Disputed income. If you think anyone will dispute a parent’s income, state what you believe is the correct amount of that parent’s income. Explain why you believe that is the true amount.

6. Available Assets. List your assets - cash, and things that you own that could easily be sold for cash. (Examples: stocks, bonds, and so on.)

7. Monthly Expenses after Separation. Fill out your monthly household expenses. Fill out your best estimate of each expense. Many expenses are not monthly. For those, take the actual amount you pay. Calculate the monthly average. Example: If you pay your car insurance every six months, take the amount you pay, divide it by 6, and put that amount in the blank under 7F.

Your total monthly expenses may end up being more than your net monthly household income. This is especially common for people who are low-income. You may put off paying a certain bill or make other cutbacks in your expenses. Your monthly expenses do not need to be equal to or less than your income. But if your expenses are far more than your income, the court might ask how you are meeting your expenses. Be ready to show how you are doing it.

8. & 9. Section 8 is for giving more details about expenses you already listed in 7.

11. Attorney Fees. If you hire a lawyer for this case, put those expenses here.

Signed at: Put the city/town and state where you are signing this form, and the date. Sign and date where indicated.

5 RCW 26.19.071(5).

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C. Sealed Financial Source Documents (Cover Sheet) – FL All Family 011

You must use this form when filing private financial documents with the court. Keep a blank copy of this form in case you need to file more financial documents later. You may attach one form to a stack of documents.

Caption. Fill out the caption.

Check the boxes next to each type of paper you are filing. If you are submitting child support worksheets, the instructions to the child support worksheets say which documents you must file.

If you are afraid for your safety or the children’s safety, you may block out information identifying your location on the copies you file with the court and deliver to the other parties.

Submitted by: Check the box showing which party you are. Then sign and print your name.

D. Confidential Information Form and Attachment - FL All Family 001 & 002

In family law cases, you must give the court information about your address and phone number, your social security number, date of birth, driver’s license, and the name and address of your employer, as well as certain information about the other people involved in the case.6

Fill out this form. File it with the court clerk. Keep a copy for yourself. Do not serve the Confidential Information Form and Attachment on the other parties.

The Confidential Information Form is normally not available to the other parties or the other parties’ lawyers. The info in the form could go to DCS (Division of Child Support) and other parts of DSHS (Washington State Department of Social and Health Services). They may release info in this form to another party. Another party could get access to this form by following certain court procedures.

When your address changes, you must update the court by filing a Notice of Address Change, even after your case is final. If you do not, legal papers may go to you at your old address. The court may enter orders against you without actual notice to you.7

1. Put your name. Put the county where the case is filed and the case number. If you have no case number yet, put the case number when the clerk gives it to you.

6 RCW 26.23.050(5)(l) & (7); GR 22(g) & (h). 7 RCW 26.23.055(2) & (3).

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2. Check yes if restraining order protection orders are currently in place. In the blank, put who the orders protect. If the orders go into effect later, file a revised and updated form. Check no and skip to 3 if there is no current restraining order or protection order in place.

3. Check the first box if you believe the safety of an adult or child would be at risk by listing your home address. In the blank, explain why.

4. Your Information. In the first table, put the info requested about yourself, including your driver’s license number and social security number (if you have these). Skip the second table.

5. Other Party’s Information. In the first table, put as much of the info requested about the other party as you can. Skip the second table. Use the Attachment to Confidential Information if there is more than one respondent.

6. Children’s Information. Put as much of the info requested about the children as you can.

7. Have the children lived with anyone other than… Check no and skip to 8 if the children have only lived with Petitioner or Respondent in the past five years. Check yes if the children have lived with someone besides petitioner or respondent/s in the past five years. Put the info requested.

8. Do other children (not parents)… Check no and skip to 9 if only Petitioner and Respondent have custody or visitation rights. Check yes if other people besides Petitioner and Respondent have custody or visitation rights. Put as much the info requested about those people as you know.

9. If you are asking for custody and are not the parent… List any other adults living in your home. Use the Attachment if there are more than two other adults living in your home.

Sign and date the form and put the place you signed it.

E. Petition to Modify Child Support Order – FL Modify 501

This form starts your case. It tells the court and other parent what you want the court to do. You must fill the Petition out completely.

If the other parent does not respond to the petition, you may be able to finalize your case by default (you get what you asked for after only a short hearing). You cannot get any relief in a default final order that your petition and/or the papers you serve on the other parent did not ask for.

Caption. Fill out the caption.

1. Put your name.

2. Correct County (Venue). Read the first part of this section. Then put the info requested.

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3. Jurisdiction. Check the first box if your existing Child Support Order is from Washington.

Check the second box if true in your case. Then check either All parties in Washington now, or No one left in issuing state, or Parties have consented, whichever is true.

If you check No one left in issuing state, you must check all the boxes immediately underneath that apply.

4. Is the state filing this Petition? Check the box that is true. If you check Yes, check all boxes immediately underneath that apply.

5. Current Child Support Order. In the first sentence, put the date the court entered your existing Child Support Order and the county and state where it was entered.

In the second sentence, put the paying parent’s name and the total amount that parent must pay under the existing Order. Then put the names of the children the existing Support Order covers.

6. Should the court modify the monthly child support amount? Check No and skip to 7 if you want other changes to the child support order. Otherwise, check Yes and check every box immediately underneath that applies.

You must check Change of Circumstances if less than one year has passed since the court entered the existing support order or you have not checked any of the other reasons in this section. Then, put a sentence or two about what has changed that requires a change in child support. (Example: Mother became disabled by illness and is no longer able to work.)

7. Should the court modify the end date for child support? Check the box that applies. If you check Yes, you must check all the boxes immediately underneath and fill in blanks that apply.

8. Should the court modify post-secondary educational support? Check No and skip to 9 if you do not want any changes to this part of your current Child Support Order. Otherwise, check the box that applies in your case, and fill in blanks as needed.

9. Should the court modify payment for children’s expenses or tax exemptions? Check No and skip to 10 if you do not want any changes to this part of your current Child Support Order. Otherwise, check the box that applies in your case, and fill in blanks as needed.

10. Should the court modify health insurance orders? Check No and skip to 11 if you do not want any changes to this part of your current Child Support Order. Otherwise, check the box that applies in your case, and fill in blanks as needed.

11. When do you want the new order to start? Check the box showing which you want.

12. Other requests. Check the second box if you want the court to order something not otherwise listed here. In the blank, explain what else you want. You may want a judgment for back support and interest owed you, or a judgment for reimbursement of uninsured medical costs owed you. Be as specific as possible. Example: Enter a Judgment of $5,526 for unpaid support and interest owed from 1/1/97 through 12/31/00.

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Person filing this Petition fills out below: Put the place (city, state) where you are signing. Date the form. Sign where it says to. Print or type your name in the next blank.

The other parent or non-parent custodian fills out below if s/he agrees to join this Petition: If the other party agrees with the Petition, s/he should check this and fill out this section. S/he should put his/her name in the first blank and check the box showing what kind of notice s/he wants about the rest of the case.

If the other party wants you to give notice before the entry of final orders, s/he should check the second box and put his/her mailing address. If the other party does not want notice, s/he should check I do not need to be notified. S/he should sign and print his/her name and date the form.

F. Sealed Personal Health Care Records (Cover Sheet) – FL All Family 012

Unless a local procedure requires otherwise, you must use this form whenever you file any papers with the court that mention any kind of health care – mental or physical health care, health insurance, or medical bills -- to make sure the records are not available to the public. Use this cover sheet on any records/correspondence with info relating to someone’s past/present/future physical or mental health condition, including past/present/future payments for health care.

Some of the papers you should use this cover sheet for are:

• Medical/mental health records and bills

• Letters/declarations from doctors and counselors

• medical bills and statements of medical coverage (or denial)

• cost estimates for medical care

• social security and L&I and other disability program letters and records

• medical evaluations

• medical insurance records

• dental records

• records of alternative health care practitioners such as massage therapists, acupuncturists or chiropractors

• genetic parentage testing.

Put this cover sheet on declarations that mention medical or mental health conditions.

Keep a blank copy of this form. You might need to file more health care records later.

Attach the confidential personal health care records to this form.

Fill out the caption. Check the boxes showing what type of records you are attaching.

Submitted by: Check the box that applies to you. Sign and print your name.

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G. Summons: Notice about Petition to Modify Child Support Order - FL Modify 500

This form tells the court and other parent that you have started a petition to modify child support order case. If you do not file this form and serve copies on the other parties, the judge can dismiss your case.

Use this form only if you are serving a party by personal service (in state or out-of-state) or the party is signing a Service Accepted form. If you have gotten court permission to serve your Petition by mail or publication, use a different Summons form. See our packet Service by Certified Mail or Publication.

Caption. Fill out the caption. After To: print the name of the other parent and each of the other parties, if any (such as the State of Washington) in the space.

1 – 3. Read these.

4. Put the name and address of the courthouse where you are filing this case. Note: King County has two different superior courts. If you are not sure in which courthouse to file your case, call the court clerk’s office.

5. Read this.

Person filing this Summons fills out below: Date the form and sign where it says to. Print or type your name in the blank below that.

Check the second box. Fill out your name and address. If you do not want the other party to know where you live, put a P.O. box number if you have one, or put the address of a friend or relative you trust to tell you immediately if you receive any legal papers.

If the address you use in the Summons later changes, you must fill out, file and serve on the other parties a Notice of Address Change. Form. You can get it at http://www.courts.wa.gov/forms.

H. Domestic Case Cover Sheet

Some local courts have their own forms. Check with the clerk.

Put the case number when the clerk assigns one.

Put the Title of the case from your Petition.

Check MDS.

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I. Declaration re: Service Members Civil Relief Act – WPF All Cases 01.0200

This declaration states whether you believe another party is on active duty in the military8 or the dependent of a Washington resident on active military duty, and a National Guard member or Reservist. Dependents are usually spouses or minor children. They may also be people for whom the service member provided most of the support for the last six months.9

When you prepare the papers to start your case, fill out a separate declaration for each respondent or nonmoving party.

You must try to find out whether the other party is on active duty in the military, or a protected dependent.10

• Check the following website: https://www.dmdc.osd.mil/appj/scra/welcome.xhtml

or

• Contact the Defense Manpower Data Center, 1600 Wilson Blvd., Suite 400, Attn: Military Verification, Arlington, VA 22209-2593; Telephone (703) 696-6762 or 5790, fax (703) 696-4156. (If you mail a request for information, include a stamped, self-addressed return envelope.)

To try to make sure the other party is not a dependent of a service member, have the Notice re Military Dependent form served with the other papers that start your case. That form is in this packet.

Put your name on the first line before Declare.

Paragraph 1. Service member status.

Paragraph 1 A.

Put the other party’s name in the blank.

8Service members protected by the federal Service Members Civil Relief Act, 50 U.S.C. App. Sections 501 et seq. include all members on Federal active duty, including regular members of the Armed Forces (Army, Navy, Air Force, Marine Corps and Coast Guard); Reserve, National Guard and Air National Guard personnel who have been activated and are on Federal active duty (whether as volunteers or as a result of involuntary activation); inductees serving with the armed forces; Public Health Service and National Oceanic and Atmospheric Administration Officers detailed for duty with the armed forces; persons who are training or studying under the supervision of the United States preliminary to induction; and National Guard and Air National Guard personnel on duty for training or other duty authorized by 32 U.S.C. §502(f) at the request of the President, for or in support of an operation during a war or national emergency declared by the President or Congress. U.S. Coast Guard Legal Assistance Service Members Civil Relief Act Guide at http://www.uscg.mil/legal/la/Legal_Assistance_SCRA_Guide.asp. For Washington State’s Service Members Civil Relief Act, see RCW 38.42.010 and so on. 9RCW 38.42.010. 10 The Service Members Civil Relief Act, RCW Ch. 38.42 (state law), and the Service Members Civil Relief Act of March 4, 1918, as amended, 50 U.S.C. App., 501 et.seq. (federal law) provide special protection for members of the military, including National Guard and Reservists, who are on active duty, and their dependents. If the other party is on active duty or the dependent of someone who is, talk with a lawyer for more information about these special rights. The court will probably appoint a lawyer to represent the other party. It may also stay (delay or stop) your case until the other party comes back from active duty.

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Check the box(es) next to the item(s) that shows his/her service member status.

Paragraph 1 B, after Factual Basis

• If you checked the website https://www.dmdc.osd.mil/appj/scra/welcome.xhtml and the site reported the other party’s military status, check the first box. Staple the report you received to this form.

• If you have another source for your answer in Paragraph 1 A, check the second box. Put what you know about whether the other party is in the military and whether they are on active duty. Describe all efforts you made to find out about the other party’s military status and the results of each effort. Example: describe contacts with the other party’s friends, family, and employers. If you contacted the Defense Manpower Data Center by fax or mail, explain that contact. Attach any certificate about military service you got in reply.

Paragraph 1 C. If the other party is on active duty, check the box at the beginning of 1 C and the box(es) under it that apply. If you check the last item, you must check the appropriate box in the text of that item.

Paragraph 2 Dependent of a Service Member Status:

Paragraph 2A. Put the other party’s name in the first line. Check the box below that applies.

Paragraph 2 B. Factual Basis:

• If you had a Notice re Military Dependent mailed to the other party at least 23 days ago (or served more than twenty days ago), and s/he did not respond to it, check the nonmoving party failed to respond to a notice. Check the box that applies. Put the date requested. Otherwise, skip that box.

• If you have another factual basis for your answer in Paragraph 2 A, check the second box and explain.

Paragraph 2 C. If the other party is a dependent of a Washington resident on active duty and a national guard member or Reservist, check the box at the beginning of 2 C, and the box(es) under it that apply. If you check the last item, you must check the appropriate box in the text of that item.

Sign your name on the signature line at the end of the declaration. Put the city, state and date of your signature. Print your name on the line below your signature.

If another party is covered by the service members civil relief acts and is willing to give up his/her rights under those acts, s/he may agree to sign the waiver form in the section on the military later in this packet.

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J. Notice re Military Dependent - FL All Family 103

Certain service members11 and dependents (usually spouses, minor children, or people who have gotten most of their recent support from the service member) can receive special protections under the law. This form tells the other parties in your case who are military dependents that if they do not report their dependent status to you within twenty days, they risk having you and the court presume they are not a military dependent if you apply for an order of default. You should have this notice served on all the other parties with the Summons and Petition, even if you believe a party has no military connection.12

• Fill out the caption.

• Sign and date the form at the bottom of the page. Print or type your name in the space indicated.

Section 9: Filing and Serving Your Petition

A. Filing your Petition

You may file your petition before or after you serve it. If you are filing in a different county from the one that entered your previous order, try to file the petition first, so your papers will have the correct case number.

Make one copy of every paper, including the financial documents. You will need more copies later. Make those copies after you have filed your petition, so they show the filing date.

Make two full sets of your papers (one set of originals and one set of copies). Compare each set with the checklist of forms near the beginning of this packet. Make sure you have all the forms.

Take the originals and the copies to the county court clerk’s office in the superior courthouse where you are filing your petition. (If you do not live in that county, ask a friend in that county to file the case for you, or ask the clerk about filing your petition by mail. You must file your petition in person if you are filing a Motion for Filing Fee Waiver.) Give the clerk the originals of the Summons, Petition, Financial Declaration, Sealed Financial Source Documents form (and the attached financial papers), Child Support Worksheets, Domestic Case Cover Sheet, Confidential Information form, Declaration re: Service Member’s Civil Relief Act, Notice re Military Dependent, declarations (if any), and, if your previous Child Support Order was from a different county, a copy of the child support order and child support worksheets from that county. You may have other forms. Be ready to pay the clerk the filing fee or give the

11 See footnote elsewhere in this packet for protected members of the military. 12 In some cases, the law allows for mailing of this notice separately. This packet does not explain how to do that.

