nINSERT "fam-1 caption.

wpt"o

Verified Petition for Modification of Support for Changing Tax Refund

nClient's nameo states the following for this Petition to Modify Support for Changing Tax Refund:

1 That nClient's nameo is the nClient's party designationo in the above-entitled cause of action.

2 That the nOpposing party's party designationo currently receives the income tax exemption for the parties’
child.

3. That there have been continuous and substantial changes which require changing the recipient of the income
tax exemption.

WHEREFORE the nClient's party designationo prays for an order from this Court modifying the recipient
of the income tax exemption, attorney fees and all other relief just and proper in the premises.

I affirm, under the penalties for perjury, that the foregoing representations are true.

_____________________________________________
nClient's nameo, nClient's party designationo

nIF Do we need a Certificate of Serv ice?o

 Certificate of Service

I hereby certify that a copy of the foregoing has been furnished to nIF Does opposing party have an attorney?o
nOpposing attorney nameo, attorney for nOpposing party's party designationo,nELSEo nOpposing party's
nameonEND IFo nHow served on opposing partyo on ________________________________________.

_________________________________________
Samuel C. HaslernEND IFo