Forms

We normally send forms to you as part of your case. If you need another copy, please print and complete any of the ones on this list. If you have questions about which form you need to complete, please contact us.

CFIN Post-Order Financial Statement

This form gives us a record of the finances of the paying parent. We use the information on this form to set how much that parent should pay for past-due child support.

CLAA Lost Warrant Affidavit

Complete this form if a check has been lost and it has been at least 10 working days since it was mailed.

CRVU Financial Statement for Review and Adjustment

This form gives us information about each parent’s finances. We use that information to look at the current child support payment amount and potentially change it to fit the parents’ current incomes.

E90A Confirmation of Custody Change

Complete this form if we currently collect child support for you but the children are now living with someone else.

I75A Insurance Credit Request

If you pay insurance premiums for your child and your order was set in Utah, you might be able to get a credit for your child’s part of those insurance premiums. Complete this form and we will see if you qualify for this credit.

OMRV Request for Review and Adjustment of Child Support Obligation

Use this form to officially ask us to start the process of reviewing your income and your child support amount. Depending on what we find, we may adjust the child support amount. To understand how the process works, we recommend first reading OM50, “Review and Adjust: Pre-review Packet.”

OM50 Review and Adjust: Pre-review Packet

This packet explains how child support amounts can be reviewed based on current income and potentially adjusted to a new amount. The packet contains a sample child support worksheet. It also includes income tables to help you calculate the potential changes. The packet also contains the form you need to officially request that we start the review and adjustment process.

PAAX Paternity Affidavit

This is a legal affidavit that names a potential father of a child.

PQUE Paternity Questionnaire

This form names a child’s potential father and gives us the information we need to pursue paternity establishment.

PQUE Cuestionario de Paternidad

URAA Written Request for Review of Past-Due Support Amount

Complete this form if you do not agree with the past-due amount that ORS shows that you owe. Be sure to include all evidence or documentation to support your claim.

URRM Written Request for Review National Medical Support Notice

Complete this form if you do not think that you can or should carry medical insurance for your child. We will use it to review the National Medical Support Notice that we sent to your employer.

XADI Affidavit of Decreased Income

This form gives us information about the paying parent's decrease in income. We use this information to help determine if an adjustment of the child support amount should be completed.

XAPP Application for Child Support Services

Complete this form to provide ORS with the information needed to open a child support services case. This form can also be completed online.

XAPP Solicitud para los Servicios de Manutención de Menores

XARR Stipulated Arrears Agreement

Complete this form to tell us that both parents agree on the balance of past-due support and that we can add that balance to the case for collection.

XEFA Electronic Payment Enrollment Form

Complete this form to sign up for electronic payments.

XPTA Extended Parent-Time Written Agreement

Complete this form to tell us that both parents agree that extended parent-time has occurred. We will use that information to adjust the child support amounts according to Utah law.