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clerk your Filing Fee Waiver order. If you do not have a Filing Fee Waiver order, the filing fee will be from $56 - $250.

Ask the clerk to stamp your copies to show the date you filed the originals. Take the stamped copies back from the clerk. The clerk will keep the originals. In some counties, the clerk will give you a case scheduling order. It will tell you important dates you will need to know for your case, including your trial date.

B. Serving the Petition and filling out the Proof of Service by Mail

After you file your papers, you must have them properly served on (delivered to) the other parties. The court does not serve the other parties. You must arrange for service and make sure your server delivers the papers properly. You cannot serve the papers on another party yourself. The next paragraphs explain the rules for service. Carefully follow the rules. If you do not do service properly, your court orders could be set aside, even years later.

1. Finding out the Other Parent’s Address If you do not know the other parent’s address, try to get it from DCS or your court file.

DCS Address Disclosure: DCS records, including the other parent’s address and workplace, are confidential. DCS has a process you can use to request the other parent’s address in order to modify support.13 Call your DCS officer or go to DCS’ website: https://www.dshs.wa.gov/esa/division-child-support. Ask for an Address Disclosure Request form, or download one at https://www.dshs.wa.gov/sites/default/files/ESA/dcs/documents/18-176A.pdf. Fill out the form. Get it notarized. (Notaries are often available at local banks.)

After you send the address disclosure request form, DCS will decide whether to:

• withhold the address

• give the other parent notice of your request and a chance to object

• release the address to you outright

DCS rules14 for disclosure explain

• when they will release or withhold the address

• when they notify the other parent of the address request

• when a party may appeal their decision

Court File. Check your court file to find the last address the other parent gave in the Child Support Order. You may be able to serve the other party at the address last written on that Order or the Confidential Information Form, if you can show you made “diligent efforts” to

13 Washington Administrative Code (WAC) 388-14A-2110. 14 See Washington Administrative Code (WAC) 388-14A 2107 and following sections for DCS disclosure rules and procedures.

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find the other party.15 Both parties must update their addresses on the Confidential Information Form. You might try to file a motion for access to the sealed form to try to get the most recent address on that form. This packet does not explain how to do that. Talk with a lawyer, or the family law facilitator or court clerk’s office.

2. Serving Your Summons and Petition to Modify Child Support Order

Copy and Organize Your Papers. Make one copy of every paper (including the orders) for each of the other parties. Usually the other parent is the only party. Sometimes there are other parties. If the child has gotten public assistance (TANF) or Medicaid, or if the child is in foster care or out-of-home placement, you must include the State of Washington as a party. (If you have any questions about who to include as a party, talk to a lawyer.) Make an extra copy of the summons to attach to the Proof of Service by Mail.

Make a set of the papers for each of the other parties. Compare it to your checklist. Make sure everything is included. (Do not give the other parties the Proof of Service by Mail or the Confidential Information Form.)

Keep a full set of copies for yourself. Put the Confidential Information Sheet in this set.

Put each of the other parties’ sets of papers in an envelope, addressed to that party, with your return address. You will use these sets for service.

How to serve: If your previous Child Support Order is from Washington, you may start a petition to modify child support by having the papers served on the other parties by certified mail.16 You do not need to get an order allowing service by mail. You do not need to have the other parent personally served with the petition and other papers. You may do so if you wish.

Do not serve the papers yourself. When you serve another party, you cannot be the one who mails or hand-delivers the legal papers to the other party. You must get a friend or relative, age 18 or older, who will mail or hand deliver the papers for you, and who will be willing to sign the Proof of Service by Mail.

Service by Mail: Have a friend or relative mail the papers by Certified Mail, Return Receipt Requested. The person serving the papers for you must go to the post office. Ask that person to send the other parties’ packets of forms by certified mail, return receipt requested. You can pay for the postage, but do not mail the forms yourself. Have the person who mailed the packets fill out and sign the Proof of Service by Mail. Personal Service: If you want, or your Child Support Order is from another state, your server may personally serve the other party/parties. You must carefully follow the rules when you are having the other parties personally served. If you do not serve the other parties properly, then your court orders could be set aside even years later. You can find the Proof of Personal Service form and instructions in our Filing for Divorce packet. If you have a party personally served with the Summons and Petition in another state, you should use the form Declaration:

15 RCW 26.23.055(3). 16 RCW 26.09.175(2).

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Personal Service Could Not be Made in Washington. This form and instructions for it are in the packet Filing for Divorce.

3. Filling Out the Proof of Service by Mail - FL All Family 107 Make copies of the blank Proof of Service by Mail if there is more than one other party to the case. Your server must complete a separate Proof of Service by Mail for each party s/he serves. After your server has completed service and signed the Proof of Service by Mail form(s), follow the instructions in this packet for filing it with the court.

If you find out after you have served the other parties that one or more of them agree with your petition and worksheets, use the instructions for finalizing your case by agreement in the packet Finalizing a Modification of Your Child Support Order. You may also want to ask if the other party is willing to sign an Agreement to Join Petition (next form, below). Otherwise, you are now done filing your child support modification.

Make some blank copies of this form. You may need to fill it out and file it several times. Use this form to show that copies of papers you file in court have been given to the other parties. Use a separate form for each party to whom papers were mailed or delivered.

Caption. Fill out the caption.

1. Have your server and put his/her name.

2. The server should check the second box.

In the first blank, the server should put the date s/he served mailed the papers. In the second blank, s/he should put who s/he mailed them to. Then s/he should check the box/es and fill out any blanks as needed to show which addresses s/he mailed them to.

3. List all documents you served: Your server must check the box (and fill in blanks as needed) for every form s/he mailed the other party. If you s/he leaves out a form, you will have no proof it was served.

I declare under penalty of perjury: Your server should sign and date the form, state the place signed (city and state), and print his/her name in the places indicated.

You must wait for the other parties to file a Response before you may have a trial by affidavit. The other parties will have 20 days to answer if they are served in Washington, and 60 days to answer if they are served outside of Washington. Our packet called Finalizing a Modification of Your Child Support Order has more information.

Section 10: How to fill out an Agreement to Join Petition (Joinder) if the Other Party Agrees with You

If the other party agrees with all the requests in the Petition and related forms referred to in the petition, ask if s/he will agree to sign a form called an Agreement to Join Petition (Joinder). You cannot force him/her to sign this form.

1. Caption. Fill out the caption.

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2. Paragraph 2. The other party should check the box he or she prefers, and, if s/he requests notice, put his/her address on the blank lines.

3. Signature. If s/he agrees, the other party should sign and date the form.

4. File the Agreement to Join Petition (Joinder), if the other party has signed it. Follow the directions for filing original court papers with the clerk and making conformed copies. Keep a conformed copy for yourself and give the other party one.

Our packet Finalizing a Modification of Your Child Support Order has more information.

Section 11: If the Other Party is in the Military or the Dependent of Someone in the Military

If the other party is, or may soon be, on active military duty17, or is the protected dependent18 of a service member, when you serve him/her with your court papers, you must include a copy of the Waiver of Rights under Service Members Civil Relief Act and Admission of Service form. If the other party is willing to give up protections under these laws, s/he must sign the form and either return it to you or file it with the court. If s/he will not agree to do this, see a lawyer. Special rules for military members and their dependents limit the court’s ability to make orders adversely affecting the rights of the service member or protected dependent.

Here are some ways to try to find out if another party is on active duty: 1. Check this website: https://scra.dmdc.osd.mil

2. Contact: Defense Manpower Data Center 1600 Wilson Blvd., Suite 400 Attn: Military Verification Arlington, VA 22209-2593 Telephone (703) 696-6762 or 5790 Fax (703) 696-4156

17 The Service Members Civil Relief Act of March 4, 1918, as amended, 50 U.S.C. App., 501 et.seq. protects service members including: All members on Federal active duty, including regular members of the Armed Forces (Army, Navy, Air Force, Marine Corps and Coast Guard); Reserve, National Guard and Air National Guard personnel who have been activated and are on Federal active duty (whether as volunteers or as a result of involuntary activation); inductees serving with the armed forces; Public Health Service and National Oceanic and Atmospheric Administration Officers detailed for duty with the armed forces; persons who are training or studying under the supervision of the United States preliminary to induction; and National Guard and Air National Guard personnel on duty for training or other duty authorized by 32 U.S.C. §502(f) at the request of the President, for or in support of an operation during a war or national emergency declared by the President or Congress. U.S. Coast Guard Legal Assistance Servicemembers Civil Relief Act Guide http://www.uscg.mil/legal/la/Legal_Assistance_SCRA_Guide.asp. For Washington State’s Service Members Civil Relief Act, see RCW 38.42.010 et seq. 18 Dependents are usually the spouse, minor child, or a person who received more than half his/her support in the last six months from a Washington resident who is on active duty and a national guard member or reservist. RCW 38.42.010.

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(If you mail a request for information, include a stamped, self-addressed return envelope.)

A. Instructions for the Waiver of Rights under Service Members Civil Relief Act form

Caption. Fill out the caption.

In the first blank, put the other party’s full name.

Talk with the other party or write a letter about the form. Include the form with the court papers when you serve the other party. Call or write the other party. Ask him/her to fill out the rest of the form with the date s/he was served with the summons and petition, the service member’s name, rank, serial number and unit. If s/he is willing to sign this form, s/he should do so in front of a notary public. S/he can either return the form to you for you to file, or file the form with the clerk’s office. The clerk can give you a copy.

Finding a Notary: Your local bank may have a notary. If you have a bank account there, the bank will sometimes provide the notary service free. Or, look up notary publics on the web.

B. File the Waiver form

If and when you get the form back from the other party, file it with the clerk’s office as soon as possible. Keep a copy for yourself. Ask the clerk to stamp your copy to show the date that the form was filed.

Section 12: Blank Forms The rest of this packet has blank forms for your use. Make a copy of each form so that you have an extra in case your first draft needs lots of changes. You may need forms from other packets. You may not need all the forms in this packet.

The Washington Administrative Office of the Courts also has Microsoft Word and PDF versions of many of these forms available on their web site at http://www.courts.wa.gov/forms.

WASHINGTON STATE CHILD SUPPORT SCHEDULE

Including:

• Definitions and Standards • Instructions • Economic Table • Worksheets

Effective Dates:

Definitions & Standards July 24, 2015 Instructions - only August 26, 2013 Economic Table October 1, 2009 Worksheets July 24, 2015

Order forms--voice mail telephone number (360) 705-5328 Internet--download forms: http://www.courts.wa.gov/ Questions about the Instructions or Worksheets? Contact: Merrie Gough Tel. (360) 357-2128 Fax (360) 956-5794 E-mail merrie.gough@courts.wa.gov or webmaster@courts.wa.gov

Child Support Hotline, State DSHS, 1 (800) 442-KIDS

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WASHINGTON STATE CHILD SUPPORT SCHEDULE DEFINITIONS AND STANDARDS

Definitions Unless the context clearly requires otherwise, these definitions apply to the standards following this section. RCW 26.19.011. Basic child support obligation: means the monthly child support obligation determined from the economic table based on the parties’ combined monthly net income and the number of children for whom support is owed. Child support schedule: means the standards, economic table, worksheets and instructions, as defined in chapter 26.19 RCW. Court: means a superior court judge, court commissioner, and presiding and reviewing officers who administratively determine or enforce child support orders. Deviation: means a child support amount that differs from the standard calculation. Economic table: means the child support table for the basic support obligation provided in RCW 26.19.020. Instructions: means the instructions developed by the Administrative Office of the Courts pursuant to RCW 26.19.050 for use in completing the worksheets. Standards: means the standards for determination of child support as provided in chapter 26.19 RCW. Standard calculation: means the presumptive amount of child support owed as determined from the child support schedule before the court considers any reasons for deviation. Support transfer payment: means the amount of money the court orders one parent to pay to another parent or custodian for child support after determination of the standard calculation and deviations. If certain expenses or credits are expected to fluctuate and the order states a formula or percentage to determine the additional amount or credit on an ongoing basis, the term “support transfer payment” does not mean the additional amount or credit. Worksheets: means the forms developed by the Administrative Office of the Courts pursuant to RCW 26.19.050 for use in determining the amount of child support. Application Standards 1. Application of the support schedule: The child support schedule

shall be applied: a. in each county of the state; b. in judicial and administrative proceedings under titles 13,

26 and 74 RCW; c. in all proceedings in which child support is determined or

modified; d. in setting temporary and permanent support; e. in automatic modification provisions or decrees entered

pursuant to RCW 26.09.100; and f. in addition to proceedings in which child support is

determined for minors, to adult children who are dependent on their parents and for whom support is ordered pursuant to RCW 26.09.100.

The provisions of RCW 26.19 for determining child support and

reasons for deviation from the standard calculation shall be applied in the same manner by the court, presiding officers and reviewing officers. RCW 26.19.035(1).

2. Written findings of fact supported by the evidence: An order for

child support shall be supported by written findings of fact upon which the support determination is based and shall include reasons for any deviation from the standard calculation and reasons for denial of a party’s request for deviation from the standard calculation. RCW 26.19.035(2).

3. Completion of worksheets: Worksheets in the form developed

by the Administrative Office of the Courts shall be completed under penalty of perjury and filed in every proceeding in which child support is determined. The court shall not accept incomplete worksheets or worksheets that vary from the worksheets developed by the Administrative Office of the Courts. RCW 26.19.035(3).

4. Court review of the worksheets and order: The court shall

review the worksheets and the order setting child support for the adequacy of the reasons set forth for any deviation or denial of any request for deviation and for the adequacy of the amount of support ordered. Each order shall state the amount of child support calculated using the standard calculation and the amount of child support actually ordered. Worksheets shall be attached to the decree or order or if filed separately, shall be initialed or signed by the judge and filed with the order. RCW 26.19.035(4).

Income Standards 1. Consideration of all income: All income and resources of each

parent’s household shall be disclosed and considered by the court when the court determines the child support obligation of each parent. Only the income of the parents of the children whose support is at issue shall be calculated for purposes of calculating the basic support obligation. Income and resources of any other person shall not be included in calculating the basic support obligation. RCW 26.19.071(1).

2. Verification of income: Tax returns for the preceding two years

and current paystubs shall be provided to verify income and deductions. Other sufficient verification shall be required for income and deductions which do not appear on tax returns or paystubs. RCW 26.19.071(2).

3. Income sources included in gross monthly income: Monthly

gross income shall include income from any source, including: salaries; wages; commissions; deferred compensation; overtime, except as excluded from income in RCW 26.19.071(4)(h); contract-related benefits; income from second jobs except as excluded from income in RCW 26.19.071(4)(h); dividends; interest; trust income; severance pay; annuities; capital gains; pension retirement benefits; workers’ compensation; unemployment benefits; maintenance actually received; bonuses; social security benefits; disability insurance benefits;

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and income from self-employment, rent, royalties, contracts, proprietorship of a business, or joint ownership of a partnership or closely held corporation. RCW 26.19.071(3).

Veterans’ disability pensions: Veterans’ disability pensions or regular compensation for disability incurred in or aggravated by service in the United States armed forces paid by the Veterans’ Administration shall be disclosed to the court. The court may consider either type of compensation as disposable income for purposes of calculating the child support obligation. See RCW 26.19.045.

