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In Massachusetts, individuals who owe child support to the Commonwealth have the opportunity to apply for an Equitable Adjustment through the Department of Revenue Child Support Enforcement Division’s Request for Equitable Adjustment form, commonly known as the Massachusetts Am 3 form. This application allows for the possibility of adjusting arrears that are owed directly to the Commonwealth, not including any amounts due to the custodial parent. To ensure a comprehensive and correctly filed request, applicants must provide a variety of documents, such as a completed Request for Equitable Adjustment form, a Statement of Financial Condition, recent verification of income, and relevant medical records, among others. Furthermore, applicants are required to authorize the Department of Revenue (DOR) to access their full credit report, aiding the DOR in the collection and enforcement of child support orders. It is critical for applicants to understand that this form is not a means to adjust any debt owed to the custodial parent and that the submission of this request does not impact the enforcement actions for collecting past-due support owed to custodial parents. Instead, it offers a pathway for those genuinely unable to fulfill their financial obligations due to specific circumstances, such as periods of documented unemployment, receipt of needs-based benefits, or significant medical disabilities, to seek relief and possibly adjust their child support arrears owed to the state.

Massachusetts Am 3 Sample

Commonwealth of Massachusetts

Department of Revenue

Child Support Enforcement Division

REQUEST FOR EQUITABLE ADJUSTMENT

Name:

APPLICATION

SSN:

Case No:

 

IMPORTANT! You can request equitable adjustment of arrears owed to the Commonwealth only.

Arrears owed to a custodial parent are not eligible for equitable adjustment.

Check List of Required Items

The following documentation must be submitted with your application or your application will be returned as incomplete. Indicate if any of the items are not applicable by writing N/A. DOR may require you to provide additional documentation as the evaluation of your request proceeds.

Unless DOR has specifically asked for the original document, please submit copies only. DOR will not return any documents to you.

Completed Request for Equitable Adjustment (this two-page form).

Completed Statement of Financial Condition.

Verification of Income

Complete pay stubs for the past 3 months, or financial statements for the past 2 years if you are self-employed.

Information from the Social Security Administration (SSA).

Social Security Earnings Statement (required for all applicants). Go to www.ssa.gov for instructions on requesting an Earnings Statement. If you receive Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI), attach a copy of the award letter.

Bank Information

Complete bank statements for all checking, savings and other bank accounts for the past 3 months.

Medical Records

Copies of any doctors’ letters, reports or medical records that support any claim of medical disability.

Power of Attorney

Power of Attorney if this offer is submitted by a designated representative.

Authorization to Request Consumer Credit Report

I, ____________________, hereby authorize DOR to obtain, and all consumer credit reporting agencies to furnish,

my full credit report in accordance with §§ 1681b(a)(2), (4) and (5), 1681b(f), 1681e and any other applicable sections of the Fair Credit Reporting Act (FCRA). (15 USC § 1681 et. seq.). I agree that DOR’s use of my credit report for collection and enforcement of my child support order is a permissible purpose as that term is defined in § 1681b of the FCRA. This authorization does not expire and any revocation of this authorization must be made in writing to DOR. Copies of this authorization are as good as the original.

____________________________________________

____________________________

Signature

Date

Mail your completed and signed application, with copies of all required documents, to:

Department of Revenue

Child Support Enforcement Division

Attn:

AM-3 2/23/10

REQUEST FOR EQUITABLE ADJUSTMENT

Name

 

Social Security Number

Date of Birth

 

 

 

 

 

 

Address

 

City/Town

State

Zip Code

 

 

 

 

 

Home Phone Number

Work Phone Number

Cell Phone Number

E-mail

 

To the Deputy Commissioner of the Child Support Enforcement Division (DOR):

1.I submit this request for equitable adjustment of past-due child support that I owe to the Commonwealth of Massachusetts. DOR’s records indicate and I believe that I owe a total of $___________ to the Commonwealth, including interest and penalty.

2.I understand that any past-due child support owed to the custodial parent is NOT subject to equitable adjustment and that even if this request is approved, DOR will continue its enforcement actions to collect any past-due support owed to the custodial parent.

3.Submission of this request for equitable adjustment does not waive any rights I might have to challenge the amount stated in paragraph 1 in the event no equitable adjustment is made.

4.I have attached a completed Statement of Financial Condition which shows that I do not have the present financial ability to pay the past-due support in full.

5.The past-due support I owe to the Commonwealth should be equitably adjusted because (check all that apply):

a. The past-due support accrued during periods I received needs-based benefits (e.g., SSI,TANF/AFDC, state

veterans’ benefits). Type of benefit: ________________________________ Dates received: ___________________

b. The past-due support accrued during periods I was unable to pay my child support because:

I had the following disability: _____________________________________________________________________

Dates of disability: ________________________ Received SSDI Yes No Injured at work Yes No

I was unemployed and did not receive unemployment benefits.

