Adopted for Optional Use
L-1400 [New 02/17] DECLARATION IN SUPPORT OF MODIFICATION OF CHILD SUPPORT Page 3 of 3
RESPONDENT/DEFENDANT:
OTHER PARENT:
7. Recent release from incarceration and decrease in earnings and/or current unemployment
I was released from incarceration on __________. I was incarcerated from __________ to __________. I am
currently unemployed as a result of my incarceration and am actively looking for work. A list of my job contacts is
attached or will be provided at the hearing. I have no current income. I am asking the court to reduce my child support
to zero until I find employment. I am willing to return to court for review hearings as necessary.
I am in a recovery
program called _____________________________________ and have been there since __________. The program
requirements are ________________________________________________________________________. I am not
allowed to work for the first ________ weeks/months. Thereafter I can work as follows: ________________________
______________________________________________________________________________________________.
I have attached verification of my enrollment and participation in this program. I am asking the court to reduce my
child support to zero until I find employment. I am willing to return to court for review hearings as necessary.
8. Other change of circumstance: ________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
9. I request child support be modified and set at zero for any full calendar months in which the parent ordered to
pay support is incarcerated or receiving SSI, and has no other assets or income. For all other periods, I
request current support remain in effect until modified by court order.
10. Other information I want the court to know concerning child support in my case that supports my request as
set forth above: ________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date: ______________________
_________________________________________________ ________________________________________
(TYPE OR PRINT NAME) (SIGNATURE OF DECLARANT)
click to sign
signature
click to edit