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Fill Your Massachusetts Am 3 Form

The Massachusetts Am 3 form is a crucial document for individuals seeking an equitable adjustment of past-due child support owed to the Commonwealth of Massachusetts. It is specifically designed by the Department of Revenue's Child Support Enforcement Division to aid those who, due to various circumstances, find it challenging to fulfill their child support obligations in full. By providing detailed personal and financial information, applicants can request a fair reassessment of their debt, but it's essential to note that this adjustment only applies to amounts owed to the Commonwealth, not to the custodial parent. To learn more about filling out the Massachusetts Am 3 form and to begin the process, click the button below.

In the intricate arena of child support, financial fluctuations and life changes can render previously determined support obligations unsustainable for some parents. Recognizing this, the Commonwealth of Massachusetts provides a mechanism—the Request for Equitable Adjustment form, also known as the Massachusetts Am 3 form—for parents to seek financial recalibration. This form is a tool specifically for those owing child support to the Commonwealth, not directly to a custodial parent, allowing them to petition for an adjustment based on significant changes in their financial landscape or personal circumstances. Among the required submissions are a completed Am 3 form, a thorough Statement of Financial Condition, verification of income over recent months or years (tailored to the applicant's employment status), Social Security Earnings Statements or relevant benefit awards, detailed bank information, medical records if applicable, and a grant of power of attorney if the request is made through a representative. Additionally, applicants must authorize the Department of Revenue (DOR) to access their consumer credit report to confirm the financial distress that hinders their ability to fulfill current support obligations. Not only does this process underpin the importance of accurate, truthful representation of one's financial standing, but it also emphasizes the Commonwealth's intention to balance enforcement of child support orders with the realities of economic hardship, whether due to disability, unemployment, or incarceration. Importantly, this form opens a dialogue between the obligor and the DOR, potentially leading to adjusted payments that reflect the obligor’s current ability to pay while continuing to enforce the support needed by the child.

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

Document Information

Fact Name Description
Purpose of Form AM-3 Allows individuals to request an equitable adjustment of arrears owed to the Commonwealth of Massachusetts, not arrears owed to a custodial parent.
Eligibility Criteria Arrears must be owed to the Commonwealth, not to a custodial parent, to qualify for an equitable adjustment.
Required Documentation Documentation includes a completed AM-3 form, Statement of Financial Condition, Verification of Income, Social Security Earnings Statement, bank information, medical records if applicable, and Power of Attorney if necessary.
Use of Credit Reports Applicants authorize the Department of Revenue (DOR) to obtain their full credit report under certain sections of the Fair Credit Reporting Act (FCRA) for the purpose of child support collection and enforcement.
Governing Law The form is governed by laws including but not limited to sections of the Fair Credit Reporting Act (15 USC § 1681 et seq.) relevant to obtaining credit reports for enforcing child support orders.
Continued Enforcement Submitting a request for equitable adjustment does not halt ongoing DOR enforcement actions to collect any past-due support owed to the custodial parent.

Guidelines on Filling in Massachusetts Am 3

Filling out the Massachusetts AM 3 form is a critical step for individuals seeking equitable adjustment of arrears owed to the Commonwealth. This process is designed to adjust past-due child support amounts under specific circumstances, but it's important to remember that any arrears owed directly to a custodial parent are not eligible for this adjustment. As you prepare to navigate through this process, ensure you have all required documentation at hand. Doing so facilitates a smoother evaluation by the Department of Revenue (DOR) and enhances the chances of a successful application. Now, let's walk through the steps to complete the form.

  1. Begin by entering your full name in the designated space at the top of the form.
  2. Next, provide your Social Security Number (SSN) and Case Number in the respective fields.
  3. For verification purposes, ensure you have a completed Statement of Financial Condition ready, including documentation like pay stubs for the last three months or financial statements for the past two years if self-employed.
  4. Gather and attach a Social Security Earnings Statement from the SSA website for all applicants. If applicable, include a copy of your award letter for SSI or SSDI.
  5. Compile complete bank statements for the past three months for all checking, savings, and other bank accounts you possess.
  6. If claiming any medical disability, attach copies of relevant medical records or doctor's reports to support your claim.
  7. In case a designated representative is submitting the application on your behalf, attach a Power of Attorney document.
  8. Fill in the authorization section to allow DOR to obtain your full credit report, as dictated by the Fair Credit Reporting Act (FCRA), by providing your signature and the date.
  9. In the next section of the form, accurately fill out your personal information, including Date of Birth, Address, and contact information such as Home Phone Number, Work Phone Number, and E-mail.
  10. Directly address the Deputy Commissioner of the Child Support Enforcement Division in the provided space, submitting your request for equitable adjustment of past-due child support, specifying the amount believed to be owed to the Commonwealth.
  11. Check the appropriate boxes that explain why the past-due support should be equitably adjusted, detailing any periods you were unable to pay support due to receiving needs-based benefits, unemployment, incarceration, or other specified reasons.
  12. Indicate whether you have custody of the minor child(ren) for whom support is owed and provide proof of custody or residence if applicable.
  13. If reconciled and currently residing with the custodial parent and the minor child, state the date of reconciliation/marriage and whether the support order has been terminated by the court.
  14. Conclude by certifying the accuracy of the information provided under the pains and penalties of perjury, sign, and date the form.
  15. Mail the completed and signed application along with copies of all required documents to the Department of Revenue Child Support Enforcement Division at the address provided on the form.