4. Income sources excluded from gross monthly income: The

following income and resources shall be disclosed but shall not be included in gross income: income of a new spouse or domestic partner or income of other adults in the household; child support received from other relationships; gifts and prizes; temporary assistance for needy families; Supplemental Security Income; general assistance; food stamps; and overtime or income from second jobs beyond forty hours per week averaged over a twelve-month period worked to provide for a current family’s needs, to retire past relationship debts, or to retire child support debt, when the court finds the income will cease when the party has paid off his or her debts. Receipt of income and resources from temporary assistance for needy families, Supplemental Security Income, general assistance and food stamps shall not be a reason to deviate from the standard calculation. RCW 26.19.071(4).

VA aid and attendant care: Aid and attendant care payments to

prevent hospitalization paid by the Veterans Administration solely to provide physical home care for a disabled veteran, and special compensation paid under 38 U.S.C. Sec. 314(k) through (r) to provide either special care or special aids, or both to assist with routine daily functions shall be disclosed. The court may not include either aid or attendant care or special medical compensation payments in gross income for purposes of calculating the child support obligation or for purposes of deviating from the standard calculation. See RCW 26.19.045.

Other aid and attendant care: Payments from any source, other

than veterans’ aid and attendance allowance or special medical compensation paid under 38 U.S.C. Sec. 314(k) through (r) for services provided by an attendant in case of a disability when the disability necessitates the hiring of the services or an attendant shall be disclosed but shall not be included in gross income and shall not be a reason to deviate from the standard calculation. RCW 26.19.055.

5. Determination of net income: The following expenses shall be

disclosed and deducted from gross monthly income to calculate net monthly income: federal and state income taxes (see the following paragraph); federal insurance contributions act deductions (FICA); mandatory pension plan payments; mandatory union or professional dues; state industrial insurance premiums; court-ordered maintenance to the extent actually paid; up to five thousand dollars per year in voluntary retirement contributions actually made if the contributions show a pattern of contributions during the one-year period preceding the action establishing the child support order unless there is a determination that the contributions were made for the purpose of reducing child support; and normal business expenses and self-employment taxes for self-employed persons. Justification shall be required for any business expense deduction about

which there is a disagreement. Items deducted from gross income shall not be a reason to deviate from the standard calculation. RCW 26.19.071(5).

Allocation of tax exemptions: The parties may agree which parent is entitled to claim the child or children as dependents for federal income tax exemptions. The court may award the exemption or exemptions and order a party to sign the federal income tax dependency exemption waiver. The court may divide the exemptions between the parties, alternate the exemptions between the parties or both. RCW 26.19.100.

6. Imputation of income: The court shall impute income to a parent when the parent is voluntarily unemployed or voluntarily underemployed. The court shall determine whether the parent is voluntarily underemployed or voluntarily unemployed based upon that parent’s work history, education, health and age or any other relevant factors. A court shall not impute income to a parent who is gainfully employed on a full-time basis, unless the court finds that the parent is voluntarily underemployed and finds that the parent is purposely underemployed to reduce the parent’s child support obligation. Income shall not be imputed for an unemployable parent. Income shall not be imputed to a parent to the extent the parent is unemployed or significantly underemployed due to the parent’s efforts to comply with court-ordered reunification efforts under chapter 13.34 RCW or under a voluntary placement agreement with an agency supervising the child. In the absence of records of a parent’s actual earnings, the court shall impute a parent’s income in the following order of priority: (a) Full-time earnings at the current rate of pay; (b) Full-time earnings at the historical rate of pay based on

reliable information, such as employment security department data;

(c) Full-time earnings at a past rate of pay where information is incomplete or sporadic;

(d) Full-time earnings at minimum wage in the jurisdiction where the parent resides if the parent has a recent history of minimum wage earnings, is recently coming off public assistance, general assistance-unemployable, supplemental security income, or disability, has recently been released from incarceration, or is a high school student;

(e) Median net monthly income of year-round full-time workers as derived from the United States bureau of census, current population reports, or such replacement report as published by the bureau of census. (See “Approximate Median Net Monthly Income” table on page 6.) RCW 26.19.071(6).

Allocation Standards 1. Basic child support: The basic child support obligation derived

from the economic table shall be allocated between the parents based on each parent’s share of the combined monthly net income. RCW 26.19.080(1).

2. Health care expenses: Health care costs are not included in the

economic table. Monthly health care costs shall be shared by the parents in the same proportion as the basic support obligation. Health care costs shall include, but not be limited to, medical,

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dental, orthodontia, vision, chiropractic, mental health treatment, prescription medications, and other similar costs for care and treatment. RCW 26.19.080(2).

3. Day care and special child rearing expenses: Day care and

special child rearing expenses, such as tuition and long distance transportation costs to and from the parents for visitation purposes, are not included in the economic table. These expenses shall be shared by the parents in the same proportion as the basic child support obligation. RCW 26.19.080(3).

4. The court may exercise its discretion to determine the necessity

for and the reasonableness of all amounts ordered in excess of the basic child support obligation. RCW 26.19.080(4).

Limitations Standards 1. Limit at 45 percent of a parent’s net income: Neither parent’s child support obligation owed for all his or her

biological or legal children may exceed 45 percent of net income except for good cause shown. a. Each child is entitled to a pro rata share of the income

available for support, but the court only applies the pro rata share to the children in the case before the court.

b. Before determining whether to apply the 45 percent limitation, the court must consider the best interests of the child(ren) and the circumstances of each parent. Such circumstances include, but are not limited to, leaving insufficient funds in the custodial parent’s household to meet the basic needs of the child(ren), comparative hardship to the affected households, assets or liabilities, and any involuntary limits on either parent’s earning capacity including incarceration, disabilities, or incapacity.

c. Good cause includes, but is not limited to, possession of substantial wealth, child(ren) with day care expenses, special medical need, educational need, psychological need, and larger families. RCW 26.19.065(1).

2. Presumptive minimum support obligation: When a parent’s

monthly net income is below 125% of the federal poverty guideline, a support order of not less than fifty dollars per child per month shall be entered unless the obligor parent establishes that it would be unjust to do so in that particular case. The decision whether there is a sufficient basis to go below the presumptive minimum payment must take into consideration the best interests of the child(ren) and circumstances of each parent. Such circumstances can include leaving insufficient funds in the custodial parent’s household to meet the basic needs of the child(ren), comparative hardship to the affected households, assets or liabilities, and earning capacity. RCW 26.19.065(2)(a).

3. Self-support reserve: The basic support obligation of the parent

making the transfer payment, excluding health care, day care, and special child-rearing expenses, shall not reduce his or her net income below the self-support reserve of 125% of the federal poverty level, except for the presumptive minimum payment of fifty dollars per child per month or when it would be unjust to apply the self-support reserve limitation after considering the best interests of the child(ren) and the circumstances of each parent. Such circumstances include, but are not limited to,

leaving insufficient funds in the custodial parent’s household to meet the basic needs of the child(ren), comparative hardship to the affected households, assets or liabilities, and earning capacity. This section shall not be construed to require monthly substantiation of income. (See the Self-Support Reserve memorandum on the courts’ website www.courts.wa.gov/forms and at www.WashingtonLawHelp.org.) RCW 26.19.065(2)(b).

4. Income above twelve thousand dollars: The economic table is presumptive for combined monthly net incomes up to and including twelve thousand dollars. When combined monthly net income exceeds twelve thousand dollars, the court may exceed the maximum presumptive amount of support upon written findings of fact. RCW 26.19.065(3).

Deviation Standards 1. Reasons for deviation from the standard calculation include but

are not limited to the following: a. Sources of income and tax planning: The court may deviate

from the standard calculation after consideration of the following:

i. Income of a new spouse or new domestic partner if the parent who is married to the new spouse or the parent who is in a domestic partnership with the new domestic partner is asking for a deviation based on any other reason. Income of a new spouse or domestic partner is not, by itself, a sufficient reason for deviation;

ii. Income of other adults in the household if the parent who is living with the other adult is asking for a deviation based on any other reason. Income of the other adults in the household is not, by itself, a sufficient reason for deviation;

iii. Child support actually received from other relationships;

iv. Gifts; v. Prizes; vi. Possession of wealth, including but not limited to

savings, investments, real estate holdings and business interests, vehicles, boats, pensions, bank accounts, insurance plans or other assets;

vii. Extraordinary income of a child; or viii. Tax planning considerations. A deviation for tax

planning may be granted only if child(ren) would not receive a lesser economic benefit due to the tax planning;

ix. Income that has been excluded under RCW 26.19.071(4)(h) if the person earning that income asks for a deviation for any other reason. RCW 26.19.075(1)(a)

b. Nonrecurring income: The court may deviate from the

standard calculation based on a finding that a particular source of income included in the calculation of the basic support obligation is not a recurring source of income. Depending on the circumstances, nonrecurring income may include overtime, contract-related benefits, bonuses or income from second jobs. Deviations for nonrecurring income shall be based on a review of the nonrecurring income received in the previous two calendar years. RCW 26.19.075(1)(b).

WSCSS-Schedule 07/2015 Page 4

c. Debt and high expenses: The court may deviate from the standard calculation after consideration of the following expenses:

i. Extraordinary debt not voluntarily incurred; ii. A significant disparity in the living costs of the parents

due to conditions beyond their control; iii. Special needs of disabled child(ren); or iv. Special medical, educational or psychological needs of

the child(ren). v. Costs anticipated to be incurred by the parents in

compliance with court-ordered reunification efforts under chapter 13.34 RCW or under a voluntary placement agreement with an agency supervising the child. RCW 26.19.075(1)(c).

d. Residential schedule: The court may deviate from the

standard calculation if the child(ren) spend(s) a significant amount of time with the parent who is obligated to make a support transfer payment. The court may not deviate on that basis if the deviation will result in insufficient funds in the household receiving the support to meet the basic needs of the child or if the child is receiving temporary assistance for needy families. When determining the amount of the deviation, the court shall consider evidence concerning the increased expenses to a parent making support transfer payments resulting from the significant amount of time spent with that parent and shall consider the decreased expenses, if any, to the party receiving the support resulting from the significant amount of time the child spends with the parent making the support transfer payment. RCW 26.19.075(1)(d).

e. Children from other relationships: The court may deviate

from the standard calculation when either or both of the parents before the court have children from other relationships to whom the parent owes a duty of support.

i. The child support schedule shall be applied to the parents and children of the family before the court to determine the presumptive amount of support.

ii. Children from other relationships shall not be counted in the number of children for purposes of determining the basic support obligation and the standard calculation.

iii. When considering a deviation from the standard calculation for children from other relationships, the court may consider only other children to whom the parent owes a duty of support. The court may consider court-ordered payments of child support for children from other relationships only to the extent that the support is actually paid.

iv. When the court has determined that either or both parents have children from other relationships, deviations under this section shall be based on consideration of the total circumstances of both households. All child support obligations paid, received, and owed for all children shall be disclosed and considered. RCW 26.19.075(1)(e).

2. All income and resources of the parties before the court, new

spouses or domestic partners, and other adults in the household shall be disclosed and considered as provided. The presumptive amount of support shall be determined according to the child support schedule. Unless specific reasons for deviation are set forth in the written findings of fact and are supported by the evidence, the court shall order each parent to pay the amount of support determined by using the standard calculation. RCW 26.19.075(2). access to the post-secondary education records as provided by statute (RCW 26.09.225). RCW 26.19.090(4).

3. The court shall enter findings that specify reasons for any deviation or any denial of a party’s request for any deviation from the standard calculation made by the court. The court shall not consider reasons for deviation until the court determines the standard calculation for each parent. RCW 26.19.075(3).

4. When reasons exist for deviation, the court shall exercise

discretion in considering the extent to which the factors would affect the support obligation. RCW 26.19.075(4).

5. Agreement of the parties is not by itself adequate reason for any

deviations from the standard calculations. RCW 26.19.075(5). Benefits paid that apply toward a person’s child support obligation If an injured worker, person with disabilities, deceased person, retired person, or veteran who owes a child support obligation receives one of these benefits:

• Department of Labor and Industries payments • Self-Insurer’s payment • Social Security Administration:

o Social Security disability dependency benefits o Retirement benefits o Survivors insurance benefits

• Veteran’s Administration benefits and shows that the child or the child’s household receives a payment from those benefits, then, the amount of the payment made on behalf of the child or on account of the child applies toward the person’s child support obligation for the same period covered by the benefit. Post-Secondary Education Standards 1. The child support schedule shall be advisory and not mandatory

for post-secondary educational support. RCW 26.19.090(1) 2. When considering whether to order support for post-secondary

educational expenses, the court shall determine whether the child is in fact dependent and is relying upon the parents for the reasonable necessities of life. The court shall exercise its discretion when determining whether and for how long to award post-secondary educational support based upon consideration of factors that include but are not limited to the following: age of the child; the child’s needs; the expectations of the parties for their child(ren) when the parents were together; the child(ren)’s prospects, desires, aptitudes, abilities or disabilities; the nature of the post-secondary education sought and the parent’s level of education, standard of living and current and future resources. Also to be considered are the amount and type of support that the child would have been afforded if the parents had stayed together. RCW 26.19.090(2).

3. The child must enroll in an accredited academic or vocational

school, must be actively pursuing a course of study commensurate with the child’s vocational goals and must be in good academic standing as defined by the institution. The court-ordered post-secondary educational support shall be automatically suspended during the period or periods the child fails to comply with these conditions. RCW 26.19.090(3).

4. The child shall also make available all academic records and

grades to both parents as a condition of receiving post-secondary educational support. Each parent shall have full and equal

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5. The court shall not order the payment of post-secondary educational expenses beyond the child’s twenty-third birthday, except for exceptional circumstances, such as mental, physical or emotional disabilities. RCW 26.19.090(5).

6. The court shall direct that either or both parents’ payments for

post-secondary educational expenses are made directly to the educational institution if feasible. If direct payments are not feasible, then the court in its discretion may order that either or both parents’ payments are made directly to the child if the child does not reside with either parent. If the child resides with one of the parents, the court may direct that the parent making the support transfer payments make the payments to the child or to the parent who has been receiving the support transfer payments. RCW 26.19.090(6).

WSCSS-Instructions 08/2013 Page 6

WASHINGTON STATE CHILD SUPPORT SCHEDULE

INSTRUCTIONS FOR WORKSHEETS

Worksheets: Fill in the names and ages of only those children whose support is at issue. Part I: Income Pursuant to INCOME STANDARD #1: Consideration of all income, “only the income of the parents of the child(ren) whose support is at issue shall be calculated for purposes of calculating the basic support obligation.” (See page 1.) Pursuant to INCOME STANDARD #2: Verification of income, “tax returns for the preceding two years and current paystubs are required for income verification purposes. Other sufficient verification shall be required for income and deductions which do not appear on tax returns or paystubs.” (See page 1.) Gross Monthly Income Gross monthly income is defined under INCOME STANDARD #3: Income sources included in gross monthly income. (See page 1.) Income exclusions are defined under INCOME STANDARD #4: Income sources excluded from gross monthly income. (See page 2.) Excluded income must be disclosed and listed in Part VIII of the worksheets. Monthly Average of Income: • If income varies during the year, divide the annual total

of the income by 12. • If paid weekly, multiply the weekly income by 52 and

divide by 12. • If paid every other week, multiply the two-week

income by 26 and divide by 12. • If paid twice a month (bi-monthly), multiply the bi-

monthly income by 24 and divide by 12. LINE 1a, Wages and Salaries: Enter the average monthly total of all salaries, wages, contract-related benefits, bonuses, and income from overtime and second jobs that is not excluded from income by RCW 26.19.071(4)(h). LINE 1b, Interest and Dividend Income: Enter the average monthly total of dividends and interest income.

