Child Support Guidelines Worksheet (Sample)

Use this worksheet to calculate the presumptive amount of child support to be ordered by the Court.
Do not file this worksheet with the court. Click the above link to create the official court form.
Fill in income, deductions, and number of children. Enter amounts as dollars per week, rounded to the nearest dollar.

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1. INCOME

				Recipient	Payor

a.	Gross Weekly income		$	Recipient Gross Weekly Income	$	Payor Gross Weekly Income
b.	Minus Child Care cost paid	_	$	Recipient child care cost	$	Payor child care cost
c.	Minus Health insurance cost paid	_	$	Recipient health insurance cost	$	Payor health insurance cost
d.	Minus Dental/Vision cost paid	_	$	Recipient dental/vision cost	$	Payor dental/vision cost
e.	Minus Other Support Obligations paid	_	$	Recipient other support obligations	$	Payor other support obligations

f.	Available income	=	$	Recipient available income	$	Payor available income


g.	Combined Available Income Recipient 1(f) + Payor 1(f)	=	$

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2. CHILD SUPPORT CALCULATION


a.	Combined support amount for one child (From Table A)		$

Adjustment for number of children covered
by this order (From Table B)

Number of children

Combined support amount 2(a) x 2(b)

Recipient's % of combined income Recipient 1(f) ÷ 1(g)


e.	Minus Recipient's share of combined support amount 2(c) x 2(d)	_	$

f.	Payor's proportional weekly suport amount 2(c) - 2(e)	=	$


g.	Weekly support amount as % of Recipient income 2(f) ÷ Recipient 1(f)		%


h.	Payor's final weekly support amount If 2(g) is 10% or more, then enter 2(f) here. Otherwise, enter the lesser of 2(f) OR (10% + 2(g)) x Payor 1(f)		=	$