INSTRUCTIONS: ARIZONA DCSE MODIFICATION PACKET (Form CSE-1178A)

Arizona recipients or payers of child support who have experienced a significant change in their financial situation may use a packet CSE-1178A to request a change in support payments. This packet can be obtained from the website maintained by the Arizona Department of Economic Security.

Arizona DCSE Modification Packet CSE-1178A Step 1: The first two pages contain instructions for completing and using this packet.

Arizona DCSE Modification Packet CSE-1178A Step 2: The third page contains a request for modification review, which must be submitted as part of your application. This document requires you to provide your name, current address, home, cell and work phone numbers, and the other party's address and phone number, as well as your date of last contact with them.

Arizona DCSE Modification Packet CSE-1178A Step 3: The fourth page contains a request for modification. Here, you must indicate your reason for seeking a modification in payments using a check mark next to the appropriate statement.

Arizona DCSE Modification Packet CSE-1178A Step 4: The fifth page contains an agreement to accept service by mail of 10 different documents that may be involved in the process.

Arizona DCSE Modification Packet CSE-1178A Step 5: The rest of the form contains an Affidavit of Financial Information. The first page of this document requires you to provide your name and contact information.

Arizona DCSE Modification Packet CSE-1178A Step 6: Sign and date your name at the top of the second page and read the instructions.

Arizona DCSE Modification Packet CSE-1178A Step 7: Section 1 on the third page concerns general information.

Arizona DCSE Modification Packet CSE-1178A Step 8: Section 2 on the fourth page concerns your employment, while Section 3 concerns your education and training.

Arizona DCSE Modification Packet CSE-1178A Step 9: Section 4 on the fifth page concerns your gross monthly income.

Arizona DCSE Modification Packet CSE-1178A Step 10: Section 5 on the sixth page concerns self-employment income, if applicable. Section 6 on this page should only be completed by the unemployed or self-employed.

Arizona DCSE Modification Packet CSE-1178A Step 11: Section 7 begins on the seventh page and is a schedule of all monthly expenses and continues through the ninth page.

Arizona DCSE Modification Packet CSE-1178A Step 12: Section 8 on the ninth page concerns your parenting or visitation time.

INSTRUCTIONS: ARKANSAS PATERNITY ACKNOWLEDGMENT SUPPLY ORDER FORM

For a hospital to obtain forms from the Paternity Acknowledgment Program operated by the Child Support Enforcement department of the Arkansas Department of Finance and Administration, use the document discussed in this form. This document can be obtained from the website operated by the Arkansas Department of Finance and Administration.

Arkansas Paternity Acknowledgment Supply Order Form Step 1: On the first blank line, enter the date.

Arkansas Paternity Acknowledgment Supply Order Form Step 2: On the second blank line, enter your name.

Arkansas Paternity Acknowledgment Supply Order Form Step 3: On the third blank line, enter the name of the hospital where birth was given.

Arkansas Paternity Acknowledgment Supply Order Form Step 4: On the fourth blank line, enter the hospital's street address.

Arkansas Paternity Acknowledgment Supply Order Form Step 5: On the fifth blank line, enter the hospital's city, state and zip code.

Arkansas Paternity Acknowledgment Supply Order Form Step 6: On the sixth blank line, enter the hospital's phone number.

Arkansas Paternity Acknowledgment Supply Order Form Step 7: On the seventh blank line, enter the hospital's fax number.

Arkansas Paternity Acknowledgment Supply Order Form Step 8: On the eighth blank line, enter the hospital's email address.

Arkansas Paternity Acknowledgment Supply Order Form Step 9: If requesting paternity acknowledgment brochures in English, enter the quantity needed on the ninth blank line.

Arkansas Paternity Acknowledgment Supply Order Form Step 10: If requesting paternity acknowledgment brochures in Spanish, enter the quantity needed on the tenth blank line.

Arkansas Paternity Acknowledgment Supply Order Form Step 11: If requesting paternity affidavits in English, enter the quantity needed on the tenth blank line.

Arkansas Paternity Acknowledgment Supply Order Form Step 12: In requesting paternity affidavits Spanish translation flyers, enter the quantity needed on the eleventh blank line.

Arkansas Paternity Acknowledgment Supply Order Form Step 13: If requesting a video in English, enter the quantity needed on the twelfth blank line.

Arkansas Paternity Acknowledgment Supply Order Form Step 14: If requesting a video in Spanish, enter the quantity needed on the thirteenth blank line.

Arkansas Paternity Acknowledgment Supply Order Form Step 15: If requesting a staff training video, enter the quantity needed on the fourteenth blank line.

Arkansas Paternity Acknowledgment Supply Order Form Step 16: Enter any miscellaneous comments where indicated.