Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Child Support Worksheet Form. This is a Kansas form and can be use in 7th Judicial District (Douglas County) Local District Court.
Loading PDF...
Tags: Child Support Worksheet, Kansas Local District Court, 7th Judicial District (Douglas County)
IN THE DISTRICT COURT OF DOUGLAS COUNTY, KANSAS
IN THE MATTER OF:
)
)
)
)
)
)
)
Petitioner
and
Respondent
CASE NO. DG
Division 3
CHILD SUPPORT WORKSHEET
MOTHER
A.
B.
INCOME COMPUTATION – WAGE EARNER
1.
Domestic Gross Income
(Insert on Line C.1. below)*
$
Self-Employment Gross Income*
Reasonable Business Expenses
Domestic Gross Income
(Insert on Line C.1. below)
(-)
ADJUSTMENTS TO DOMESTIC GROSS INCOME
1.
2.
3.
4.
5.
D.
$
INCOME COMPUTATION – SELF-EMPLOYED
1.
2.
3.
C.
FATHER
Domestic Gross Income
Court-Ordered Child Support Paid
Court-Ordered Maintenance Paid
Court-Ordered Maintenance Received
Child Support Income
(Insert on Line D.1. below)
(-)
(-)
(+)
COMPUTATION OF CHILD SUPPORT
1.
Child Support Income
2.
Proportionate Shares of Combined Income
(Each parent’s income divided by combined income)
Gross Child Support Obligation**
(Using the combined income from Line D.1.,
find the amount for each child and enter total for
all children)
3.
Age of Children
Number Per Age Category
Total Amount
+
=
0-5
6-11
+
%
12-18
%
Total
+
=
* Interstate Pay Differential Adjustment?
Yes
No
**Multiple Family Application?
Yes
No
American LegalNet, Inc.
www.FormsWorkflow.com
Case No.
MOTHER
4.
Health and Dental Insurance Premium
5.
Work-Related Child Care Costs
Formula: Amt. – ((Amt. X %) + (.25 x (Amt. x %)))
for each child care credit
Example: 200 – ((200 x .30%) + (.25 x (200 x .30%)))
Parents’ Total Child Support Obligation
6.
7.
8.
9.
E.
$
(Line D.3. plus Lines D.4. & D.5.)
Parental Child Support Obligation
(Line D.2. times Line D.6. for each parent)
Adjustment for Insurance and Child Care
(Subtract for actual payment made for items
D.4. and D.5.)
Basic Parental Child Support Obligation
(Line D.7. minus Line D.8.;
Insert on Line F.1. below)
+ $
=
=
(-)
CHILD SUPPORT ADJUSTMENTS
APPLICABLE
N/A
CATEGORY
AMOUNT ALLOWED
MOTHER
FATHER
1.
Long Distance Parenting Time Costs
(+/-)
2.
Parenting Time Adjustment (if b. %___) (+/-)
3.
Income Tax Considerations
(+/-)
4.
Special Needs
(+/-)
5.
Agreement Past Majority
(+/-)
6.
Overall Financial Condition
(+/-)
7. TOTAL (Insert on Line F.2. below)
F.
FATHER
(+/-)
(+/-)
(+/-)
(+/-)
(+/-)
(+/-)
DEVIATION(S) FROM REBUTTABLE PRESUMPTION AMOUNT
AMOUNT ALLOWED
MOTHER
FATHER
1.
2.
3.
4.
5.
Basic Parental Child Support Obligation
(Line D.9. from above)
Total Child Support Adjustments
(+/-)
(Line E.7. from above)
Adjusted Subtotal (Line F.1. +/- Line F.2.)
Enforcement Fee Allowance**
Percentage
(Applied only to Nonresidential Parent) Flat Fee $
((Line F.3. x Collection Fee %) x .5)
or (Monthly Flat Fee x .5)
(+)
Net Parental Child Support Obligation
(Line F.3. + Line F.4.)
%
(+)
**Parent with nonprimary residency
District Judge Pro Tem
Prepared By:
(Your signature here)
American LegalNet, Inc.
www.FormsWorkflow.com
