What You Are Asking For

a. General Information

Yes. Check this box if you want to talk to the judge at a court hearing before they decide. Hearing Date: Leave blank unless the court tells you a date. The court usually fills this in. Hearing Time: Leave blank unless the court tells you a time. The court usually fills this in. Family Courts & Services Center, 601 N. Pecos Rd. Las Vegas, NV 89101, courtroom Check this box if your hearing will be at the Family Courts & Services Center on Pecos Road. courtroom Write the courtroom number for the Family Courts Center, if the court gives you one. Regional Justice Center, 200 Lewis Ave. Las Vegas, NV 89101, courtroom Check this box if your hearing will be at the Regional Justice Center on Lewis Avenue. courtroom Write the courtroom number for the Regional Justice Center, if the court gives you one. No. The judge will write a decision after reviewing the request in chambers on: Check this box if you want the judge to decide based only on the written papers, with no hearing. I tried to resolve this issue with the other party before filing this motion. Check this box if you talked to the other parent and tried to work out this issue before filing. I did not try to resolve this issue with the other party before filing this motion. Any attempt to resolve the issue would have been useless or impractical because (explain why you did not try to resolve this issue directly with the other party before filing this motion) Check this box if you did not try to work it out with the other parent first. You will need to explain why below. explain why you did not try to resolve this issue directly with the other party before filing this motion Explain in your own words why trying to talk to the other parent first would not have helped or was not possible. No, legal custody should not be changed. (STOP. Go to Section 3) Check this box if you do not want to change who makes major decisions for the child. If you check this, skip ahead to Section 3. Yes, legal custody should be changed. Listed below are the current legal custody order and the legal custody order I would like the Court to order. Check this box if you want to change who makes major decisions for the child. Then fill in the table below. It is in the best interest of the child(ren) to change legal custody because (explain): Explain why changing who makes major decisions is good for your child. Give clear facts about what has changed since the last order. Substantial Change in Circumstances Affecting the Child(ren). Since the last custody order, there has been a substantial change in circumstances affecting the welfare of the child(ren). (explain major changes since the last order and how they affect the kids): Describe what has changed in your family or living situation since the last custody order, and explain how those changes affect your children.

b. Possession & Access

Visitation should not be changed. (STOP. Go to Section B) Check this box if you do not want to change the current visitation schedule. If you check this, you should skip ahead to Section B. The regular visitation / timeshare should be changed. My proposed new visitation / timeshare schedule is attached as Exhibit 1. Check this box if you want to change the everyday visit or time-sharing schedule. You will need to attach your new schedule as Exhibit 1. The holiday schedule should be changed. My proposed new holiday schedule is attached as Exhibit 1. Check this box if you want to change how holidays are split between parents. You will need to attach your new holiday schedule as Exhibit 1. It is in the best interest of the child(ren) to modify visitation because (explain): Explain why changing the visitation schedule would be good for the child. Give clear reasons, like the child's needs or changes in your family's situation. Not Applicable ( check if not applicable, and go to section C) Check this box only if you are not asking to change child support. If you check it, skip the rest of this section and move on to section C.

c. Child Support

(Name of parent ordered to pay child support) Write the full name of the parent who was ordered to pay child support in the current order. ordered to pay $______ per month in child support. Enter the dollar amount paid each month under the current child support order. Child support should be reset based on the change in custody I am requesting. Check this if you want support recalculated because you are also asking to change who has custody. The gross monthly income of the person paying child support has changed by more than 20% since the last child support order was entered. Check this if the paying parent's monthly income has gone up or down by more than 20% since the last order. It has been more than three years since child support was last reviewed. Check this if more than three years have passed since the child support amount was last looked at.

d. Children's Basic Information

The following child(ren) has/have emancipated (write child's name(s)): Check this if one or more children are now legally adults or no longer need support. The following child(ren) has/have emancipated (write child's name(s)): Write the names of the children who are now grown up or no longer need support.

e. Child Support

The parties are not following the custodial schedule on which child support was based: Check this if the parents are not following the parenting time schedule that the support amount was based on. (explain the custodial schedule you have been following): Describe the actual parenting time schedule you have been following, such as how many days the children spend with each parent. It is in the children's best interest to modify child support because (tell the judge why it is in the children's best interest to change child support): Explain why changing the support amount is good for your children, such as changes in their needs or costs. Child support should be modified so that (name of person who should pay child support) Check this box if you want a specific person to pay a set amount of child support each month. pays (amount) Write the full name of the parent who should pay child support. $________ per month in child support. Enter the dollar amount you think should be paid each month. I'm not sure how much child support should be paid. The judge should set child support. Check this box if you don't know the amount and want the judge to decide. Other (explain how much child support should be ordered and how you came up with the amount of child support): Check this box if you have a different request and want to explain it yourself. Other (explain how much child support should be ordered and how you came up with the amount of child support): Explain how much support should be paid and how you figured out that amount. No, there are no child care costs for either parent. Check this box if neither parent pays for child care, like daycare or a babysitter. Yes, the monthly child care costs for the child(ren) are: $ Check this box if there are monthly child care costs, then fill in the amount. Yes, the monthly child care costs for the child(ren) are: $ Enter how much is paid each month for child care, like daycare. should be paid by me only Check this box if you think you alone should pay the child care costs. the other parent only Check this box if you think the other parent alone should pay the child care costs. both parents equally. Check this box if you think both parents should split the child care costs evenly.

f. Health & Medical Support

Medicaid. Check this box if the children should get their health coverage through Medicaid. Private / Employer Insurance. The monthly premium should be paid by Check this box if the children should be covered by private or work-based insurance. me only Check this box if you think you alone should pay the monthly insurance cost. the other parent only Check this box if you think the other parent alone should pay the monthly insurance cost. both parents equally. Check this box if you think both parents should split the insurance cost evenly. Other: Check this box if you have a different plan for the children's medical coverage. Other: Describe your other plan for how the children will get medical coverage. In addition to the relief requested above, I would like the Court to also order the following: (Explain anything else that you would like the judge to order, or enter "N/A" if you do not want anything else. Be specific.) List anything else you want the judge to order. Write "N/A" if there is nothing else.