LINE 1c, Business Income: Enter the average monthly income from self-employment, rent, royalties, contracts, proprietorship of a business, or joint ownership of a partnership or closely held corporation. LINE 1d, Maintenance Received: Enter the monthly amount of maintenance actually received. LINE 1e, Other Income: Enter the average monthly total of other income. (Other income includes, but is not limited to: trust income, severance pay, annuities, capital gains, pension retirement benefits, workers compensation, unemployment benefits, social security benefits and disability insurance benefits.) LINE 1f, Imputed Income: Enter the imputed gross monthly income for a parent who is voluntarily unemployed, underemployed or if you do not have records of a parent’s actual earnings. Refer to “INCOME STANDARD #6: Imputation of income.” (See page 2.) Impute income using the first method possible based on the information you have in the following order: Calculate full-time earnings using either: 1. Current rate of pay; 2. Historical rate of pay based on reliable information; 3. Past rate of pay, if current information is incomplete or

sporadic; or 4. Minimum wage where the parent lives when the parent

has a history of minimum wage or government assistance is recently released from incarceration or is a high school student.

Historical rate of pay information may be available from the Division of Child Support. Use form 18-701: “Request for Income Information for Purposes of Entering a Child Support Order”, available online at: http://www.dshs.wa.gov/dcs/Resources/Forms.asp If you impute income using one of the four methods, above, enter the amount in line 1f. Also, in line 26 of the Worksheets, explain which method you used to impute income and how you calculated the amount of imputed income. If you cannot use any of the above methods, impute the parent’s net monthly income using the table below, and enter the appropriate amount for the parent’s age and gender on line 1f and on line 3. The table, below, shows net income, after deductions. So if you impute using this table, you will not enter any deductions on the worksheet under line 2. Leave lines 2a through 2i blank. For this parent, go to line 4. Also, in line 26 of the Worksheets, explain that net income was imputed using the Approximate Median Net Monthly Income Table.

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Approximate Median Net Monthly Income MALE age FEMALE $1,832 15-24 $1,632 $2,804 25-34 $2,446 $3,448 35-44 $2,693 $3,569 45-54 $2,714 $3,735 55-64 $2,814 $4,084 65 + $2,960 U.S. Census Bureau, Current Population Survey, 2009 Annual Social and Economic Supplement, Table PINC-01. Selected Characteristics of People 15 Years Old and Over by Total Money Income in 2008, Work Experience in 2008, Race, Hispanic Origin, and Sex, Worked Full Time, Year Round. [Net income has been determined by subtracting FICA (7.65 percent) and the tax liability for a single person (one withholding allowance).] LINE 1g, Total Gross Monthly Income: Add the monthly income amounts for each parent (lines 1a through 1f) and enter the totals on line 1g. Monthly Deductions from Gross Income Allowable monthly deductions from gross income are defined under INCOME STANDARD #5: Determination of net income. (See page 2.) Monthly Average of Deductions: If a deduction is annual or varies during the year, divide the annual total of the deduction by 12 to determine a monthly amount. LINE 2a, Income Taxes: Enter the monthly amount actually owed for state and federal income taxes. (The amount of income tax withheld on a paycheck may not be the actual amount of income tax owed due to tax refund, etc. It is appropriate to consider tax returns from prior years as indicating the actual amount of income tax owed if income has not changed.) LINE 2b, FICA/Self Employment Taxes: Enter the total monthly amount of FICA, Social Security, Medicare and Self-employment taxes owed. LINE 2c, State Industrial Insurance Deductions: Enter the monthly amount of state industrial insurance deductions. LINE 2d, Mandatory Union/Professional Dues: Enter the monthly cost of mandatory union or professional dues. LINE 2e, Mandatory Pension Plan Payments: Enter the monthly cost of mandatory pension plan payments amount.

LINE2f, Voluntary Retirement Contributions: Enter the monthly cost of voluntary Retirement Contributions. Divide the amount of the voluntary retirement contribution, up to $5,000 per year, by 12 to calculate the monthly cost. (For more information regarding limitations on the allowable deduction of voluntary retirement contributions, refer to INCOME STANDARD #5: Determination of net income. See page 2.) LINE 2g, Maintenance Paid: Enter the monthly amount of maintenance actually paid pursuant to a court order. LINE 2h, Normal Business Expenses: If self-employed, enter the amount of normal business expenses. (Pursuant to INCOME STANDARD #5: Determination of net income, “justification shall be required for any business expense deduction about which there is a disagreement.” See page 2.) LINE 2i, Total Deductions From Gross Income: Add the monthly deductions for each parent (lines 2a through 2h) and enter the totals on line 2i. LINE 3, Monthly Net Income: For each parent, subtract total deductions (line 2i) from total gross monthly income (line 1g) and enter these amounts on line 3. LINE 4, Combined Monthly Net Income: Add the parents’ monthly net incomes (line 3) and enter the total on line 4. LINE 5, Basic Child Support Obligation: In the work area provided on line 5, enter the basic support obligation amount determined for each child. Add these amounts together and enter the total in the box on line 5. (To determine a per child basic support obligation, see the following economic table instructions.)

Economic Table Instructions To use the Economic Table to determine an individual support amount for each child: • Locate in the left-hand column the combined

monthly net income amount closest to the amount entered on line 4 of Worksheet (round up when the combined monthly net income falls halfway between the two amounts in the left-hand column);

• Locate on the top row the family size for the number

of children for whom child support is being determined (when determining family size for the required worksheets, do not include child(ren) from other relationships); and

• circle the two numbers in the columns listed below the

family size that are across from the net income. The amount in the “A” column is the basic support amount for a child up to age 11. The amount in the “B” column is the basic support amount for a child 12 years of age or older.

WSCSS-Instructions 08/2013 Page 8

LINE 6, Proportional Share of Income: Divide the monthly net income for each parent (line 3) by the combined monthly net income (line 4) and enter these amounts on line 6. (The entries on line 6 when added together should equal 1.00.) Part II: Basic Child Support Obligation LINE 7, Each Parent’s Basic Child Support Obligation without consideration of low income limitations: Multiply the total basic child support obligation (amount in box on line 5) by the income share proportion for each parent (line 6) and enter these amounts on line 7. (The amounts entered on line 7 added together should equal the amount entered on line 5.) LINE 8, Calculating low income limitations: Fill in only those that apply: To calculate the low-income limitation standards in lines 8b and 8c, you will need to know the self-support reserve amount, which is 125 % of the current federal poverty guideline. As of January 20, 2011, self-support reserve is $1,134. The guideline and self-support reserve change roughly annually. To check the current self-support reserve amount go to the courts’ web site at: www.courts.wa.gov, or go to www.WashingtonLawHelp.org. Enter the self-support reserve amount in the space provided in line 8. (For more information, see Limitation Standard #2 on page 3 of the Definitions and Standards.) 8a. Is combined net income less than $1,000? If combined net monthly income on line 4 is less than $1,000, enter each parent’s presumptive support obligation of $50 per child. Do not enter an amount on line 8a if combined income on line 4 is more than $1,000. 8b. Is monthly net income less than self-support reserve? For each parent whose monthly net income on line 3 is less than the self support reserve, enter the parent’s presumptive support obligation of $50 per child. Do not use this box for a parent whose net income on line 3 is greater than the self-support reserve. 8c. Is monthly net income equal to or more than self-support reserve? Subtract the self-support reserve from line 3 and enter this amount or enter $50 per child whichever is greater. Do not use this box if the amount is greater than the amount in line 7. LINE 9, Each parent’s basic child support obligation after calculating applicable limitations: For each parent, enter the lowest amount from line 7, 8a – 8c, but not less than the presumptive $50 per child.

Part III: Health Care, Day Care, and Special Child Rearing Expenses Pursuant to ALLOCATION STANDARD #4: “the court may exercise its discretion to determine the necessity for and the reasonableness of all amounts ordered in excess of the basic child support obligation.” (See page 2.) Pursuant to ALLOCATION STANDARD #2: Health care expenses and #3: Day care and special child rearing expenses, health care, day care, and special child rearing expenses shall be shared by the parents in the same proportion as the basic support obligation. (See page 2.) NOTE: The court order should reflect that health care, day care and special child rearing expenses not listed should be apportioned by the same percentage as the basic child support obligation. Monthly Average of Expenses: If a health care, day care, or special child rearing expense is annual or varies during the year, divide the annual total of the expense by 12 to determine a monthly amount. Health Care Expenses LINE 10a, Monthly Health Insurance Premiums Paid For Child(ren): List the monthly amount paid by each parent for health care insurance for the child(ren) of the relationship. (When determining an insurance premium amount, do not include the portion of the premium paid by an employer or other third party and/or the portion of the premium that covers the parent or other household members.) LINE 10b, Uninsured Monthly Health Care Expenses Paid For Child(ren): List the monthly amount paid by each parent for the child(ren)’s health care expenses not reimbursed by insurance. LINE 10c, Total Monthly Health Care Expenses: For each parent add the health insurance premium payments (line 10a) to the uninsured health care payments (line 10b) and enter these amounts on line 10c. LINE 10d, Combined Monthly Health Care Expenses: Add the parents’ total health care payments (line 10c) and enter this amount on line 10d. Day Care and Special Expenses LINE 11a, Day Care Expenses: Enter average monthly day care costs. LINE 11b, Education Expenses: Enter the average monthly costs of tuition and other related educational expenses. LINE 11c, Long Distance Transportation Expenses: Enter the average monthly costs of long distance travel incurred pursuant to the residential or visitation schedule.

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LINE 11d, Other Special Expenses: Identify any other special expenses and enter the average monthly cost of each. LINE 11e, Total Day Care and Special Expenses: Add the monthly expenses for each parent (lines 11a through 11d) and enter these totals on line 11e. LINE 12, Combined Monthly Total of Day Care and Special Expenses: Add the parents’ total expenses (line 11e) and enter this total on line 12. LINE 13, Total Health Care, Day Care and Special Expenses: Add the health care expenses (line 10d) to the combined monthly total of day care and special expenses (line 12) and enter this amount on line 13. LINE 14, Each Parent’s Obligation For Health Care, Day Care And Special Expenses: Multiply the total health care, day care, and special expense amount (line 13) by the income proportion for each parent (line 6) and enter these amounts on line 14. LINE 15, Gross Child Support Obligation: For each parent, add the basic child support obligation (line 9) to the obligation for extraordinary health care, day care and special expenses (line 14). Enter these amounts on line 15. Part V: Child Support Credits Child support credits are provided in cases where parents make direct payments to third parties for the cost of goods and services which are included in the standard calculation support obligation (e.g., payments to an insurance company or a day care provider). LINE 16a, Monthly Health Care Expenses Credit: Enter the total monthly health care expenses amounts from line 10c for each parent. LINE 16b, Day Care And Special Expenses Credit: Enter the total day care and special expenses amounts from line 11e for each parent. LINE 16c, Other Ordinary Expense Credit: If approval of another ordinary expense credit is being requested, in the space provided, specify the expense and enter the average monthly cost in the column of the parent to receive the credit. (It is generally assumed that ordinary expenses are paid in accordance with the child(ren)’s residence. If payment of a specific ordinary expense does not follow this assumption, the parent paying for this expense may request approval of an ordinary expense credit. This credit is discretionary with the court.) LINE 16d, Total Support Credits: For each parent, add the entries on lines 16 a through c and enter the totals on line 16d.

Part VI: Standard Calculation/Presumptive Transfer Payment LINE 17, For Each Parent: subtract the total support credits (line 16d) from the gross child support obligation (line 15) and enter the resulting amounts on line 17. If the amount is less than $50 per child for either parent, then enter the presumptive minimum support obligation of $50 per child, instead of the lower amount. Part VII: Additional Informational Calculations LINE 18, 45% of Each Parent’s Net Income From Line 3: For each parent, multiply line 3 by .45. Refer to LIMITATIONS Standards #1: Limit at 45% of a parent’s net income. LINE 19, 25% of Each Parent’s Basic Support Obligation from Line 9: For each parent, multiply line 9 by .25. Part VIII: Additional Factors for Consideration Pursuant to INCOME STANDARD #1: Consideration of all income: “all income and resources of each parent’s household shall be disclosed and considered by the court when the court determines the child support obligation of each parent.” (See page 1.) LINE 20 a-h, Household Assets: Enter the estimated present value of assets of the household. LINE 21, Household Debt: Describe and enter the amount of liens against assets owned by the household and/or any extraordinary debt. Other Household Income LINE 22a, Income of Current Spouse or Domestic Partner: If a parent is currently married to or in a domestic partnership with someone other than the parent of the child(ren) for whom support is being determined, list the name and enter the income of the present spouse or domestic partner. LINE 22b, Income of Other Adults In The Household: List the names and enter the incomes of other adults residing in the household. LINE 22c, Gross income from overtime or from second jobs the party is asking the court to exclude per INCOME STANDARD #4, Income sources excluded from gross monthly income (see page 2). LINE 22d, Income of Children: If the amount is considered to be extraordinary, list the name and enter the income of children residing in the home.

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LINE 22e, Income from Child Support: List the name of the child(ren) for whom support is received and enter the amount of the support income. Do not include the child(ren) for whom support is being determined. LINE 22f, Income from Assistance Programs: List the program and enter the amount of any income received from assistance programs. (Assistance programs include, but are not limited to: temporary assistance for needy families, SSI, general assistance, food stamps and aid and attendance allowances.) LINE 22g, Other Income: Describe and enter the amount of any other income of the household. (Include income from gifts and prizes on this line.) LINE 23, Nonrecurring Income: Describe and enter the amount of any income included in the calculation of gross income (LINE 1g) which is nonrecurring. (Pursuant to DEVIATION STANDARD #1b: Nonrecurring income, “depending on the circumstances, nonrecurring income may include overtime, contract-related benefits, bonuses or income from second jobs.” See page 3.) LINE 24, Child Support Owed, Monthly, for Biological or Legal Child(ren). List the names and ages and enter the amount of child support owed for other children, (not the children for whom support is being determined). Is the support paid? Check [ ] Yes or [ ] No. LINE 25, Other Child(ren) Living in Each Household: List the names and ages of children, other than those for whom support is being determined, who are living in each household. LINE 26, Other Factors For Consideration: In the space provided list any other factors that should be considered in determining the child support obligation. (For information regarding other factors for consideration, refer to DEVIATION STANDARDS. See page 3.) Also use this space to explain how you calculated the income and deductions in lines 1 and 2. Nonparental Custody Cases: When the children do not reside with either parent, the household income and resources of the children’s custodian(s) should be listed on line 26.