Reason for unemployment: ______________________________________________________________________

Dates of unemployment: ________________________

I was incarcerated. Dates and place of incarceration: __________________________________________________

Other. Please explain: __________________________________________________________________________

_____________________________________________________________________________________________

If you checked any box in Paragraph 5b: Did you file for modification of your support order during the period you were

unable to pay support? Yes No Explain: ______________________________________________________________

c. I have custody of the minor child for whom I owe support. Yes No Attach custody order or proof of residence.

d. I am reconciled and reside with the custodial parent and the minor child for whom I owe past-due support. Date of reconciliation/marriage: __________ Has support order been terminated by the court? Yes No

I certify under the pains and penalties of perjury that the information provided above is true and accurate to the best of my knowledge and belief. I understand that if I fail to provide complete information or provide false information, my request for equitable adjustment will be denied. I also understand that DOR may continue its enforcement actions while this request for equitable adjustment is under consideration.

Signature

Date

AM-3 2/23/10

Form Breakdown

Fact Detail
Purpose of the Form Allows individuals to request an equitable adjustment of past-due child support owed to the Commonwealth of Massachusetts, not including arrears owed to a custodial parent.
Eligibility for Request Arrears must be owed to the Commonwealth. Adjustments for arrears owed directly to a custodial parent are not permitted.
Required Documentation Applicants must submit a completed request form, statement of financial condition, verification of income, Social Security Administration information, bank statements, medical records (if applicable), and a power of attorney (if applicable).
Governing Law The request is made under the authority of the Fair Credit Reporting Act (FCRA), specifically sections 1681b(a)(2), (4), and (5), 1681b(f), and 1681e, among any other applicable sections.

How to Write Massachusetts Am 3

Completing the Massachusetts AM 3 form requires attention to detail and gathering specific documentation related to one's financial situation and the reasons for the request. This process is critical for those seeking an equitable adjustment of past-due child support owed to the Commonwealth. By providing accurate and comprehensive information, individuals can effectively communicate their circumstances to the Department of Revenue Child Support Enforcement Division, facilitating a fair assessment of their request.

Steps to Complete the Massachusetts AM 3 Form:

  1. Begin by entering your personal details including your full name, social security number (SSN), case number, and the current date at the top of the form.
  2. Under 'Check List of Required Items', ensure you have gathered all necessary documentation listed, which includes the completed Request for Equitable Adjustment form (the form you are currently filling), a completed Statement of Financial Condition, verification of income, information from the Social Security Administration, bank information for the past 3 months, medical records if applicable, and Power of Attorney if submitted by a representative.
  3. In the 'Authorization to Request Consumer Credit Report' section, print your name to authorize the Department of Revenue (DOR) to obtain your full credit report for the purposes outlined. Sign and date this authorization.
  4. Proceed to the 'REQUEST FOR EQUITABLE ADJUSTMENT' section, provide your full name, social security number, date of birth, complete address, contact phone numbers, and email address.
  5. Address the Deputy Commissioner directly as instructed, submitting your request for the equitable adjustment of past-due child support, specifying the total amount you believe you owe to the Commonwealth.
  6. Acknowledge that past-due support owed to the custodial parent is not subject to equitable adjustment and that DOR will continue to enforce collection of these amounts.
  7. State that this submission does not waive any rights to challenge the stated amount if no equitable adjustment is made.
  8. Attach the completed Statement of Financial Condition to prove your current financial inability to pay the past-due support in full.
  9. In paragraph 5, check all applicable reasons for the request of equitable adjustment including receiving needs-based benefits, having a disability, being unemployed, incarcerated, or other specified reasons. Provide relevant details such as types of benefits, dates of disability, unemployment, incarceration, or other explanations as necessary.
  10. If applicable, indicate whether you sought a modification of your support order during periods you were unable for support payment and provide explanations.
  11. Check whether you currently have custody of the minor child for whom you owe support or if you have reconciled with and reside with the custodial parent and minor child. Attach custody order or proof of residence if required.
  12. Sign and date the form under the certification that your information is truthful and accurate under the penalties of perjury.
  13. Finally, mail your completed, signed form along with copies of all required documents to the Department of Revenue Child Support Enforcement Division at the provided address.

By carefully following these steps, applicants can ensure their request for equitable adjustment is properly submitted for consideration.

Discover More on Massachusetts Am 3

What is the purpose of the Massachusetts AM-3 Form?

