1. (1) The following form, or another form containing all of the information herein, may be used to commence an action to establish a support order pursuant to T.C.A. § 36-5-401 et seq. IN THE _____________ COURT OF ______________ COUNTY, TENNESSEE STATE OF TENNESSEE ex. rel., _____________________________________ Docket No. ________________ Petitioner

   1. v. IV-D No. ________________ _____________________________________ Respondent PETITION TO SET SUPPORT Comes the Petitioner, and would respectfully request this Honorable Court to issue an order of support for the minor children: __________________________, DOB _________________ __________________________, DOB _________________ __________________________, DOB _________________ __________________________, DOB _________________ Petitioner alleges he/she is the: (check one) ____ mother ____ father ____ non-parent caretaker of the above-named child(ren) who are in his/her physical custody. Petitioner alleges the child(ren) have been in his/her physical custody since: (check one) ____ birth ____ date of physical custody ___________________________________ Petitioner alleges there is no other person or entity entitled to support for these child(ren) for the time petitioner has had physical custody. Petitioner alleges Respondent(s) is/are the legal parent(s) of the child(ren) and have a duty to support the child(ren). WHEREFORE, PETITIONER PRAYS:
   2. 1. That this petition be filed and proper process issue.
   3. 2. That this Court set current and retroactive child support for said child(ren) in accordance with the State guidelines, including medical support for said child(ren), to be paid by income assignment to Central Collections.
   4. 3. That the Respondent be ordered to pay the costs of this cause.
   5. 4. For such other and further relief as this cause may require. _______________________________ Petitioner _______________________________ Petitioner’s Address and Phone _______________________________ STATE OF TENNESSEE COUNTY OF ____________________ _____________________________________, petitioner, being first duly sworn, affirms that the petitioner has read the foregoing petition, knows the contents of the petition, and that the petition is true and correct to the best of petitioner’s knowledge, information and belief. _____________________________ Petitioner Sworn to and subscribed before me this ____ day of ___________________, 20___. _______________________________ NOTARY PUBLIC / CLERK My commission expires: _________________

2. (2) The following form, or another form containing all of the information herein, may be used to commence an action to modify a support order pursuant to T.C.A. § 36-5-401 et seq. Where the petition language indicates a choice between Petitioner or Respondent, circle the appropriate choice. IN THE _____________ COURT OF ______________ COUNTY, TENNESSEE STATE OF TENNESSEE ex. rel., _____________________________________ Docket No. ________________ Petitioner

   1. v. IV-D No. ________________ _____________________________________ Respondent PETITION FOR MODIFICATION Comes the Petitioner / Respondent, and would respectfully show this Honorable Court that an order was entered herein whereby the Respondent was ordered to pay support for the minor children: __________________________, DOB _________________ __________________________, DOB _________________ __________________________, DOB _________________ __________________________, DOB _________________ in the amount of $_________ monthly. Petitioner / Respondent alleges that it is appropriate to modify child support for the following reason(s): _____________________________________________________________________________ ____________________________________________________________________________ , which results in a significant variance according to the child support guidelines. WHEREFORE, PETITIONER / RESPONDENT PRAYS:
   2. 1. That this petition be filed and proper process issue.
   3. 2. That this Court modify the child support for said children in accordance with the State guidelines, including medical support, with support to be paid by income assignment to the state Central Collections unit for said children.
   4. 3. That the Petitioner / Respondent be ordered to pay the costs of this cause.
   5. 4. For such other and further relief as this cause may require. _____________________________________ Petitioner / Respondent _____________________________________ Petitioner’s / Respondent’s Address and Phone _____________________________________ STATE OF TENNESSEE COUNTY OF ____________________ _____________________________________, being first duly sworn, affirms that he/she has read the foregoing petition, knows the contents of the petition, and that the petition is true and correct to the best of his/her knowledge, information and belief. ____________________________________ Petitioner / Respondent Sworn to and subscribed before me this ____ day of ___________________, 20___. ____________________________________ NOTARY PUBLIC / CLERK My commission expires: _________________

3. (3) The following form, or another form containing all of the information herein, may be used to commence an action to enforce a support order pursuant to T.C.A. § 36-5-401 et seq. IN THE _____________ COURT OF ______________ COUNTY, TENNESSEE STATE OF TENNESSEE ex. rel., _____________________________________ Docket No. ________________ Petitioner

   1. v. IV-D No. ________________ _____________________________________ Respondent PETITION TO ENFORCE CHILD SUPPORT Comes the Petitioner, and would respectfully show this Honorable Court that an order was entered herein whereby the Respondent was ordered to pay support for the minor child(ren): __________________________, DOB _________________ __________________________, DOB _________________ __________________________, DOB _________________ __________________________, DOB _________________ in the amount of $________ monthly. Petitioner alleges Respondent is not paying support according to the terms of the order. WHEREFORE, PETITIONER PRAYS:
   2. 1. That this petition be filed and proper process issue.
   3. 2. That this Court enforce the child support for said child(ren) by any means the court finds appropriate, including but not limited to income assignment, issuance of liens on real and/or personal property of respondent, requiring a bond or security to assure payment.
   4. 3. That the Respondent be ordered to pay the costs of this cause.
   5. 4. For such other and further relief as this cause may require. _____________________________________ Petitioner _____________________________________ Petitioner’s Address and Phone _____________________________________ STATE OF TENNESSEE COUNTY OF ____________________ _____________________________________, petitioner, being first duly sworn, affirms that the petitioner has read the foregoing petition, knows the contents of the petition, and that the petition is true and correct to the best of petitioner’s knowledge, information and belief. ____________________________________ Petitioner Sworn to and subscribed before me this ____ day of ___________________, 20___. ____________________________________ NOTARY PUBLIC / CLERK My commission expires: _________________

Authority: T.C.A. §36-5-406. Administrative History: New rule filed December 17, 1985; effective January 14, 1986. Amendment filed March 24, 2009; effective June 7, 2009.