After submitting your AM 3 form, an evaluation process by the Department of Revenue will follow, during which you may be requested to provide additional documentation. Throughout this process, it's crucial to maintain open communication lines with the DOR and respond promptly to any inquiries. This proactive approach can significantly contribute to a timely and favorable evaluation of your request for equitable adjustment.

More About Massachusetts Am 3

What is the Massachusetts AM 3 form used for?

The Massachusetts AM 3 form is a document utilized by individuals to request an equitable adjustment of past-due child support amounts owed to the Commonwealth of Massachusetts. This mechanism is specifically designed to address situations where a person, due to financial hardship or other extenuating circumstances, is unable to fulfill the full amount of child support arrears owed to the state. Importantly, this process does not apply to arrears owed directly to a custodial parent, focusing instead on amounts due to the state itself.

What documentation is required when submitting the AM 3 form?

When submitting the AM 3 form, individuals are required to provide a comprehensive set of documents to support their request for an equitable adjustment. These include a completed Request for Equitable Adjustment form, a Statement of Financial Condition, pay stubs for the last three months or financial statements for the last two years if self-employed, a Social Security Earnings Statement, copies of bank statements for all bank accounts from the last three months, any pertinent medical records, and Power of Attorney if represented by someone else. It's crucial that applicants attach these documents to ensure the application is processed without delays. Failure to include any required documentation could result in the application being returned as incomplete.

Can arrears owed to a custodial parent be adjusted through this form?

No, the AM 3 form cannot be used to request an equitable adjustment for any arrears that are owed directly to a custodial parent. This form is strictly for adjusting debts that are owed to the Commonwealth of Massachusetts. Any support that is owed directly to a custodial parent is not eligible for adjustment through this process, and the Department of Revenue (DOR) will continue its enforcement actions to collect these amounts.

What happens after submitting the AM 3 form?

After submitting the AM 3 form, along with all the required documentation, the Commonwealth of Massachusetts Department of Revenue’s Child Support Enforcement Division will review the request. During this review, the DOR may require additional documents as part of their evaluation process. Applicants must be prepared to provide any further information as requested. Once the review is complete, the DOR will make a decision on whether to grant the requested equitable adjustment. It's important to note that submitting this request does not halt DOR’s enforcement actions to collect any past-due support owed to the custodial parent.

Is the authorization to request consumer credit reports permanent?

Yes, the authorization to request consumer credit reports provided within the AM 3 application is considered permanent and does not expire. The purpose of this authorization is to allow the Department of Revenue (DOR) to use the applicant's credit report for the collection and enforcement of the child support order, deemed a permissible purpose under the Fair Credit Reporting Act (FCRA). If an applicant wishes to revoke this authorization, it must be done in writing and submitted directly to the DOR. Copies of this authorization are considered as valid as the original document submitted.

Common mistakes

When filling out the Massachusetts Request for Equitable Adjustment (Form AM-3), individuals frequently encounter a variety of pitfalls that may impact the assessment of their case. Recognizing and avoiding these common mistakes is essential for a smooth and effective application process.

  1. Not providing complete information: Applicants often submit forms with missing details, such as incomplete personal data or financial information. The form requires comprehensive information to evaluate your case thoroughly.

  2. Failure to attach required documentation: The application necessitates various documents, including financial statements and medical records if applicable. Overlooking or omitting any required document may result in the application being returned as incomplete.

  3. Incorrectly stating non-applicable items: Some applicants forget to mark items that do not apply to them with "N/A." This oversight could lead to misunderstandings regarding the completeness of their submission.

  4. Not submitting copies: The form specifies that copies, rather than original documents, should be submitted unless specifically requested. Providing originals when not needed could risk the loss of important documents, as they will not be returned.

  5. Forgetting to sign the form: An unsigned form is considered incomplete. The signature, along with the date, certifies that the information provided is true and accurate to the best of the applicant's knowledge.

  6. Omission of Power of Attorney: If a designated representative is submitting the request on behalf of the applicant, failing to include a Power of Attorney can delay the process. This document is crucial for verifying the representative’s authority to act.