The Massachusetts AM-3 Form serves as a formal request for an equitable adjustment of past-due child support amounts owed to the Commonwealth. This form allows individuals to request a review and potential adjustment of their child support arrears, but only those owed to the state. It's important to note that arrears owed directly to a custodial parent are not eligible for this adjustment.

Who can apply for an equitable adjustment using the AM-3 Form?

Any individual who owes past-due child support to the Commonwealth of Massachusetts can apply for an equitable adjustment. However, it is critical that applicants understand this request only pertains to debts owed to the state and not to the custodial parent or guardian.

What documents are necessary to accompany the AM-3 Form?

When submitting the AM-3 Form, applicants must include a completed Statement of Financial Condition, verification of income (including pay stubs or financial statements), Social Security Earnings Statement, bank information (from the past three months), medical records if applicable, and Power of Attorney if the request is submitted by a representative. Failure to include all required documentation could result in the application being returned as incomplete.

Is there a deadline for submitting the AM-3 Form?

The document does not specify a deadline for submission. However, individuals seeking an equitable adjustment are encouraged to submit their application as soon as they believe they have a valid reason for adjustment, to expedite the review process.

Can the AM-3 Form be submitted by someone other than the individual owing child support?

Yes, the form can be submitted by a designated representative on behalf of the individual owing child support. If submitted by a representative, a Power of Attorney document must be included with the application package.

What happens after submitting the AM-3 Form?

After submitting the form and necessary documentation, the Department of Revenue (DOR) will review the request for an equitable adjustment. This may involve further requests for information or clarification. The decision process time can vary based on the complexity of the case and the volume of applications being processed.

Does submitting an AM-3 Form affect child support enforcement actions?

No, submitting an AM-3 Form does not halt or impact ongoing enforcement actions for any past-due support owed to the custodial parent. Enforcement actions will continue even while the request for equitable adjustment is under consideration.

Can I appeal if my request for equitable adjustment is denied?

If your request for equitable adjustment through the AM-3 Form is denied, you have the right to challenge the decision. The specific process for appeal will depend on the reasons for denial and may vary on a case-by-case basis.

How can I ensure my AM-3 Form is processed quickly?

To expedite the processing of your AM-3 Form, ensure all sections of the form are filled out accurately and completely. Attach all required documents, clearly labeled and organized, to prevent delays due to requests for additional information. Submitting a thorough and complete application is the best way to ensure a prompt review.

Common mistakes

Filling out the Massachusetts Am 3 form for a request for equitable adjustment in child support arrears to the Commonwealth requires careful attention to detail. Here are eight common mistakes people tend to make when completing this form:

  1. Not submitting necessary attachments: The form explicitly requires a list of documents to support the request. Failing to attach these documents, like the Statement of Financial Condition, pay stubs, or medical records, can result in the application being returned as incomplete.
  2. Overlooking the need for a Power of Attorney: If someone else is submitting the application on behalf of the applicant, a Power of Attorney must be included. Missing this document can cause delays or outright rejection of the application.
  3. Misunderstanding the scope: Some applicants mistakenly try to request an adjustment for arrears owed directly to a custodial parent, which is not permissible under this form. The request can only cover arrears owed to the Commonwealth.
  4. Failing to provide income verification: Whether employed or self-employed, thorough and accurate income verification for the stipulated periods is essential. Skipping or providing incomplete financial information can hinder the application's approval.
  5. Incorrectly filling out contact information: Simple errors in the name, social security number, or contact details can complicate or delay the process. Accuracy in these areas is crucial.
  6. Omitting medical documentation: If claiming a medical disability as a reason for not being able to pay support, failing to attach relevant medical records or doctor’s notes can weaken the case.
  7. Not indicating non-applicable sections properly: The form requests that applicants mark sections that do not apply with N/A. Ignoring this instruction can cause confusion about whether sections were missed or intentionally left blank.
  8. Signing without certifying: The signature at the end of the document certifies that all provided information is true and accurate to the best of the applicant's knowledge. Submitting the form without the signature, or with a signature that doesn't match legal records, can invalidate the entire request.

Ensuring each of these steps is carefully followed can greatly affect the outcome of the application for equitable adjustment. It's also important to remember that while this form focuses on arrears owed to the Commonwealth, individuals remain responsible for any debt owed directly to custodial parents, and this form does not impact those obligations.

Documents used along the form

In the process of managing child support obligations, especially in Massachusetts, the Request for Equitable Adjustment form (the Massachusetts Am 3 form) plays a significant role. This form enables individuals to seek an adjustment of arrears owed to the Commonwealth, but not those owed to a custodial parent. Alongside this form, various other documents are often required to support the application, ensuring a comprehensive review and a fair determination by the Department of Revenue Child Support Enforcement Division.

