CHILD SUPPORT FINDINGS Docket No. Commonwealth of Massachusetts The Trial Court Probate and Family Court The amount of the order which would result from the application of the Child Support Guidelines is: $ Weekly Biweekly Monthly Other (specify) After hearing, the Court finds the presumptiveness of the Child Support Guidelines has been rebutted because, after considering the best interests of the child(ren), the application of the Guidelines would be unjust or inappropriate. The specific facts of this case which justify departure from the Guidelines are: The Court has reviewed the agreement dated presented by the parties, and accepts the agreed-upon facts as stated in the agreement. A child has special needs or aptitudes. A child has extraordinary medical or other expenses. Application of the Guidelines, particularly in low income cases, leaves a party without the ability to self support. Payor is incarcerated, is likely to remain incarcerated for an additional 3 years and has insufficient financial resources to pay support. Application of the guidelines would result in a gross disparity in the standard of living between the two households such that one household is left with an unreasonably low percentage of the combined available income. A parent has extraordinary medical expenses. A parent has extraordinary travel or other expenses related to parenting. Application of the guidelines may adversely impact re-unification of a parent and child where the child has been temporarily removed from the household based upon allegation of neglect. Absent deviation, application of the guidelines would lead to an order that is unjust, inappropriate or not in the best interests of the child, considering the Principles of the Guidelines. Other (specify): Departure from the Guidelines is consistent with the best interests of the child(ren). The Guidelines are not applicable in this case because: The combined gross income of the parties exceeds $250,000. Other (specify): Per Court Order dated was ordered to pay Other (specify) Date: $ Weekly plaintiff/petitioner Biweekly defendant/petitioner Monthly JUSTICE OF THE PROBATE AND FAMILY COURT