Many of the following forms can now be submitted electronically by going to http://www.childsupport.state.pa.us


This page is provided in order to assist parties in their support cases by giving them necessary information prior to arriving at the Elk County Domestic Relations Section office. The following forms and policies not only allow you to access information from your home or office, but they also enable you to reduce the amount of time spent at the Elk County Domestic Relations Section office by completing forms and preparing payments prior to arriving.

Forms

1. Petition to Modify Support. If there has been a substantial change in circumstances that requires a modification to your support, you must file a Petition to Modify Support. Petitions must be filed online and submitted electronically. You may also print out the petition to modify, complete it, and mail it to DRS. Make sure that all the information is filled in and petition is signed.
   Petition to Modify
   Instructions for Petition to Modify

2. Change of Address and/or Change of Employer. All changes in a party’s address or employment must be reported to the Elk County Domestic Relations Section within seven days in writing. If you have changed employers, phone numbers, e-mail, or mailing address, please fill out the form below and mail or bring it into the office.
   Employer / Address Change

3. Entry of Appearance of Attorney. If you have hired an attorney for your support case, please have your attorney fill out the form below. If you are an attorney that has been retained for a support case, please fill out the entry of appearance below. Please note that the entry of appearance must state which party is being represented by the attorney. The attorney’s name must be printed clearly so that the Elk County Domestic Relations Section staff can read the name.
   Entry of Appearance of Attorney

4. Intake Questionnaire. When a new support case is initiated, the plaintiff opening the case must complete an intake questionnaire, If you are planning to open a support case, you must file the intake questionnaire online and submit it electronically. You may also print out the intake questionnaire, complete it, and mail it to DRS. 
   Intake Questionnaire

5. Income / Expense Statement. All parties to a support action are required to complete an Income and Expense Statement and bring that statement to their initial conference. If you have not received your income/expense statement in the mail or you have lost it, please print out the form below and fill it out prior to your conference.
   Income / Expense Statement

6. Request for Continuance of Support Conference or Hearing. You may request a continuance of your hearing or conference by submitting the form below at least seven (7) days prior to the scheduled event. You must list on your request the days you will be available for the continued conference or hearing.
   Request for Continuance

7. Request to Appear by Telephone for Conference. If you live outside of Elk County and the surrounding counties, you may request to appear by telephone at your conference. In order to make that request, you must fill out the attached form. The form must be submitted to our office at least three (3) days prior to the scheduled conference.
   Request to Appear by Telephone for Conference

8. Request to Appear by Telephone for Hearing. If you live outside of Elk County and the surrounding counties, you may request to appear by telephone at your hearing. In order to make that request, you must fill out the attached form. The form must be submitted to our office at least seven (7) days prior to the scheduled hearing. Because the hearing requires sworn testimony, if you elect to appear by telephone you must appear at your local child support agency and have someone from that agency available to witness the administration of an oath.
   Request to Appear by Telephone for Hearing

9. Payment Coupon. If you are paying support, you may use one of these coupons to make a payment directly to the State Collection and Disbursement Unit (SCDU) in Harrisburg, Pennsylvania. You will need your PACSES member number.
   Payment Coupon

10. Physician Information Request. If you are disabled or have a medical condition that limits your ability to work, you must have your physician fill out the form below. Bring the completed form to your conference or hearing as evidence of your limitations.
    Physician Information Request

11. Work Search - Job Application Form. If you are in the Elk County Domestic Relations Section Work Search Program, you must present evidence that you applied for a certain number of job applications every week or month, depending on your court order. Below is the form upon which you transcribe your job applications. Bring this completed form with you to any work search conference, or send the completed form to the Elk County Domestic Relations Section before the deadline specified in your court order.
    Work Search - Job Application Form

12. Work Search - Notice of Employment Form. If you are in the Elk County Domestic Relations Section Work Search Program and you have found a job, you must fill out the form below and send it into the Elk County Domestic Relations Section within ten (10) days of starting the new job.
    Work Search - Notice of Employment Form

13. Health Insurance Coverage Information. If you have been asked to verify health insurance coverage or have changed health insurance coverage for any person in your support action, please fill out the form below and mail or fax it to the Elk County Domestic Relations Section.
    Health Insurance Coverage Information

14. Request a Hearing Pursuant to a 20 Day Notice. If you have an interim order of court establishing a support obligation, with a notice that you may object to the support obligation within twenty (20) days, you may use the form below to request a hearing. Fill out the form and return in to the Elk County Domestic Relations Section prior to the expiration of the twenty (20) day time frame set forth in your interim order.
    Request a Hearing After a 20 Day Notice

15. Summary of Medical and/or Dental Bills for Reimbursement. Use the form below for submitting a request for unreimbursed medical expenses. See “Procedures” below for an explanation of the proper steps to take in seeking reimbursement for medical expenses not covered by insurance.
    Summary of Medical and/or Dental Bills for Reimbursement

16. Request for Information. Whenever you need information regarding your case that is not available on-line (see https://www.humanservices.state.pa.us/csws/home_controller.aspx), you may send a written request to the Elk County Domestic Relations Section. The letter below should be used for any requests for information.
    Request for Information
    Information Request Instructions

17. Request for Payment History. You may use the following form to request a payment history of your child support case. This form may also be used by other agencies who need to verify that a party is paying his or her support obligation. You may request an audited or unaudited payment history.
    Request for Payment History

18. Memorandum of Modification Agreement. If both parties to a support action agree to a modification of support, they may fill out the following form and send it to the Elk County Domestic Relations Section.
    Memorandum of Modification Agreement

19. Poverty Affidavit. If you are unable to afford filing fees, you may submit the following Poverty Affidavit, along with your filing, as a request to waive fees. The application will be reviewed by the President Judge and approved or denied.
    Poverty Affidavit Form

20. Application for Assignment of Counsel. A party may petition to have counsel assigned to represent them during contempt procedures. Assigned counsel is not available for establishing or modifying a support obligation. If you are scheduled for a contempt procedure and you are not able to afford counsel, you must submit the Poverty Affidavit set forth in the preceding paragraph as well as the Application for Assignment of Counsel below.
    Application for Assignment of Counsel

Policies

1. Identification. When you appear for any appointment at the Elk County Domestic Relations Section, you must have with you a form of identification. Preferably, the identification should have a photo of you, such as a driver’s license or state ID card.

