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STATE OF MAINE
SUPERIOR COURTDISTRICT COURT
Docket No. Docket No.
MOTION TO MODIFY
v.Child Support Only
(19-A M.R.S. § 1657 &
Defendant19-A M.R.S. § 2009)
1. I am the PlaintiffDefendant in this case.
Plaintiff now resides in (town), (county), (state).
Defendant now resides in (town), (county), (state), OR
Residence of the other party is unknown and I haveused reasonable efforts to locate the other party.
2. Circumstances have changed substantially since the Court's Judgment or Order in this case, dated .
The changes concern the following issues (Check √the boxes that apply):
Parental Rights and Responsibilities
Primary Physical Residence of the minor child(ren), file and exchange FM-050
Rights of contact or visitation with the minor child(ren)
Child Support, file and exchange FM-050, Child Support Affidavit
Spousal Support (Alimony)
3. If this motion involves any issues relating to the children in this case, complete subparagraphs A thru E. If not,
go on to paragraph 4.)
A.Plaintiff and Defendant are the parents of the following child(ren):
NameDateof BirthPresent Address
B. List below where and with whom the child(ren) have lived within the past 5 years.
Name and present address ofDates child(ren) livedTown and State where child(ren)
person child(ren) lived withwith that person lived with that person
C. Plaintiff has not been involved in any way in, and has no information about, another court case in any state
concerning the custody of the child(ren), except as follows:
Protection from Abuse: State/Court/Docket No.:
Protective Custody: State/Court/Docket No.:
Other (describe what kind of other case)
D. No one other than the parties has physical custody of the child(ren), or claims to have custody or visitation
rights with respect to the child(ren), except as follows:
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