  • Statement of Financial Condition: This document provides a detailed overview of the applicant's financial situation, including income, expenses, assets, and liabilities. It is crucial for evaluating an individual’s capacity to fulfill child support obligations.
  • Verification of Income: This includes copies of the most recent pay stubs for employed individuals or financial statements for the self-employed, covering the relevant periods specified by the Department of Revenue. It is essential for confirming earnings and employment status.
  • Social Security Earnings Statement: Obtained from the Social Security Administration, this statement is vital for confirming an applicant's earnings history and any benefits received, such as Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI).
  • Bank Information: Recent bank statements for all checking, savings, and other accounts give insight into an applicant's financial resources.
  • Medical Records: Documents such as doctor's letters, reports, or medical records support claims of medical disability that may affect one's ability to pay child support.
  • Power of Attorney: When an application is submitted by a designated representative, a Power of Attorney document is required to establish the representative’s authority to act on behalf of the applicant.
  • Authorization to Request Consumer Credit Report: This authorization allows the Department of Revenue to obtain a full credit report of the applicant. It helps assess financial responsibility and capability in the context of child support arrears.
  • Proof of Custody or Reconciliation: If applicable, documentation such as a custody order or proof of residence with the child can be pivotal, especially for those claiming either custody of or reconciliation with the custodial parent and the child.

Each document plays a pivotal role in the equitable adjustment process, providing a comprehensive picture of the applicant's circumstances. Accurate and complete submissions are essential for a thorough evaluation. Collectively, these documents ensure that every application for an equitable adjustment of child support arrearages is evaluated fairly and judiciously, respecting the financial realities of the applicant while upholding the interests of the child or children involved.

Similar forms

The Massachusetts Am 3 form is similar to other legal forms used in family law and child support cases, each serving a distinct but related purpose in helping individuals and legal entities navigate the complexities of child support adjustments, financial declarations, and consent for gathering personal information. Understanding these similarities can provide valuable insights into the broader legal context of child support enforcement and adjustment processes.

One such document is the Financial Statement Short Form, commonly used in family law proceedings to disclose financial information. This form requires detailed financial information from the party, including income, expenses, assets, and liabilities. Similar to the Massachusetts Am 3 form, where applicants must submit a “Statement of Financial Condition,” the Financial Statement Short Form is used to assess an individual’s financial ability to pay child support or justify a request for adjustment. Both forms play a crucial role in determining financial capabilities and obligations, thereby ensuring that child support arrangements are fair and reflective of the current financial situation of the parties involved.

Another document closely related to the Massachusetts Am 3 form is the Request for Modification of Child Support Order. This request form is used when an individual seeks to change the terms of an existing child support order due to a significant change in circumstances, such as a change in income, employment status, or the financial needs of the child. Like the Am 3 form, which is used to request the equitable adjustment of arrears owed to the Commonwealth, the modification request form is anchored in the principle that child support obligations should align with the present circumstances of the non-custodial parent. Both documents underscore the legal system’s flexibility in accommodating changes in an individual's financial situation, emphasizing the importance of maintaining support arrangements that are in the best interest of the child.

Additionally, the Authorization to Release Information form is another document that shares similarities with the Massachusetts Am 3 form, specifically in the section that authorizes the Department of Revenue (DOR) to obtain a complete credit report. Both the Authorization to Release Information form and the Am 3 form contain provisions that allow for the collection of personal data for specific purposes — in the case of the Am 3 form, to support the collection and enforcement of a child support order. Each form requires the explicit consent of the individual, demonstrating the legal safeguards in place to protect personal information while enabling the necessary assessments for child support enforcement and adjustment.

Dos and Don'ts

When filling out the Massachusetts AM-3 form for an equitable adjustment, it's important to approach this process with due diligence and careful attention to detail. Here’s a list of things you should and shouldn't do to ensure your application is complete and accurately reflects your situation.

Do:
  • Read all instructions carefully before starting to fill out the form, ensuring you understand what is required of you.
  • Gather all required documentation before beginning. This includes your financial statements, pay stubs for the past three months, social security earnings statement, bank statements, medical records (if applicable), and power of attorney (if applicable).
  • Provide accurate and truthful information. False statements can lead to a denial of your request or potentially legal consequences.
  • Ensure that all sections of the form are completed. If a section does not apply to you, mark it with N/A (not applicable) instead of leaving it blank.
  • Sign and date the form. An unsigned application is considered incomplete and will not be processed.
Don't:
  • Submit the original documents unless specifically requested by the Department of Revenue (DOR). Sending copies is advisable as originals may not be returned.
  • Forget to check the authorization box to allow the DOR to obtain your credit report, as required under the Fair Credit Reporting Act. Your application cannot be processed without this consent.
  • Overlook mailing the completed and signed application with all the required documents to the correct address of the Department of Revenue Child Support Enforcement Division. Incomplete submissions can result in a delay or denial of your adjustment request.