WSCSS-Economic Table 10/2009

WASHINGTON STATE CHILD SUPPORT SCHEDULE ECONOMIC TABLE

MONTHLY BASIC SUPPORT OBLIGATION PER CHILD (KEY: A = AGE 0-11 B = AGE 12-18)

Combined Monthly Net

One Child Family

Two Children Family

Three Children Family

Four Children Family

Five Children Family

Income A B A B A B A B A B For income less than $1,000, the obligation is based upon the resources and living expenses of each household. Minimum support shall not be less than $50 per child per month except when allowed by RCW 26.19.065(2). 1000 220 272 171 211 143 177 121 149 105 130 1100 242 299 188 232 157 194 133 164 116 143 1200 264 326 205 253 171 211 144 179 126 156 1300 285 352 221 274 185 228 156 193 136 168 1400 307 379 238 294 199 246 168 208 147 181 1500 327 404 254 313 212 262 179 221 156 193 1600 347 428 269 333 225 278 190 235 166 205 1700 367 453 285 352 238 294 201 248 175 217 1800 387 478 300 371 251 310 212 262 185 228 1900 407 503 316 390 264 326 223 275 194 240 2000 427 527 331 409 277 342 234 289 204 252 2100 447 552 347 429 289 358 245 303 213 264 2200 467 577 362 448 302 374 256 316 223 276 2300 487 601 378 467 315 390 267 330 233 288 2400 506 626 393 486 328 406 278 343 242 299 2500 526 650 408 505 341 421 288 356 251 311 2600 534 661 416 513 346 428 293 362 256 316 2700 542 670 421 520 351 435 298 368 259 321 2800 549 679 427 527 356 440 301 372 262 324 2900 556 686 431 533 360 445 305 376 266 328 3000 561 693 436 538 364 449 308 380 268 331 3100 566 699 439 543 367 453 310 383 270 334 3200 569 704 442 546 369 457 312 386 272 336 3300 573 708 445 549 371 459 314 388 273 339 3400 574 710 446 551 372 460 315 389 274 340 3500 575 711 447 552 373 461 316 390 275 341 3600 577 712 448 553 374 462 317 391 276 342 3700 578 713 449 554 375 463 318 392 277 343 3800 581 719 452 558 377 466 319 394 278 344 3900 596 736 463 572 386 477 326 404 284 352 4000 609 753 473 584 395 488 334 413 291 360 4100 623 770 484 598 404 500 341 422 298 368 4200 638 788 495 611 413 511 350 431 305 377 4300 651 805 506 625 422 522 357 441 311 385 4400 664 821 516 637 431 532 364 449 317 392 4500 677 836 525 649 438 542 371 458 323 400 4600 689 851 535 661 446 552 377 467 329 407 4700 701 866 545 673 455 562 384 475 335 414 4800 713 882 554 685 463 572 391 483 341 422 4900 726 897 564 697 470 581 398 491 347 429 5000 738 912 574 708 479 592 404 500 353 437 5100 751 928 584 720 487 602 411 509 359 443 5200 763 943 593 732 494 611 418 517 365 451 5300 776 959 602 744 503 621 425 525 371 458 5400 788 974 612 756 511 632 432 533 377 466 5500 800 989 622 768 518 641 439 542 383 473 5600 812 1004 632 779 527 651 446 551 389 480 5700 825 1019 641 791 535 661 452 559 395 488 5800 837 1035 650 803 543 671 459 567 401 495 5900 850 1050 660 815 551 681 466 575 407 502 6000 862 1065 670 827 559 691 473 584 413 509 6100 875 1081 680 839 567 701 479 593 418 517 6200 887 1096 689 851 575 710 486 601 424 524 6300 899 1112 699 863 583 721 493 609 430 532 6400 911 1127 709 875 591 731 500 617 436 539 6500 924 1142 718 887 599 740 506 626 442 546 6600 936 1157 728 899 607 750 513 635 448 554 6700 949 1172 737 911 615 761 520 643 454 561 6800 961 1188 747 923 623 770 527 651 460 568 6900 974 1203 757 935 631 780 533 659 466 575 7000 986 1218 767 946 639 790 540 668 472 583 7100 998 1233 776 958 647 800 547 677 478 591 7200 1009 1248 785 971 654 809 554 684 484 598 7300 1021 1262 794 982 662 818 560 693 490 605 7400 1033 1276 803 993 670 828 567 701 496 613 7500 1044 1290 812 1004 677 837 574 709 502 620 7600 1055 1305 821 1015 685 846 581 718 507 627 7700 1067 1319 830 1026 692 855 587 726 513 634 7800 1078 1333 839 1037 700 865 594 734 519 642 7900 1089 1346 848 1048 707 874 601 742 525 649 8000 1100 1360 857 1059 714 883 607 750 531 656 8100 1112 1374 865 1069 722 892 614 759 536 663 8200 1123 1387 874 1080 729 901 620 767 542 670 8300 1134 1401 882 1091 736 910 627 775 548 677

WSCSS-Economic Table 10/2009

8400 1144 1414 891 1101 743 919 633 783 553 684 8500 1155 1428 899 1112 750 928 640 791 559 691 8600 1166 1441 908 1122 758 936 646 799 565 698 8700 1177 1454 916 1133 765 945 653 807 570 705 8800 1187 1467 925 1143 772 954 659 815 576 712 8900 1198 1481 933 1153 779 962 665 822 582 719 9000 1208 1493 941 1163 786 971 672 830 587 726 9100 1219 1506 949 1173 792 980 678 838 593 732 9200 1229 1519 957 1183 799 988 684 846 598 739 9300 1239 1532 966 1193 806 996 691 854 604 746 9400 1250 1545 974 1203 813 1005 697 861 609 753 9500 1260 1557 982 1213 820 1013 703 869 614 759 9600 1270 1570 989 1223 826 1021 709 877 620 766 9700 1280 1582 997 1233 833 1030 716 884 625 773 9800 1290 1594 1005 1242 840 1038 722 892 631 779 9900 1300 1606 1013 1252 846 1046 728 900 636 786 10000 1310 1619 1021 1262 853 1054 734 907 641 793 10100 1319 1631 1028 1271 859 1062 740 915 647 799 10200 1329 1643 1036 1281 866 1070 746 922 652 806 10300 1339 1655 1044 1290 872 1078 752 930 657 812 10400 1348 1666 1051 1299 879 1086 758 937 662 819 10500 1358 1678 1059 1308 885 1094 764 944 668 825 10600 1367 1690 1066 1318 891 1102 770 952 673 832 10700 1377 1701 1073 1327 898 1109 776 959 678 838 10800 1386 1713 1081 1336 904 1117 782 966 683 844 10900 1395 1724 1088 1345 910 1125 788 974 688 851 11000 1404 1736 1095 1354 916 1132 794 981 693 857 11100 1413 1747 1102 1363 922 1140 799 988 698 863 11200 1422 1758 1110 1371 928 1147 805 995 703 869 11300 1431 1769 1117 1380 934 1155 811 1002 708 876 11400 1440 1780 1124 1389 940 1162 817 1009 714 882 11500 1449 1791 1131 1398 946 1170 822 1017 719 888 11600 1458 1802 1138 1406 952 1177 828 1024 723 894 11700 1467 1813 1145 1415 958 1184 834 1031 728 900 11800 1475 1823 1151 1423 964 1191 839 1038 733 906 11900 1484 1834 1158 1431 970 1199 845 1045 738 912 12000 1492 1844 1165 1440 975 1206 851 1051 743 919

The economic table is presumptive for combined monthly net incomes up to and including twelve thousand dollars. When combined monthly net income exceeds twelve thousand dollars, the court may exceed the maximum presumptive amount of support upon written findings of fact.

WSCSS-Worksheets - Mandatory (CSW/CSWP) 05/2016 Page 1 of 5

Washington State Child Support Schedule Worksheets Proposed by (name) ___________________ State of WA Other _______________.

(CSWP) Or, Signed by the Judicial/Reviewing Officer. (CSW) County Case No. Child/ren and Age/s: Parents’ names: (Column 1) (Column 2)

Column 1 Column 2

Part I: Income (see Instructions, page 6) 1. Gross Monthly Income a. Wages and Salaries $ $ b. Interest and Dividend Income $ $ c. Business Income $ $ d. Maintenance Received $ $ e. Other Income $ $ f. Imputed Income $ $ g. Total Gross Monthly Income (add lines 1a through 1f) $ $ 2. Monthly Deductions from Gross Income

a. Income Taxes (Federal and State) $ $ b. FICA (Soc. Sec.+ Medicare)/Self-Employment Taxes $ $ c. State Industrial Insurance Deductions $ $ d. Mandatory Union/Professional Dues $ $ e. Mandatory Pension Plan Payments $ $ f. Voluntary Retirement Contributions $ $ g. Maintenance Paid $ $ h. Normal Business Expenses $ $ i. Total Deductions from Gross Income (add lines 2a through 2h)

$

$

3. Monthly Net Income (line 1g minus 2i) $ $ 4. Combined Monthly Net Income (add both parents’ monthly net incomes from line 3)

$

5. Basic Child Support Obligation (enter total amount in box →)

Child #1 _________ Child #3 __________ Child #5 __________ Child #2 _________ Child #4 __________

$

6. Proportional Share of Income (divide line 3 by line 4 for each parent)

.

.

WSCSS-Worksheets - Mandatory (CSW/CSWP) 05/2016 Page 2 of 5

Column 1 Column 2

Part II: Basic Child Support Obligation (see Instructions, page 7) 7. Each Parent’s Basic Child Support Obligation without consideration

of low income limitations. (Multiply each number on line 6 by line 5.) $

$

8. Calculating low income limitations: Fill in only those that apply. Self-Support Reserve: (125% of the Federal Poverty Guideline.) $

a. Is Combined Net Income Less Than $1,000? If yes, for each parent enter the presumptive $50 per child. $ $

b. Is Monthly Net Income Less Than Self-Support Reserve? If yes, for that parent enter the presumptive $50 per child. $ $

c. Is Monthly Net Income equal to or more than Self-Support Reserve? If yes, for each parent subtract the self-support reserve from line 3. If that amount is less than line 7, enter that amount or the presumptive $50 per child, whichever is greater. $ $

9. Each parent’s basic child support obligation after calculating applicable limitations. For each parent, enter the lowest amount from line 7, 8a - 8c, but not less than the presumptive $50 per child. $ $

Part III: Health Care, Day Care, and Special Child Rearing Expenses (see Instructions, page 8)

10. Health Care Expenses

a. Monthly Health Insurance Premiums Paid for Child(ren)

$ $

b. Uninsured Monthly Health Care Expenses Paid for Child(ren)

$ $

c. Total Monthly Health Care Expenses (line 10a plus line 10b)

$ $

d. Combined Monthly Health Care Expenses (add both parents’ totals from line 10c)

$

11. Day Care and Special Expenses a. Day Care Expenses $ $ b. Education Expenses $ $ c. Long Distance Transportation Expenses $ $ d. Other Special Expenses (describe) $ $ $ $ $ $ $ $ e. Total Day Care and Special Expenses (add lines 11a through 11d)

$

$

12. Combined Monthly Total Day Care and Special Expenses (add both parents’ day care and special expenses from line 11e)

$

13. Total Health Care, Day Care, and Special Expenses (line 10d plus line 12)

$

14. Each Parent’s Obligation for Health Care, Day Care, and Special Expenses (multiply each number on line 6 by line 13)

$

$

Part IV: Gross Child Support Obligation 15. Gross Child Support Obligation (line 9 plus line 14) $ $

WSCSS-Worksheets - Mandatory (CSW/CSWP) 05/2016 Page 3 of 5

Column 1 Column 2

Part V: Child Support Credits (see Instructions, page 9) 16. Child Support Credits a. Monthly Health Care Expenses Credit $ $ b. Day Care and Special Expenses Credit $ $ c. Other Ordinary Expenses Credit (describe)

$

$

d. Total Support Credits (add lines 16a through 16c) $ $

Part VI: Standard Calculation/Presumptive Transfer Payment (see Instructions, page 9) 17. Standard Calculation (line 15 minus line 16d or $50 per child

whichever is greater) $ $ Part VII: Additional Informational Calculations 18. 45 % of each parent’s net income from line 3 (.45 x amount from

line 3 for each parent) $ $ 19. 25% of each parent’s basic support obligation from line 9 (.25 x

amount from line 9 for each parent) $ $ Part VIII: Additional Factors for Consideration (see Instructions, page 9) 20. Household Assets (List the estimated present value of all major household assets.)

a. Real Estate $ $

b. Investments $ $ c. Vehicles and Boats $ $ d. Bank Accounts and Cash $ $ e. Retirement Accounts $ $ f. Other (describe) $ $ $ $ 21. Household Debt

(List liens against household assets, extraordinary debt.)

$ $ $ $ $ $ $ $ $ $ 22. Other Household Income a. Income Of Current Spouse or Domestic Partner

(if not the other parent of this action) Name __________________________________________ Name __________________________________________

$ $

$ $

b. Income Of Other Adults In Household Name __________________________________________ Name __________________________________________

$ $

$ $

WSCSS-Worksheets - Mandatory (CSW/CSWP) 05/2016 Page 4 of 5

Column 1 Column 2

c. Gross income from overtime or from second jobs the party is asking the court to exclude per Instructions, page 8

_________________________________________________

$

$

d. Income Of Child(ren) (if considered extraordinary) Name __________________________________________ Name __________________________________________

$ $

$ $

e. Income From Child Support Name __________________________________________ Name __________________________________________

$ $

$ $

f. Income From Assistance Programs Program ________________________________________ Program ________________________________________

$ $

$ $

g. Other Income (describe) ________________________________________________ ________________________________________________

$ $

$ $

23. Non-Recurring Income (describe) _________________________________________________ _________________________________________________

$ $

$ $

24. Child Support Owed, Monthly, for Biological or Legal Child(ren)

Name/age: _____________________________ Paid [ ] Yes [ ] No $ $

Name/age: _____________________________ Paid [ ] Yes [ ] No $ $

Name/age: _____________________________ Paid [ ] Yes [ ] No $ $

25. Other Child(ren) Living In Each Household

(First name(s) and age(s))

26. Other Factors For Consideration

WSCSS-Worksheets - Mandatory (CSW/CSWP) 05/2016 Page 5 of 5

Other Factors for Consideration (continued) (attach additional pages as necessary)

Signature and Dates I declare, under penalty of perjury under the laws of the State of Washington, the information contained in these Worksheets is complete, true, and correct.

Parent’s Signature (Column 1) Parent’s Signature (Column 2) Date City Date City

________________________________________ _______________________________________ Judicial/Reviewing Officer Date This worksheet has been certified by the State of Washington Administrative Office of the Courts.

Photocopying of the worksheet is permitted.

RCW 26.18.220(1) Mandatory Form (05/2016) FL All Family 131

Financial Declaration

p. 1 of 6

Superior Court of Washington, County of In re:

Petitioner/s (person/s who started this case):

And Respondent/s (other party/parties):

No.

Financial Declaration of (name): (FNDCLR)

Financial Declaration

1. Your personal information

Name: Highest year of education you completed: Your job/profession is:

Are you working now?

Yes. List the date you were hired (month / year):

No. List the last date you worked (month / year):

What was your monthly pay before taxes: $

Why are you not working now?

2. Summary of your financial information (Complete this section after filling out the rest of this form.)

1. Total Monthly Net Income (copy from section 3, line C. 3.) $

2. Total Monthly Expenses After Separation (copy from section 7, line I.) $

3. Total Monthly Payments for Other Debts (copy from section 9) $

4. Total Monthly Expenses + Payments for Other Debts (add line 2 and line 3) $

Gross Monthly Income of Other Party (copy from section 3. A.) $

RCW 26.18.220(1) Mandatory Form (05/2016) FL All Family 131

Financial Declaration

p. 2 of 6

3. Income List monthly income and deductions below for you and the other person in your case. If your case involves child support, this same information is required on your Child Support Worksheets. If you do not know the other person’s financial information, give an estimate.

Tip: If you do not get paid once a month, calculate your monthly income like this: Monthly income = Weekly x 4.3 or 2-week x 2.15 or Twice a month x 2 A. Gross Monthly Income (before taxes, deductions, or retirement contributions) You Other Party

Monthly wage / salary

Income from interest / dividends

Income from business

Spousal support / maintenance received (Paid by: )

Other income

Total Gross Monthly Income (add all lines above)

Total gross income for this year before deductions (starting January 1 of this year until now)

B. Monthly Deductions You Other Party

Income taxes (federal and state)

FICA (Soc.Sec. + Medicare) or self-employment taxes

State Industrial Insurance (Workers’ Comp.)