2. Metal Detector. All individuals who are scheduled to appear at the Elk County Domestic Relations Section will be required to pass through a metal detector.

3. Children.The Elk County Domestic Relations Section does not have child care facilities available. DO NOT bring any minor children with you to the Elk County Domestic Relations Section. You may request prior approval from the Elk County Domestic Relations Section to bring children to the office. Any request will be evaluated based upon the reason for the request and/or the need to have the child(ren) present.

4. Appearance by Telephone. If you reside out of state and would like to appear for a support conference or hearing by phone, you must complete the appropriate form and obtain approval from the Elk County Domestic Relations Section. The form is available through this website (see “Forms” above).

5. Sheriff. If you feel threatened by the opposing party in your case, or you for any other reason wish to have a deputy from the Elk County Sheriff’s Department present at your conference or hearing, you must inform the Elk County Domestic Relations Section in advance. Any request for the sheriff’s presence must be made at least three (3) days prior to your scheduled appointment.

Procedures

1. Medical Expenses. Below are the rules and procedures for plaintiff and defendant in reference to medical expenses. IMPORTANT: ONLY COSTS THAT ARE NOT COVERED BY INSURANCE ARE TO BE SUBMITTED FOR REIMBURSEMENT.

• All medical bills are to be submitted to the opposing party directly. The opposing party has one month to make the requested payment unless other arrangements are made with the health care provider and/or other party.

• If the bills are not paid within the one month period, said bills are to be submitted to the Domestic Relations Section

• When submitting bills to either the opposing party or the Domestic Relations Section the following timetable is to be used:

• All expenses which may be covered by a major medical plan are to be submitted on an annual basis. A party may request only a share of the deductible and the non-reimbursement portion. If said procedure is not practical due to financial circumstances, exceptions may be allowed by the Hearing Officer.

• All expenses not subject to a major medical plan are to be submitted on a monthly basis.

• Expenses to be allocated shall be provided to the other party no later than March 31 of the year following the calendar year in which the final bill was received by the party seeking allocation. Expenses received in an untimely manner shall be at the court’s discretion.

• All bills submitted should be copies of the actual bills received. Said bill or copy must contain the following information:

• Date the services were rendered
• To whom the services were rendered
• Who provided the services
• Type of treatment
• Fees incurred
• No expense may be submitted while insurance is pending
• Balance due after insurance benefit has been paid

• All prescription receipts must include the prescription numbers. Over the counter medications are not considered prescription expenses; therefore, they cannot be submitted for reimbursement.

• Any receipts for copies of vouchers processed will be charged at $0.25 per page. Costs will be assessed upon intervention of the Domestic Relations Section due to either party’s failure to comply with these rules.

• If submitting a request for reimbursement for more than one (1) expense, the other party’s share must be totaled indicating the amount you are seeking as reimbursement. Forms are available on this website for your use (see “Forms” above).

1. Distribution of Support Payments. When an obligor has separate support cases with court-ordered obligations for a child/family in one case and spousal; alimony; or alimony pendete lite-only in another, the order of distribution of support payments will be in the following order:

• Current month’s child support and family support obligations, which include child and spousal support.

• Current month’s medical, child care, and other court-ordered child/family support-related expenses.

• Current month’s ordered on arrears amounts for child/family support obligation(s).

• Current month’s ordered on arrears amounts for medical, child care, and other court-ordered child/family support obligations.

• Current month’s spousal support, alimony, or alimony pendente lite support obligations.

• Cumulative arrears for child/family support, medical, child care, and other court-ordered child/family support-related expenses.

• Cumulative arrears for spousal support, alimony, or alimony pendente lite support obligations.

• Genetic testing fees.

• Court costs.

1. Tips for Self Represented Litigants. Here are some tips for those who choose to represent themselves in cases before the Elk County Domestic Relations Section:

• Use a lawyer if you need help. The Elk County Domestic Relations Section staff cannot give you any legal advice. You may want to meet with a lawyer to discuss your case even if the lawyer does not represent you in your conference or hearing.

1. Be respectful. Try to stay calm. Do not argue, interrupt, yell, or swear at the hearing or conference officer or other party.

• Come prepared and organized. You will need to share copies of evidence or supporting documents, so bring at least three (3) copies of any papers you plan to use (tax returns, bills, pay stubs, letters etc.). Write out the questions you plan to ask and go over them.

• Arrive early. We like to start the hearings and conferences on time. Remember that other cases may take longer than expected, so be prepared to wait. Do not bring young children unless you have another adult to watch them outside the office.

• Speak clearly, slowly, and loud enough so everyone can hear you. Ask questions when you do not hear or understand something or are confused about what you should do. Do not interrupt the hearing or conference officer or the other party; wait your turn to talk. Take notes so you remember important information.

• Do not bring food or beverages into the conference or hearing. You also cannot smoke. Turn off cell phone and pagers. Cameras, including cell phone cameras, cannot be used in the conference or hearing. Tape recorders are not allowed. Do not carry pocket knives, multi-tool kits, screwdrivers, scissors, razors, guns, ammunition, syringes, pepper sprays etc. Any prohibited items will be taken from you and returned when you leave the Elk County Domestic Relations Section.