  7. Incorrect or incomplete financial information: Applicants sometimes provide inaccurate or incomplete data regarding their financial status. This mistake can lead to an erroneous assessment of one's ability to pay the past-due support.

In order to ensure a comprehensive and accurate review of your request for an equitable adjustment, it is essential to thoroughly complete the form and provide all required documentation. Attention to detail and adherence to the instructions can significantly influence the outcome of your application.

Documents used along the form

When pursuing an equitable adjustment of child support arrears in Massachusetts, as outlined in the AM 3 form, it's crucial to complement your application with a variety of additional documents that bolster your case. Each document serves as a piece of the puzzle in providing a comprehensive view of your financial situation and reasons for seeking adjustment.

  • Statement of Financial Condition: This document is a detailed account of your financial status. It includes information about your assets, liabilities, income, and expenses, offering a snapshot of your economic situation to support your inability to pay the stated arrears in full.
  • Verification of Income: Pay stubs or financial statements provide proof of your current earnings or lack thereof. For the self-employed, submitting detailed business financials for the past two years is necessary.
  • Social Security Earnings Statement: A report from the Social Security Administration that details your earnings history and contributions, valuable for verifying past income levels and determining potential adjustments.
  • Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) Award Letter: This document confirms the receipt of disability benefits, which may influence the adjustment process by illustrating limited income due to disability.
  • Bank Statements: Copies of recent bank statements for all your accounts provide a real-time view of your financial resources, further detailing your inability to pay the arrears.
  • Medical Records: Documents that substantiate any claims of medical disability that might have affected your ability to earn income and thus contribute to the child support arrears.
  • Power of Attorney: If a representative is handling the application on your behalf, a power of attorney document must be included to authorize them to act for you in all matters related to the adjustment request.
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  • Authorization to Request Consumer Credit Report:
  • This allows the Department of Revenue to access your credit report, helping to assess your financial behavior and capacity to settle the arrears, under the Fair Credit Reporting Act guidelines.

Collectively, these documents paint a thorough picture of the applicant's circumstances, enabling the Department of Revenue to make an informed decision regarding the request for equitable adjustment. Understanding the role of each document in the application process is essential for presenting a compelling case to the authorities.

Similar forms

The Massachusetts Am 3 form is similar to other legal documents that individuals may encounter when dealing with family law matters, particularly those that involve financial adjustments due to changes in circumstances. One of these similar documents is the Income and Expense Declaration used in some states for modifying child support orders.

The Income and Expense Declaration is comparable to the Massachusetts Am 3 form in several ways. Both documents require detailed financial information from the applicant, including income verification, and documentation of expenses and liabilities. They are tools for reviewing a party's current financial situation to determine if an adjustment to child support obligations is warranted. The requirement to attach additional supportive documentation, such as pay stubs or financial statements, and information regarding any dependents, is a commonality shared between the forms. The primary purpose of both documents is to ensure that child support payments remain fair and reflect the current financial capabilities of the paying party.

Another document similar to the Massachusetts Am 3 form is the Modification of Child Support Order application. Like the Am 3 form, this application is used to request a review of the current child support arrangements based on a significant change in circumstances. This could include changes in employment status, income level, or the financial needs of the child. Applicants are required to provide substantiating evidence of their current financial status, including any factors that have changed since the last order was established. Both forms serve the purpose of ensuring child support orders are equitable and take into account the present-day reality of the individuals involved.

Financial Statement forms, often used in family court proceedings, also share similarities with the Massachusetts Am 3 form. These comprehensive forms collect detailed financial information from an individual, including assets, debts, monthly expenses, and income. The provided data offers a snapshot of the individual's financial health, which courts use to make informed decisions regarding spousal support, child support, and the division of assets. While the specific purpose of these forms may vary, they all emphasize the necessity for clarity, accuracy, and completeness in presenting one’s financial situation to the court or relevant authority.

Dos and Don'ts

When filling out the Massachusetts AM 3 form for requesting an equitable adjustment of child support arrears owed to the Commonwealth, it's vital to approach the process thoughtfully and accurately. Here are six key dos and don'ts to keep in mind:

  • Do thoroughly check that all required items listed on the form are included in your submission. If an item is not applicable, clearly mark it as "N/A" to indicate this to the reviewers.
  • Do provide detailed and up-to-date documentation for all financial statements and income verifications, such as your pay stubs for the last three months or, if self-employed, financial statements for the past two years.
  • Do ensure that any medical records or letters submitted to support a claim of medical disability are current and comprehensively describe how the disability impacts your ability to pay child support.
  • Don't submit original documents unless specifically requested by the Department of Revenue (Dor). Make sure to send copies of all required documents to avoid any loss of important records.
  • Don't forget to sign the Authorization to Request Consumer Credit Report section and the final certification at the end of the form. An unsigned form is incomplete and will lead to delays in the processing of your request.
  • Don't overlook checking whether any personal information has changed, such as addresses or phone numbers, to ensure that all communications from the DOR reach you without any issues.

Accurately completing the AM 3 form and providing all the necessary supporting documentation can significantly impact the outcome of your request for an equitable adjustment. Paying close attention to these dos and don'ts can help streamline the process and increase your chances of a favorable resolution.

Misconceptions

There are several common misconceptions associated with the Request for Equitable Adjustment (Form AM-3) from the Massachusetts Department of Revenue’s Child Support Enforcement Division. Understanding these can help applicants more accurately navigate the process.

  • Misconception 1: Arrears owed to both the Commonwealth and the custodial parent can be adjusted.

    In truth, only arrears owed to the Commonwealth are eligible for equitable adjustment. Debts owed directly to a custodial parent cannot be adjusted through this form.

  • Misconception 2: Once the application is submitted, no further documentation is required.

    Applicants may be required to provide additional documents as the Department of Revenue evaluates the request, indicating that the initial submission is a part of an ongoing review process.

  • Misconception 3: Original documents are needed for the application.

    Actually, applicants should submit copies of the required documents, not the originals, as these will not be returned.

  • Misconception 4: Approval for equitable adjustment means cessation of enforcement actions.

    Despite approval, enforcement actions to collect any past-due support owed to the custodial parent will continue.

  • Misconception 5: This application waives the applicant's rights to challenge the stated amount owed.

    Submission of this request does not waive any rights to dispute the amount of arrears owed to the Commonwealth, as noted in the form itself.

  • Misconception 6: Any type of child support debt can be adjusted.

    Only past-due support owed to the Commonwealth is eligible, not current or future child support payments.

  • Misconception 7: The form requests a credit report authorization for unrelated reasons.

    The credit report is specifically for the collection and enforcement of child support orders, a permitted use under the Fair Credit Reporting Act (FCRA).

  • Misconception 8: Financial inability to pay is the only reason for equitable adjustment.

    Other reasons, such as accruing arrears while receiving needs-based benefits or being unable to pay due to incarceration, unemployment, or disability, are also valid.

  • Misconception 9: Filing the form guarantees an adjustment.

    Filing the form is merely a request; the Department of Revenue will review the application and may or may not approve the adjustment.

  • Misconception 10: Custody of the child automatically qualifies for adjustment.

    Having custody does not automatically qualify the debt for adjustment; other criteria in the form must also be met.

Understanding these misconceptions can help individuals correctly prepare and manage their expectations when submitting a Request for Equitable Adjustment through Form AM-3.

Key takeaways

Understanding the Massachusetts Am 3 form and its implications can significantly impact individuals dealing with child support adjustments. This form is specifically designed for those seeking to adjust arrears owed to the Commonwealth of Massachusetts. Here are seven key takeaways for filling out and using the request for equitable adjustment form, ensuring clarity and compliance in navigating this process.

  • The Am 3 form is explicitly used for requesting the equitable adjustment of arrears owed only to the Commonwealth; it does not apply to arrears owed directly to custodial parents. This distinction is critical for applicants to recognize before proceeding with their application.
  • Applicants must provide a comprehensive array of documentation alongside their request, including a completed Statement of Financial Condition and Verification of Income. Failing to submit the required documents results in the application being deemed incomplete and therefore, returned.
  • Verification of Income is a crucial component of the application process. Applicants must furnish either complete pay stubs for the last three months or, for those who are self-employed, financial statements for the past two years.
  • Supporting documents play a pivotal role in bolstering an application for equitable adjustment. Required supporting documents range from Social Security Earnings Statements to medical records and bank information, underscoring the need for thorough and detailed submission.
  • The form also necessitates an Authorization to Request Consumer Credit Report, indicating the Department of Revenue's (DOR) right to obtain a full credit report under the Fair Credit Reporting Act (FCRA). This authorization underscores the comprehensive review process undertaken by DOR in assessing requests for equitable adjustment.
  • It is essential for applicants to understand that submission of the Am 3 form does not waive any rights they might have to dispute the amount of past-due support indicated, in the event that no equitable adjustment is made. Applicants retain the right to challenge the stated amounts, highlighting the form’s role in the broader context of child support obligations and enforcement.
  • The declaration section at the end of the form requires applicants to certify the accuracy and truthfulness of the information provided under penalty of perjury. It's a legal acknowledgment that underscores the seriousness and legal implications of the request process.

In conclusion, filling out the Massachusetts Am 3 form is a detailed process that requires attention to specific documentation and a clear understanding of one’s rights and responsibilities. Recognizing the nuances of this request can aid applicants in navigating the complexities of child support adjustments with the Commonwealth, ensuring that all proceedings are managed correctly and equitably.

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