Mandatory union or professional dues

Mandatory pension plan payments

Voluntary retirement contributions (up to the limit in RCW 26.19.071(5)(g))

Spousal support / maintenance paid

Normal business expenses

Total Monthly Deductions (add all lines above)

C. Net Monthly Income You Other Party

1. Total Gross Monthly Income (from A above)

2. Total Monthly Deductions (from B above)

3. Net Monthly Income (Line 1 minus Line 2)

RCW 26.18.220(1) Mandatory Form (05/2016) FL All Family 131

Financial Declaration

p. 3 of 6

4. Other Income and Household Income

Tip: If this income is not once a month, calculate the monthly amount like this: Monthly income = Weekly x 4.3 or 2-week x 2.15 or Twice a month x 2 A. Other Income (Do not repeat income you already listed on page 2.) You Other Party

Child support received from other relationships

Other income (From: )

Other income (From: )

Total Other Income (add all lines above)

B. Household Income (Monthly income of other adults living in the home) Your Home Other Party’s

Home

Other adult’s gross income (Name: )

Other adult’s gross income (Name: )

Total Household Income of other adults in the home (add all lines above)

5. Disputed Income – If you disagree with the other party’s statements about anyone’s income, explain why the other party’s statements are not correct, and your statements are correct:

6. Available Assets List your liquid assets, like cash, stocks, bonds, that can be easily cashed.

Cash on hand and money in all checking & savings accounts $

Stocks, bonds, CDs and other liquid financial accounts $

Cash value of life insurance $

Other liquid assets $

Total Available Assets (add all lines above)

RCW 26.18.220(1) Mandatory Form (05/2016) FL All Family 131

Financial Declaration

p. 4 of 6

7. Monthly Expenses After Separation Tell the court what your monthly expenses are (or will be) after separation. If you have dependent children, your expenses must be based on the parenting plan or schedule you expect to have for the children.

A. Housing Expenses F. Transportation Expenses Rent / Mortgage Payment Automobile payment (loan or lease) Property Tax (if not in monthly payment) Auto insurance, license, registration Homeowner’s or Rental Insurance Gas and auto maintenance Other mortgage, contract, or debt payments based on equity in your home

Parking, tolls, public transportation

Homeowner’s Association dues or fees Other transportation expenses Total Housing Expenses Total Transportation Expenses

B. Utilities Expenses G. Personal Expenses (not children’s) Electricity and heating (gas and oil) Clothes Water, sewer, garbage Hair care, personal care Telephone(s) Recreation, clubs, gifts Cable, Internet Education, books, magazines Other (specify): Other Personal Expenses

Total Utilities Expenses Total Personal Expenses

C. Food and Household Expenses H. Other Expenses Groceries for (number of people): _____ Life insurance (not deducted from pay) Household supplies (cleaning, paper, pets) Other (specify): Eating out Other (specify): Other (specify): Other (specify):

Total Food and Household Expenses Total Other Expenses

D. Children’s Expenses List all Total Expenses from above: Childcare, babysitting A. Total Housing Expenses Clothes, diapers B. Total Utilities Expenses Tuition, after-school programs, lessons C. Total Food and Household Expenses Other expenses for children D. Total Children’s Expenses

Total Children’s Expenses E. Total Health Care Expenses F. Total Transportation Expenses E. Health Care Expenses G. Total Personal Expenses Insurance premium (health, vision, dental) H. Total Other Expenses Health, vision, dental, orthodontia, mental health expenses not covered by insurance

I. All Total Expenses (add A - H above)

Other health expenses not covered by insurance

Use section 11 below to explain any unusual expenses, or attach additional pages.

Total Health Care Expenses

RCW 26.18.220(1) Mandatory Form (05/2016) FL All Family 131

Financial Declaration

p. 5 of 6

8. Debts included in Monthly Expenses listed in section 7 above Debt for what expense

(mortgage, car loan, etc.) Who do you owe

(Name of creditor) Amount you owe this

creditor now Last Monthly

Payment made $ Date: $ Date: $ Date: $ Date:

9. Monthly payments for other debts (not included in expenses listed in section 7) Describe Debt

(credit card, loan, etc.) Who do you owe

(Name of creditor) Amount you owe this creditor now

Last Monthly Payment (Date and Amount)

$ Date: $ $ Date: $ $ Date: $ $ Date: $ $ Date: $ $ Date: $

Total Monthly Payments for Debts

10. Explanation of expenses or debts (if any needed):

11. Lawyer Fees List your total lawyer fees and costs for this case as of today.

Amount paid $ Source of the money you used to pay these fees and costs:

Amount still owed $ Describe your agreement with your lawyer to pay your fees and costs:

Total Fees/Costs $

I declare under penalty of perjury under the laws of the state of Washington that the facts I have provided on this form are true.

Signed at (city and state): Date:

Sign here Print name

RCW 26.18.220(1) Mandatory Form (05/2016) FL All Family 131

Financial Declaration

p. 6 of 6

Financial Records – You must provide financial records as required by statute and state and local court rules. These records may include: Personal Income Tax Returns Pay stubs

Partnership or Corporate Income Tax Returns Other financial records

Important! Do not attach financial records to this form. Financial records should be served on the other party and filed with the court separately using the Sealed Financial Source Documents cover sheet (FL All Family 011). If filed separately using the cover sheet, the records will be sealed to protect your privacy (although they will be available to all parties and lawyers in this case, court personnel and certain state agencies and boards.) See GR 22(c)(2).

GR 22(b)(8), (g) Mandatory Form (05/2016) FL All Family 011

Sealed Financial Source Documents

p. 1 of __

Superior Court of Washington, County of In re:

Petitioner/s (person/s who started this case):

And Respondent/s (other party/parties):

No.

Sealed Financial Source Documents (Cover Sheet) (SEALFN) Clerk’s action required.

For use in Family Law and Guardianship cases.

Sealed Financial Source Documents (Cover Sheet)

Use this form as a cover sheet to keep your financial documents private from the public. On the first page of each document, write the word “SEALED” 1 inch from the top of the page.

Check the documents you are attaching to this cover sheet to be sealed:

Income tax records Pay stubs or other proof of earnings

Credit card statements Bank statements

Checks or the equivalent Loan application documents

Check registers Retirement plan orders

Other financial information sealed by court order (specify):

Submitted by: Petitioner or his/her lawyer Respondent or his/her lawyer

Sign here Print name (if lawyer, also provide WSBA #)

Important! The other person and the lawyers in your case can see your sealed documents. If you need to keep your address information private for safety reasons, you may cross out or delete your address information.

RCW 26.23.050; 26.50.160; GR 22 Mandatory Form (05/2016) FL All Family 001

Confidential Information

p. 1 of 2

Confidential Information (CIF)

Clerk: Do not file in a public access file Superior Court of Washington, County:

Case No.:

Important! Only court staff and some state agencies may see this form. The other party and his/her lawyer may not see this form unless a court order allows it. State agencies may disclose the information in this form according to their own rules.

1. Who is completing this form? (Name):

2. Is there a current restraining or protection order involving the parties or children? Yes No If Yes, who does the order protect? (Name/s):

3. Does your address information need to be confidential to protect your or your children’s health, safety, or liberty? (Check one): Yes No If Yes, explain why?

4. Your Information Full name (first, middle, last):

Date of birth (MM/DD/YYYY):

Sex: M F

Driver’s license/Identicard (#, state):

Race:

Relationship to children in this case:

Mailing address (This address will not be kept private.) (street address or PO box, city, state zip):

If your case is only about a protection order, the information below is not required. Skip to 5. Home address (check one): same as mailing address listed below (street, city, state, zip): Phone: Email: Social Sec. #: Employer’s name: Employer’s phone: Employer’s address:

5. Other Party’s Information – This person is a (check one): Petitioner Respondent Full name (first, middle, last):

Date of birth (MM/DD/YYYY):

Sex: M F

Driver’s license/Identicard (#, state):

Race:

Relationship to children in this case:

Mailing address (This address will not be kept private.) (street address or PO box, city, state zip):

If your case is only about a protection order, the information below is not required. Skip to 6. Home address (check one): same as mailing address listed below (street, city, state, zip): Phone: Email: Social Sec. #: Employer’s name: Employer’s phone: Employer’s address:

RCW 26.23.050; 26.50.160; GR 22 Mandatory Form (05/2016) FL All Family 001

Confidential Information

p. 2 of 2

Skip sections 6 – 9 if your case does not involve children. Sign at the end. 6. Children’s Information (You do not have to fill out the children’s Social Security numbers if your

case is only about a protection order.)

Child’s full name (first, middle, last) Date of birth

(MM/DD/YYYY) Race Sex Soc. Sec.

# Current location: lives with

1. M F

Petitioner Respondent other:

2. M F

Petitioner Respondent other:

3. M F

Petitioner Respondent other:

4. M F

Petitioner Respondent other:

5. M F

Petitioner Respondent other:

6. M F

Petitioner Respondent other:

7. Have the children lived with anyone other than Petitioner or Respondent during the last five years? (Check one): No Yes If Yes, fill out below:

Children lived with (name) That person’s current address

1.

2.

8. Do other people (not parents) have custody or visitation rights to the children? (Check one): No Yes If Yes, fill out below:

Person with rights (name) That person’s current address

1.

2.

9. If you are asking for custody and are not the parent, list all other adults living in your home:

1. (Name): Date of birth (MM/DD/YYYY):

2. (Name): Date of birth (MM/DD/YYYY):

I declare under penalty of perjury under Washington State law that the information on this form about me is true. The information about the other party is the best information I have or is unavailable because (explain):

Check here if you need more space to list other Petitioners, Respondents, or children. Put that information on the Attachment to Confidential Information, form FL All Family 002, and attach it to this form.

Signed at (city and state): Date:

Petitioner/Respondent signs here Print name here

RCW 26.23.050 Mandatory Form (05/2016) FL All Family 002

Attachment to Confidential Information (Additional Parties or Children)

p. 1 of 1

Attachment to Confidential Information (Additional Parties or Children) (AT)

Clerk: Do not file in a public access file

County:

Case No.:

Use this form if there are more parties or children in your case than you can list on the Confidential Information form. 1. Other Party’s Information (if any) – This person is a (check one): Petitioner Respondent

Full name (first, middle, last):

Date of birth (MM/DD/YYYY):

Sex: M F

Driver’s license/Identicard (#, state):

Race:

Relationship to children in this case:

Mailing address (This address will not be kept private.) (street address or PO box, city, state zip):

If your case is only about a protection order, the information below is not required. Skip to 2. Home address (check one): same as mailing address listed below (street, city, state, zip): Phone: Email: Social Sec. #: Employer’s name: Employer’s phone: Employer’s address:

2. Other Party’s Information (if any) – This person is a (check one): Petitioner Respondent Full name (first, middle, last):

Date of birth (MM/DD/YYYY):

Sex: M F

Driver’s license/Identicard (#, state):

Race:

Relationship to children in this case:

Mailing address (This address will not be kept private.) (street address or PO box, city, state zip):

If your case is only about a protection order, the information below is not required. Skip to 3. Home address (check one): same as mailing address listed below (street, city, state, zip): Phone: Email: Social Sec. #: Employer’s name: Employer’s phone: Employer’s address:

3. Other Children’s Information (if any) (You do not have to fill out the children’s Social Security numbers if your case is only about a protection order.)

Child’s full name (first, middle, last)

Date of birth (MM/DD/YYYY)

Race Sex Soc. Sec. #

Current location: lives with

7. M F

Petitioner Respondent other:

8. M F

Petitioner Respondent other:

RCW 26.09.170; .175 Mandatory Form (05/2016) FL All Family 501

Petition to Modify Child Support Order

p. 1 of 8

Superior Court of Washington, County of In re:

Petitioner/s (see * below):

And Respondent/s (other party/parties):

No.

Petition to Modify Child Support Order (PTMD)

* If you’re filing this Petition in: the same case number as the current Child Support Order, the person who is listed as the Petitioner in the

current order will stay Petitioner, even if s/he is not the person asking to modify the order now. a different case number or county from where the current Child Support Order was filed, the person asking to

modify the order may be the Petitioner. To modify a Child Support Order from a sealed Parentage case, contact the Superior Court Clerk’s office about who to list as Petitioner and if there is a new case number.

Petition to Modify Child Support Order

1. My name is: . I ask the court to modify a Child Support Order. I am filing and serving proposed Child Support Schedule Worksheets at the same time as this Petition.

Important! Check your county’s Local Court Rules for other forms and information that must be filed.

2. Correct County (Venue) This is the correct county for this case to be heard because: the children live in this county, the person who has the care, custody or control of the children lives in this county, or the current Child Support Order was issued in this county.

The children live in (county): , (state): .

The Petitioner (name): lives in (county): , (state): .

The Respondent (name): lives in (county): , (state): .

RCW 26.09.170; .175 Mandatory Form (05/2016) FL All Family 501

Petition to Modify Child Support Order

p. 2 of 8

3. Jurisdiction to modify order The court has authority to modify the current Child Support Order because it was issued by a (check one):

Washington state court.

Different state or jurisdiction, but has been registered in a Washington state court and (check one):

All parties in Washington now: All the parties to the current order (other than a State party) now live in this

state; and The children do not live in the state or jurisdiction where the order was issued.

No one left in issuing state: None of the children or parties to the current order (other than a State party)

live in the state or jurisdiction where the order was issued; The person asking to modify the order (Petitioner) lives outside of Washington;

and Washington has personal jurisdiction over the Respondent because s/he

(check all that apply): lives in this state now. will be personally served in this state with a Summons and Petition for this

case. lived in this state with the children. lived in this state and paid for pregnancy costs or support for the children. did or said something that caused the children to live in this state. had sex in this state, which may have produced the children. signed an agreement to join this Petition or other document agreeing that

the court can decide his or her rights in this case. other (specify):

Parties have consented: At least one child or party to the current order lives in Washington state now; and Each party to the current order (other than a State party) has filed a consent

with the court that issued the current order agreeing that a Washington court may modify the order and take continuing, exclusive jurisdiction.

4. Is the state filing this Petition? (Check one): No. This Petition is filed by a parent or non-parent custodian.

Yes. The state Department of Social and Health Services (DSHS) is filing this Petition because (check all that apply):

the children receive public assistance. the children do not receive public assistance, but one of the parties asked DSHS to

review the order and DSHS decided the order should be modified. another state or jurisdiction asked for this modification.

RCW 26.09.170; .175 Mandatory Form (05/2016) FL All Family 501

Petition to Modify Child Support Order

p. 3 of 8

5. Current Child Support Order The Child Support Order I want to modify was signed by the court on (date):

in (county): , (state): .

That order says (name): must pay

(amount): $ each month for (children’s names):

. Important! Attach or file a certified copy of the current child support order that you want to change if it was issued in a different county or state.

6. Should the court modify the monthly child support amount? No. Yes. I ask the court to order child support based on Washington state law. The monthly child support amount should be changed now because (check all that apply):

Agreement – The parties agree to the changes. 1 year or more has passed – The current order was signed at least one year ago and (check all that apply):

the current order causes severe financial hardship for me or the children. a child has turned 12 and has the right to more support. I want to add a Periodic Adjustment provision according to RCW 26.09.100.

2 years or more have passed – The current order was signed at least two full years (24 months) ago and (check all that apply):

the parents’ income has changed. the economic table or standards in RCW 26.19 have changed.

(Note – You may be able to use a Motion to Adjust Child Support Order (form FL Modify 521) instead of this Petition if 24 months have passed and the only reasons for your requests are that the parents’ income has changed, or the economic table or standards have changed.)

