On or about (date), the Court ordered the Defendant to pay $ per for the support of the following persons:
Since the entry of that order, the circumstances have changed substantially as follows(state specific change in circumstances):
WHEREFORE, the requests the Court to the present Order.
I verify the statements in this Petition are true and correct. I understand that false statements herein are subject to the penalties of 18 PA C.S. § 4904, relating to unsworn falsification to authorities.