By following these guidelines and carefully preparing your AM-3 form, you take an important step toward managing your child support obligations in a way that reflects your current financial capabilities.

Misconceptions

Understanding the Massachusetts AM 3 form, or the Request for Equitable Adjustment, often comes with misconceptions. Here are seven common ones clarified:

  • Misconception 1: The AM 3 form can adjust all child support arrears. In reality, the form only applies to arrears owed to the Commonwealth of Massachusetts. Arrears owed directly to a custodial parent are ineligible for adjustment through this process.
  • Misconception 2: Submission guarantees approval. Filing the AM 3 form does not guarantee that the request for equitable adjustment will be approved. The Department of Revenue (DOR) reviews each application meticulously before making a decision.
  • Misconception 3: You need to submit original documents. The form explicitly states that applicants should submit copies of the required documentation, not the originals. The DOR does not return documents, so keeping the originals is crucial.
  • Misconception 4: Completing the AM 3 form will stop all enforcement actions for child support arrears. Even if a request for equitable adjustment is under consideration or approved, the DOR may continue its efforts to collect any past-due support owed to the custodial parent.
  • Misconception 5: Any type of documentation is acceptable for income verification. The AM 3 form specifically requires complete pay stubs from the past three months or financial statements for the past two years if self-employed. This requirement ensures that income verification aligns with the DOR's standards.
  • Misconception 6: Medical disability claims don't need supporting documents. If claiming that past-due support accrued during periods of medical disability, applicants must attach relevant medical records, doctor's letters, or reports to support their claim.
  • Misconception 7: There's no need to inform the DOR if you have settled arrears directly with the custodial parent. Even if arrears owed to the Commonwealth are being adjusted, any arrangements or payments made directly to a custodial parent should be communicated to the DOR. Otherwise, the official records may not reflect these transactions, potentially leading to confusion or further enforcement actions.

Correctly understanding and navigating the Request for Equitable Adjustment process is crucial for those looking to adjust their child support arrears owed to the Commonwealth of Massachusetts. By dispelling these misconceptions, individuals can better prepare their applications and set realistic expectations.

Key takeaways

The Massachusetts Form AM-3, Request for Equitable Adjustment, is a critical document for individuals owing past-due child support to the Commonwealth. This form provides a structured means for requesting an adjustment to the amount owed under certain circumstances. Understanding the key takeaways can significantly impact the outcome for applicants. Below are four principal aspects to consider:

  • Eligibility for Requesting Adjustment: The form is specifically designed for arrears owed to the Commonwealth of Massachusetts, not to the custodial parent. This limitation highlights the form's scope, emphasizing the state's willingness to adjust debts owed directly to it but not interfering with the amounts owed to individuals.
  • Documentation Requirement: A comprehensive list of required documents accompanies the application, which includes financial statements, income verification, medical records (if applicable), and a completed Statement of Financial Condition. This requirement underscores the importance of thorough documentation in supporting the request for an equitable adjustment. Applicants are instructed to provide copies, maintaining the originals, indicating the seriousness with which the Department of Revenue (DOR) treats these documents.
  • Application Conditions: The form elaborates specific conditions under which past-due support may qualify for adjustment. These include periods of receiving needs-based benefits, disability impacting the ability to pay, unemployment without benefits, incarceration, and living arrangements such as having custody of or residing with the minor child in question. This detailed listing provides clear guidelines for applicants, conveying the DOR’s openness to consider various life circumstances affecting one’s ability to pay child support.
  • Procedural Rights and Obligations: Submitting the form does not waive the applicant's rights to challenge the stated amount owed if no adjustment is made. Additionally, the rigorous certification process and the requirement for complete and truthful information, under penalty of perjury, emphasize the legal seriousness of this request. These provisions ensure applicants understand the importance of accuracy in their submissions and the potential legal consequences of misinformation.

In conclusion, the Form AM-3 serves as a vital tool for individuals seeking relief from certain types of child support debt in Massachusetts. Its structured approach to documenting and reviewing requests reflects a balance between the need for financial accountability and the recognition of legitimate financial hardships. Understanding these key aspects can help applicants navigate the process more effectively, potentially leading to outcomes that better reflect their current financial capabilities.

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