Default or Past Agreement – The current order was issued by default or agreement, without the court independently examining the evidence to decide a reasonable amount of support according to the law.

Change of Circumstances – There has been a substantial change in circumstances

since the current order was signed. (Describe):

RCW 26.09.170; .175 Mandatory Form (05/2016) FL All Family 501

Petition to Modify Child Support Order

p. 4 of 8

7. Should the court modify the end date for child support? No. Yes. The end date should be modified because (check all that apply):

Agreement – The parties agree to the changes.

Finish High School – The current order was signed at least one year ago. (Child’s name): will still be in high school when s/he turns 18 and will need support until s/he finishes high school. I ask the court to order child support for this child to continue past his/her 18th birthday until he/she finishes high school.

Dependent Adult Child – The current order says support must be paid for each child until the child turns 18 or is no longer enrolled in high school, whichever happens last. Support should continue past this time for (child’s name): because this child will be unable to support him/herself and will remain dependent past the age of 18. This child’s situation has changed substantially since the current order was signed. (Describe):

Support for this child should continue until (check one): this child is able to support him/herself and is no longer dependent on the

parents. other:

Default or Past Agreement – The current order was issued by default or agreement, without the court independently examining the evidence to decide a reasonable end date for support according to the law.

RCW 26.09.170; .175 Mandatory Form (05/2016) FL All Family 501

Petition to Modify Child Support Order

p. 5 of 8

8. Should the court modify post-secondary educational support? No.

Yes. Issue was reserved – The current order allows a parent or non-parent custodian to ask the court for post-secondary support at a later date without showing a substantial change of circumstances. I ask the court to order the parents to pay post-secondary support, and to set a specific post-secondary support amount or percentage of expenses for (Children’s names): . These children depend on the parents for the reasonable necessities of life and will be ready to start a college or vocational program around (month/year): . Yes. Support was granted, need to set an amount – The current order says the parents must pay for the children’s post-secondary support, but did not set a payment amount or percentage. I ask the court to order a specific post-secondary support amount or percentage of expenses for (children’s names): who will be ready to start a college or vocational program around (month/year): . Yes. Modify – I ask the court to (check all that apply):

Require – The current order says post-secondary support is not required. I ask the court to change the order so that post-secondary support is required for (Children’s names): . These children depend on the parents for the reasonable necessities of life and need support for college or vocational school.

Cancel – The current order says the parents must pay for the children’s post-secondary (college or vocational school) support. I ask the court to change the order so that post-secondary support is no longer required.

Change Amount – The current order requires the parents to pay a specific amount or percentage of expenses for the children’s post-secondary (college or vocational school) support. I ask the court to change the amount or percentage.

These changes should be made because (check all that apply):

Agreement – The parties agree to the changes.

Default or Past Agreement – The current order was issued by default or agreement, without the court independently examining the evidence to decide these issues.

Change of Circumstances – There has been a substantial change in circumstances since the current order was signed. (Describe):

9. Should the court modify payment for children’s expenses or tax exemptions? No.

Yes. I ask the court to order or change (check all that apply):

day care expenses.

RCW 26.09.170; .175 Mandatory Form (05/2016) FL All Family 501

Petition to Modify Child Support Order

p. 6 of 8

educational expenses.

long-distance transportation expenses.

other expenses.

tax exemptions. Order that parties have the right to claim the children as their dependents on their tax forms in this way (specify):

These changes should be made because (check all that apply):

Agreement – The parties agree to the changes.

2 years or more have passed – It has been at least two full years (24 months) since the order was signed and these requests are based only on changes in the parents’ income or the economic table or standards in RCW 26.19.

(Note – You may be able to use a Motion to Adjust Child Support Order (form FL Modify 521) instead of this Petition if 24 months have passed and the only reasons for your requests are that the parents’ income has changed, or the economic table or standards have changed.)

Default or Past Agreement – The current order was issued by default or agreement, without the court independently examining the evidence to decide these issues.

Change of Circumstances – There has been a substantial change in circumstances

since the current order was signed. (Describe):

10. Should the court modify health insurance orders? No.

Yes. I ask the court to change the health insurance orders as follows:

Order one or both parents to provide or pay for health insurance coverage for the children if it is available through an employer or union for less than 25% of his/her basic support obligation (Worksheets, line 19), and order each parent to pay his/her share of the children’s healthcare costs that are not covered by insurance.

Other (specify):

These changes should be made because (check all that apply):

Agreement – The parties agree to the changes.

2 years or more have passed – It has been at least two full years (24 months) since the order was signed and these requests are based only on changes in the parents’ income or the economic table or standards in RCW 26.19.

RCW 26.09.170; .175 Mandatory Form (05/2016) FL All Family 501

Petition to Modify Child Support Order

p. 7 of 8

Note – You may be able to use a Motion to Adjust Child Support Order (form FL Modify 521) instead of this Petition if 24 months have passed and the only reasons for your requests are that the parents’ income has changed, or the economic table or standards have changed.

Default or Past Agreement – The current order was issued by default or agreement, without the court independently examining the evidence to decide these issues.

Change of Circumstances – There has been a substantial change in circumstances

since the current order was signed. (Describe):

11. When do you want the new order to start? I want the new Child Support Order to take effect:

on the day this Petition is filed. other (specify):

If the changes to the Child Support Order cause an overpayment or an underpayment of support or other expenses, I ask the court to order payment or give credit for those amounts.

12. Other Requests Does not apply.

I ask the court to order payment of lawyer fees and court costs.

Other (specify):

Person filing this Petition fills out below: I declare under penalty of perjury under the laws of the state of Washington that the facts I have provided on this form are true.

Signed at (city and state): Date:

Person filing this Petition signs here Print name

Lawyer (if any) fills out below:

Lawyer signs here Print name and WSBA No. Date

Warning! Documents filed with the court are available for anyone to see unless they are sealed. Financial, medical, and confidential reports, as described in General Rule 22, must be sealed so they can only be seen by the court, the other parties, and the lawyers in your case. Seal those documents by filing them separately, using a Sealed cover sheet (form FL All Family 011, 012, or 013). You may ask for an order to

RCW 26.09.170; .175 Mandatory Form (05/2016) FL All Family 501

Petition to Modify Child Support Order

p. 8 of 8

seal other documents.

The other parent or non-parent custodian fills out below if s/he agrees to join this Petition: I, (name): , agree to join this Petition. I understand that if I fill out and sign below, the court may approve the requests listed in this Petition unless I file and serve a Response before the court signs final orders. (Check one):

I do not need to be notified about the court’s hearings or decisions in this case.

The person who filed this Petition must notify me about any hearings in this case. (List an address where you agree to accept legal documents. This may be a lawyer’s address or any other address.)

street number or P.O. box city state zip

(If this address changes before the case ends, you must notify all parties and the court clerk in writing. You may use the Notice of Address Change form (FL All Family 120). You must also update your Confidential Information Form (FL All Family 001).)

Person joining Petition signs here Print name Date

RCW 26.09.175(2),(3), CR 4.1 Mandatory Form (05/2016) FL Modify 500

Summons: Notice about Modifying a Child Support Order

p. 1 of 2

Superior Court of Washington, County of In re:

Petitioner/s (as listed on the Petition):

And Respondent/s (as listed on the Petition):

No.

Summons: Notice about Petition to Modify Child Support Order (SM)

Summons: Notice about Petition to Modify Child Support Order

To: (name/s of the party or parties who did not file this Summons and Petition)

The person filing this Summons and Petition asked the court to modify the Child Support Order. You must respond in writing for the court to consider your side.

Deadline! Your Response must be served on the other party within 20 days of the date you were served this Summons (60 days if you were served outside of Washington State). If the case has been filed, you must also file your Response by the same deadline. If you do not file and serve your Response or a Notice of Appearance by the deadline:

No one has to notify you about other hearings in this case, and

The court may approve the requests in the Petition without hearing your side (called a default judgment).

Follow these steps:

1. Read the Petition and any other documents you receive with this Summons. These documents explain what the other party is asking for.

2. Fill out the Response to Petition to Modify a Child Support Order (form FL Modify 502). You can get the Response and other forms at:

The Washington State Courts’ website: www.courts.wa.gov/forms, The Administrative Office of the Courts – call: (360) 705-5328,

RCW 26.09.175(2),(3), CR 4.1 Mandatory Form (05/2016) FL Modify 500

Summons: Notice about Modifying a Child Support Order

p. 2 of 2

Washington LawHelp: www.washingtonlawhelp.org, or The Superior Court Clerk’s office or county law library (for a fee).

3. Serve (give) a copy of your Response to the person who filed this Summons at the address below and to any other parties. You may use certified mail with return receipt requested. For more information on how to serve, read Superior Court Civil Rule 5.

4. File your original Response with the court clerk at this address: Superior Court Clerk, County

address city state zip

If there is no “Case No.” listed on page 1, this case may not have been filed and you will not be able to file a Response. Contact the Superior Court Clerk or check www.courts.wa.gov to find out. If the case was not filed, you must still serve your Response, and you may demand that the other party file this case with the court. Your demand must be in writing and must be served on the other party or his/her lawyer (whoever signed this Summons). If the other party does not file papers for this case within 14 days of being served with your demand, this service on you of the Summons and Petition will not be valid. If the other party does file, then you must file your original Response with the court clerk at the address above.

5. Lawyer not required: It’s a good idea to talk to a lawyer, but you may file and serve your Response without one.

Person filing this Summons fills out below:

Signature of person filing this Summons or lawyer Date

Print name (and WSBA No., if lawyer)

I agree to accept legal papers for this case at (check one):

my lawyer’s address:

lawyer’s address city state zip

Email (if applicable):

the following address (this does not have to be your home address):

address city state zip

(Optional) email:

(If this address changes before the case ends, you must notify all parties and the court in writing. You may use the Notice of Address Change form (FL All Family 120). You must also update your Confidential Information Form (FL All Family 001).)

This Summons is issued according to Rule 4.1 of the Superior Court Civil Rules of the State of Washington.

RCW 38.42.050(3) Optional Form (05/2016) FL All Family 103

Notice Re Military Dependent

p. 1 of 2

Superior Court of Washington, County of In re:

Petitioner/s (person/s who started this case):

And Respondent/s (other party/parties):

No.

Notice Re Military Dependent (NTDMP)

Notice Re Military Dependent (For qualified Reservist or National Guard member dependents only – not regular U.S. Armed Service member dependents. Military service members have other legal protections that are not described in this Notice.)

You qualify for special legal protections in this case if you are a military dependent and: Your spouse (or parent, if you are under 18) is a Washington resident who is a member of

the National Guard or Reserves called to active military duty for more than 30 days in a row, or

For the last 6 months or longer, 50% or more of your income was from a Washington resident who is a member of the National Guard or Reserves called to active military duty for more than 30 days in a row.

If you qualify… You should tell me in writing that you qualify within 20 days of the date you get this Notice. After you notify me, the Court will not approve final orders without first assigning a lawyer to help you. You will not lose any rights in this case by notifying me about your status. Notifying me about your status is not the same as appearing or responding to the Petition.

If you do not notify me… The Court will assume you are not a protected military dependent, and may approve final orders without hearing your side.

This is a summary of the notice described in RCW 38.42.050(3)(a). The full text is on page 2.

Person who filed Petition or lawyer signs here Print name and WSBA # if lawyer Date

RCW 38.42.050(3) Optional Form (05/2016) FL All Family 103

Notice Re Military Dependent

p. 2 of 2

NOTICE: State and federal law provide protections to defendants who are in the military service, and to their dependents. Dependents of a service member are the service member's spouse, the service member's minor child, or an individual for whom the service member provided more than one-half of the individual's support for one hundred eighty days immediately preceding an application for relief.

One protection provided is the protection against the entry of a default judgment in certain circumstances. This notice pertains only to a defendant who is a dependent of a member of the national guard or a military reserve component under a call to active service, or a national guard member under a call to service authorized by the governor of the state of Washington, for a period of more than thirty consecutive days. Other defendants in military service also have protections against default judgments not covered by this notice.

If you are the dependent of a member of the national guard or a military reserve component under a call to active service, or a national guard member under a call to service authorized by the governor of the state of Washington, for a period of more than thirty consecutive days, you should notify the plaintiff or the plaintiff's attorneys in writing of your status as such within twenty days of the receipt of this notice. If you fail to do so, then a court or an administrative tribunal may presume that you are not a dependent of an active duty member of the national guard or reserves, or a national guard member under a call to service authorized by the governor of the state of Washington, and proceed with the entry of an order of default and/or a default judgment without further proof of your status. Your response to the plaintiff or plaintiff's attorneys about your status does not constitute an appearance for jurisdictional purposes in any pending litigation nor a waiver of your rights.

Decl re Service Member’s Civil Relief Act (AFSCR) - Page 1 of 2 WPF All Cases 01.0200 (07/2013) RCW 38.42.050

Superior Court of Washington County of

In re:

Petitioner, and

Respondent.

No. Declaration re: Service Members Civil Relief Act (Optional Use) (AFSCR)

I (name) ______________________________ , Declare that: 1. Service member status ---

(Name of nonmoving party)____________________________:

is not a service member. is a service member (fill out below):

Military Branch

State of Residence

Duty Status Protection of Rights

U.S. Armed Forces National Guard or Reserves

Washington Not Washington

On active military duty Not on active military duty

In this case, the service member: has his/her own lawyer. has a lawyer appointed by the court.

The court: has suspended or delayed this case. has not suspended or delayed this case.

I am unable to determine whether the nonmoving party is or is not on active duty in the U.S. armed forces;

I am unable to determine whether the nonmoving party is or is not on active duty as a National Guard member or a Reservist residing in Washington.

Decl re Service Member’s Civil Relief Act (AFSCR) - Page 2 of 2 WPF All Cases 01.0200 (07/2013) RCW 38.42.050

The information above is based on the following:

See the attached Department of Defense Manpower Data Center Status Report Pursuant to Servicemembers Civil Relief Act (SCRA) obtained from https://www.dmdc.osd.mil/appj/scra/. (You must have the person’s social security number to search in this site.)

My personal knowledge (explain): 2. Dependent of a service member status ---

(Name of the nonmoving party) __________________________________:

is not a dependent of a resident of Washington who is on active duty and is a National Guard member or a Reservist;

is a dependent of a resident of Washington who is on active duty and is a National Guard member or a Reservist:

The nonmoving party is represented by an attorney. The court has appointed an attorney to represent the nonmoving party. A stay of these proceedings has has not been entered by the court;

I am unable to determine whether the nonmoving party is a dependent of a resident of Washington who is on active duty and is a National Guard member or a Reservist.

The information above is based on the following:

The nonmoving party failed to respond to a notice to him or her as a dependent of a person in Military Service that was served on mailed by first class mail on (date) ________________________________________ , therefore he or she should be presumed not a dependent of a resident of Washington who is on active duty and is a National Guard member or a Reservist.

My personal knowledge (explain):

I declare under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct.

Signed at (city) ______________________, (state) _____________ on (date) ____________________ . Signature of Petitioner or Lawyer/WSBA No. Print Name

CR 4(d)(4) and (g), RCW 4.28.100 Optional Form (05/2016) FL All Family 107

Proof of Service by Mail

p. 1 of 3

Superior Court of Washington, County of In re:

Petitioner/s (person/s who started this case):

And Respondent/s (other party/parties):

No.

Proof of Service by Mail (AFML)

Proof of Service by Mail Warning! Use this form only if the court has signed an Order to Allow Service by Mail for documents that otherwise must be personally served. Use the Proof of Mailing or Hand Delivery form (FL All Family 112) to show service of documents that do not have to be personally served.

