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MODIFICATION OF PATERNITY REGARDING CHILD CUSTODY AND/OR CHILD SUPPORT (OR BOTH) QUESTIONNAIRE
On behalf of Witt, Hicklin, Snider & Fain, P.C., we want to thank you for allowing us the opportunity to meet with you to discuss your modification needs and goals. If you choose to have us help you with this vital legal process, we will do our very best to merit your trust and confidence, and we will give our best efforts to convince you that you have made the right choice.

We want to be sure to do a good and thorough job of gathering up the information we will need in order to assess your situation.  This Questionnaire minimizes the possibility of anything being overlooked, and it allows us to focus the time we spend with you upon discussing your needs and goals. All information you furnish to us will be held in strictest confidence.

Please complete this Questionnaire in advance of our initial meeting. If you are unsure about any question, please go ahead and answer it as best you can and mark it with a question mark so we may discuss it when we meet.

Witt, Hicklin, Snider & Fain, P.C.
2300 Higgins Road
P.O. Box 1517
Platte City, Missouri  64079
(816) 858-2750
www.wittlaw.com
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Email *
Today's Date: *
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Date of Judgement: *
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Prior Orders/Litigation since Date of Judgement; and if pending litigation, please indicate "pending" and include case number, and if applicable, the trial date setting: *
Custody arrangement under court's previous Judgement regarding custody: *
Are there previous Orders for child support? Please list the date and the amount of previous support orders: *
Change in circumstances since Judgment: *
Requesting Modification of: *
Other Party/Parent's (First, Middle, Last) *
Your Name (First, Middle, Last) *
Date of Birth *
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State of Birth *
Social Security Number *
Address: *
Home Phone Number *
Cell Number *
Email: *
Employer/Address: *
Employer/Phone: *
Other Party/Parent's Address: *
Other Party/Parent's Date of Birth *
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Other Party/Parent's State of Birth: *
Other Party/Parent's Social Security Number: *
Other Party/Parent's Employer/Address: *
Other Party/Parent's Employer/Phone: *
Where/When to Serve: *
Do you have other children not born of the marriage? *
If yes, please list the name, age, date of birth, SSN and present address of those children. Please also list the amount of child support, if any, you pay/receive for these other children not born of the marriage. *
List the children born of the marriage, including their names, age, DOB, Present Address, and SSN. *
Is there any other litigation or proceedings regarding the children? *
Is there any local, state or federal agency file or record regarding you, your spouse, or any child born of the marriage? If so, please explain the situation, *
Please list the address you would like to be designated as the address for the children for mailing and educational purposes. *
Please list your average yearly gross income: *
Please list your other party/parent's average yearly gross income: *
Your highest education level: *
The other party's highest education level: *
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