Server declares:

1. My name is: . I am not a party to this case. I am 18 or older.

2. Service by mail allowed (Check one):

The court signed an order on (date): that allows me to serve the documents listed in section 4 below by mail.

I served a Summons and Petition to Modify Child Support Order to change a Child Support Order that was signed by a Washington State Court. (The law allows these documents to be served by return receipt mail without a court order. RCW 26.09.175(2)(a).)

I served a Notice of Intent to Move with Children (Relocation). (The law allows this Notice to be served by return receipt mail without a court order. RCW 26.09.440.)

I served an Objection about Moving with Children and Petition about Changing a Parenting/Custody Order (Relocation). (The law allows this Objection to be served by return receipt mail without a court order. RCW 26.09.480.)

3. On (date): , I personally mailed two copies of the documents listed below to (name): at each address

CR 4(d)(4) and (g), RCW 4.28.100 Optional Form (05/2016) FL All Family 107

Proof of Service by Mail

p. 2 of 3

listed below. I mailed one copy by regular, prepaid first class mail. I mailed the other copy by certified mail with return receipt requested. The return receipt is taped below.

(Check all that apply):

Last known mailing address:

street number or P.O. box city state zip

Other appropriate address approved by the court:

Addressed to him/her: directly in care of (name): at:

street number or P.O. box city state zip

4. List all documents you served (check all that apply): (The most common documents are listed below. Check only those documents that were served. Use the “Other” boxes to write in the title of each document you served that is not already listed.)

Petition to/for

Summons (Attach a copy.) Notice of Hearing

Order Setting Case Schedule Motion for Temporary Family Law Order and Restraining Order

Notice Re Military Dependent Proposed Temporary Family Law Order

Proposed Parenting Plan Motion for Immediate Restraining Order (Ex Parte)

Proposed Child Support Order Immediate Restraining Order (Ex Parte) and Hearing Notice

Proposed Child Support Worksheets Restraining Order

Sealed Financial Documents Motion for Contempt Hearing

Financial Declaration Order to Go to Court for Contempt Hearing

Declaration of:

Notice of Intent to Move with Children (Relocation)

Declaration of:

Objection about Moving with Children and Petition about Changing a Parenting/ Custody Order (Relocation)

Declaration of:

Other:

Declaration of:

Other:

CR 4(d)(4) and (g), RCW 4.28.100 Optional Form (05/2016) FL All Family 107

Proof of Service by Mail

p. 3 of 3

5. Other information (if any):

I declare under penalty of perjury under the laws of the state of Washington that the statements on this form are true.

Signed at (city and state): Date:

Signature of server Print or type name of server

To the party having these documents served: File the original Proof of Service by Mail with the court clerk. If you served a Restraining Order signed by the court, you must also give a copy of this Proof

of Service by Mail and a Law Enforcement Information Sheet to law enforcement. Tape return receipt below:

If you cannot determine the appropriate category, please describe the cause of action below. ____________________________________________________________________________________ Please Note: Public information in court files and pleadings may be posted on a public Web site.

CASE TYPES 3 - 6 ___________________________ COUNTY SUPERIOR COURT

CASE INFORMATION COVER SHEET Case Number ___________________ Case Title _______________________________________ Attorney Name ____________________________ Bar Membership Number _________________

Please check one category that best describes this case for indexing purposes. Accurate case indexing not only saves time in docketing new cases, but helps in forecasting needed judicial resources. Cause of action definitions are listed on the back of this form. Thank you for your cooperation. DOMESTIC RELATIONS ___ Annulment/Invalidity (INV 3) ___ Child Custody (CUS 3) ___ Committed Intimate Relationship (CIR 3) ___ Dissolution with Children (DIC 3) ___ Dissolution with no Children (DIN 3) ___ Dissolution of Domestic Partnership with Children (DPC 3) ___ Dissolution of Domestic Partnership with No Children (DPN 3) ___ Foreign Judgment (FJU 3) ___ Invalidity-Domestic Partnership (INP 3) ___ Legal Separation (SEP 3) ___ Legal Separation-Domestic Partnership (SPD 3) ___ Mandatory Wage Assignment (MWA 3) ___ Modification (MOD 3) ___ Modification: Support Only (MDS 3) ___ Out-of-State Custody (OSC 3) ___ Parenting Plan/Child Support (PPS 3) ___ Reciprocal, Respondent in County (RIC 3) ___ Reciprocal, Respondent Out of County (ROC 3) DOMESTIC VIOLENCE/ANTIHARASSMENT ___ Confidential Name Change (CHN 5) MENTAL ILLNESS ___ Alcohol/Drug Treatment (ALT 6) ___ Mental Illness-Adult (MI 6) ___ Mental Illness-Juvenile (MIJ 6) ___ Mental Illness-Other Venue (MIO 6) ___ Mental Illness-Family Petition (MIF 6) ADOPTION/PARENTAGE

___ Adoption (ADP 5) ___ Confidential Intermediary (MSC 5) ___ Initial Pre-Placement Report (PPR 5) ___ Modification (MOD 5) ___ Parentage (PAT 5) ___ Parentage/URESA/UIFSA (PUR 5) ___ Relinquishment (REL 5) ___ (Title 26)Termination of Parent-Child Relationship (TER 5) PROBATE/GUARDIANSHIP ___ Absentee (ABS 4) ___ Disclaimer (DSC 4) ___ Estate (EST 4) ___ Foreign Will (FNW 4) ___ Guardianship (GDN 4) ___ Guardianship/Estate (G/E 4) ___ Guardianship of the Estate (GDE 4) ___ Guardianship of the Person (GDP 4) ___ Limited Guardianship (LGD 4) ___ Limited Guardianship of the Estate (LGE 4) ___ Limited Guardianship of the Person (LGP 4) ___ Minor Guardianship (MGD 4) ___ Minor Settlement (With guardianship) (MST 4) ___ Non-Probate Notice to Creditors (NNC 4) ___ Sealed Will Repository (SWR 4) ___ Trust/Estate Dispute Resolution (TDR 4) ___ Trust (TRS 4) ___ Will Only (WLL 4)

Case Types 3 - 6 Last Revised: 6/23/2015

DOMESTIC RELATIONS Annulment--Invalidity--Petition claiming an illegal or invalid marriage. Child Custody--Petition involving the immediate charge and control of a child. Committed Intimate Relationship- Petition for distribution of property from a committed intimate relationship (i.e., a stable, marital-like relationship where both parties cohabit with knowledge that a lawful marriage between them does not exist). Dissolution with Children--Petition to terminate a marriage other than annulment, with children of that marriage. Dissolution with no Children--Petition to terminate a marriage other than annulment, with no children of that marriage. Dissolution of Domestic Partnership–With Children--Petition to terminate a domestic partnership, other than annulment, with children of that domestic partnership. Dissolution of Domestic Partnership–With No Children--Petition to terminate a domestic partnership, other than annulment, with no children of that domestic partnership. Foreign Judgment--A judgment, decree, or order of a court of the United States, or any state or territory, which is entitled to full faith and credit in this state. Invalidity–Domestic Partnership-- Petition to invalidate a domestic partnership. Legal Separation--Petition to live separate and apart. Legal Separation-Domestic Partnership -- Petition to live separate and apart in a domestic partnership. Mandatory Wage Assignment--Petition for wage assignment. Modification--Petition seeking amendment of a previous order or decree. Modification: Support Only--Petition seeking amendment of a previous order or decree regarding support. Out-of-State Custody--Recording custody established out-of-state. Parenting Plan/Child Support—Petition for Residential Schedule/Parenting Plan/Child Support in circumstances set forth in RCW 26.26.375. Reciprocal, Respondent-in-County-Petition to enforce orders between states under URESA for respondents in the county. Reciprocal, Respondent-Out-of-County-Petition to enforce orders between states under URESA for respondents out of the county. DOMESTIC VIOLENCE/ ANTIHARASSMENT Confidential Name Change--Petition for name change, when domestic

violence/antiharassment issues require confidentiality. MENTAL ILLNESS Alcohol/Drug Treatment--Petition for involuntary treatment for one who is incapacitated by alcohol or drugs. Mental Illness--Adult--Petition for involuntary treatment for an adult who is incapacitated by mental illness. Mental Illness--Juvenile--Petition for involuntary treatment for a juvenile who is incapacitated by mental illness. Mental Illness–Other Venue--Petition to modify or revoke a Less Restrictive Alternative originally issued in another county. Mental Illness-Family Petition-- Petition for review of a DMHP decision to not detain a person for evaluation and treatment involuntary treatment under the Involuntary Treatment Act. Petition filed by family member, guardian, or conservator of the person named in the petition. ADOPTION/PARENTAGE Adoption--Petition to establish a new, permanent relationship of parent and child not having that relationship. Confidential Intermediary--Petition to appoint a confidential intermediary to contact the adopted person(s), birth parent(s), or other relative(s). Initial Pre-Placement --An initial pre-placement report filed on a child by the DSHS prior to the filing of adoption papers. Modification--Petition seeking amendment of a previous order or decree. Parentage --Petition to determine the legal status of a parent. Paternity/URESA/UIFSA --Petition to determine the legal status of a parent which is filed in conjunction with the reciprocal report entered under the URESA or UIFSA acts. Relinquishment--Petition to relinquish a child to DSHS, an agency, or a prospective adoptive parent. (Title 26) Termination of Parent-Child Relationship--Petition to terminate a parent-child relationship when parent has not executed a written consent. PROBATE/GUARDIANSHIP Absentee--Petition to determine the location of absent owner of real or personal property. Disclaimer--Recording a written instrument disclaiming an interest by beneficiaries. Estate--Petition seeking court settlement of a deceased person's property. Foreign Will--Filing of a will for probate that has been proved in another state, territory,

or foreign country. Guardianship--Petition to appoint a guardian over a person and estate to manage the affairs of an incompetent or non-resident person. Guardianship/Estate--Petition seeking court settlement for the property of a deceased person who was the ward of a guardian. Guardianship of the Estate – Petition to appoint a guardian over the estate to manage the affairs of an incompetent or non-resident person. Guardianship of the Person – Petition to appoint a guardian over a person to manage the affairs of an incompetent or non-resident person. Limited Guardianship--Petition to appoint a limited guardian with only partial responsibility for the ward's person and property, where the ward is not fully incompetent. Limited Guardianship of the Estate--Petition to appoint a limited guardian with only partial responsibility for the person’s property, where the ward is not fully incompetent. Limited Guardianship of the Person--Petition to appoint a limited guardian with only partial responsibility for the person, where the ward is not fully incompetent. Minor Guardianship--Petition is based solely on the underage status of the Ward/Minor. Minor Settlements--Petition for a court decision that an award to a minor is appropriate when letters of guardianship are required (e.g., net settlement value is greater than $25,000). Non-Probate Notice to Creditors--The filing of a non-probate notice to creditors in a case in which no probate action is expected (e.g., an estate with a living trust which does not require probate, providing the heirs with an opportunity to start the time period for creditor filing of claims). Sealed Will Repository – Filing a will under seal before a testator’s death, as authorized by RCW 11.12.265. Trust/Estate Dispute Resolution – The filing of a dispute in any estate, guardianship, or trust. Trust-- A case filed, by order, separately from a guardianship or probate case. Will Only--Filing a will when no further action shall be taken.

GR 22(b)(3), (g) Mandatory Form (05/2016) FL All Family 012

Sealed Personal Health Care Records

p. 1 of __

Superior Court of Washington, County of In re:

Petitioner/s (person/s who started this case):

And Respondent/s (other party/parties):

No.

Sealed Personal Health Care Records (Cover Sheet) (SEALPHC)

Clerk’s action required.

For use in Family Law and Guardianship cases.

Sealed Personal Health Care Records (Cover Sheet)

Use this form as a cover sheet to keep your personal health information private from the public. On the first page of each document, write the word “SEALED” 1 inch from the top of the page.

Check the documents you are attaching to this cover sheet to be sealed:

Health records of any kind (including correspondence) related to a person’s physical or mental condition, or payment for health care.

Genetic test records for parentage.

Submitted by: Petitioner or his/her lawyer Respondent or his/her lawyer

Sign here Print name (if lawyer, also provide WSBA #)

Important! The other person and the lawyers in your case can see your sealed documents. If you need to keep your address information private for safety reasons, you may cross out or delete your address information.

Mandatory Form (05/2016) FL All Family 119

Agreement to Join Petition (Joinder) p. 1 of 1

Superior Court of Washington, County of In re:

Petitioner/s (person/s who started this case):

And Respondent/s (other party/parties):

No.

Agreement to Join Petition (Joinder) (JN)

Agreement to Join Petition (Joinder) 1. My name is: .

2. I have read and I agree to join the Petition filed by the other side: (title of Petition): .

I understand that if I fill out and sign below, the court may approve the requests listed in the Petition unless I file and serve a Response before the court signs final orders. (Check one):

I do not need to be notified about the court’s hearings or decisions in this case. I ask the other side to notify me about any hearings in this case. (List an address where you agree to accept legal documents. This may be a lawyer’s address or any other address.)

address city state zip

(Optional) email:

If this address changes before the case ends, you must notify all parties and the court in writing. You may use the Notice of Address Change form (FL All Family 120). You must also update your Confidential Information form (FL All Family 001) if this case involves parentage or child support.

3. Other (if any):

Sign here Print name Date

Waiver of Rights Under Service Members Civil Relief Act – Page 1 of 2

Superior Court of Washington County of _________________

In re: Petitioner, and Respondent.

No. Waiver Of Rights Under Servicemembers Civil Relief Act And Admission Of Service (No Mandatory Form Available)

My name is . I am the nonrequesting party in the

above-entitled action. The requesting party has requested a modification of child support. I am a member or

the dependent of a member of the United States military and I am informed of my rights under the

Servicemembers Civil Relief Act of March 4, 1918, as amended and the Military Servicemembers Civil

Relief Act, RCW Ch. 38.42. I waive my rights under the Service Members Civil Relief Act and the Military

Service Members’ Civil Relief Act, RCW Ch. 38.42 and I request the court to determine whether to grant the

relief requested by the requesting party.

I received a copy of the Summons and Petition for Modification of Child Support and other

documents listed in the Proof of Personal Service or Acceptance of Service in this matter on

___________________.

Name of Servicemember:

Rank:

Waiver of Rights Under Service Members Civil Relief Act – Page 2 of 2

Serial No.:

Unit:

Signed at ___________________________________, on _____________________________. [Place] [Date] Signature of Nonrequesting Party Print or Type Name SUBSCRIBED AND SWORN to before me this day of , .

NOTARY PUBLIC in and for the state of , residing at . My Commission Expires: .

3224EN FILING A PETITION TO MODIFY A CHILD SUPPORT ORDER - EVALUATION FORM

Your comments are appreciated and will help to make this packet more useful to others. Please take a moment to complete this form and return it to:

LeeAnn Friedman Northwest Justice Project

500 W. 8th, Suite 275 Vancouver, WA 98660

Or email to webmaster@nwjustice.org 1. Where did you get this packet?

CLEAR washingtonlawhelp.org Court Clerk or Facilitator

Other:

2. What is your primary language?

3. Are you low-income? yes no

4. What is the last grade you finished in school?

5. Did you read the instructions? yes no

6. Did you need the help of an agency, court facilitator, or advocate to complete your

case? yes no

If yes, what agency or individual helped you?

7. Did you find anything hard to understand? yes no

If yes, please tell us what.

8. Did you find any mistakes? yes no

Describe mistakes. Include the page #.

9. Additional Comments [use back if you need to]:

10. Today’s Date: