ARIZONA SUPERIOR COURT, PIMA COUNTY SELF-SERVICE PACKET PARENT'S WORKSHEET FOR CHILD SUPPORT AMOUNT Petitioner (1) Respondent (2) Custodial Parent (4): Father [ ] No. of Children (6): Mother [ ] (3) Case No. ATLAS No. Prepared By (5): Father [ ] Date Prepared (7) Father Gross Income (8) Estimated Father [ ] Mother [ ] Attributed Father [ ] Mother [ ] Spousal Maintenance Paid (9) Spousal Maintenance Received (10) Child Support Paid/Contributed (11) Support of Other Children (12) Adjusted Gross Income (13) Combined Adjusted Gross Income (14) Basic Child Support Obligation (15) Plus Costs for: Medical/Dental/Vision Insurance (16) Childcare (17) for [ ] One Child [ ] or More Than One Child Education Expenses (18) Extraordinary Child (19) Subtotal (20) No. of Children Age 12 or Over Adj. % (21) Total Adjustments for Costs (22) Total Child Support Obligation (23) Each Parent s % of Combined Income (24) Each Parent s Share of the Total Support Obligation (25) Less Paying Parent s Costs (26) Costs Associated with Parenting Time (27): Table A [ ] Table B [ ] No. of Days Line (15) x ______% Adjustments Subtotal (28) Preliminary Child Support Amount (29) Self Support Reserve Test for Payor (30) Line (13) $ Less Paid Arrears $ Less $775 Child Support Amount to be Paid By (31): Father [ ] Mother [ ] Travel Related to Parenting Time (32) Medical/Dental/Vision Costs Not Paid by Insurance (33) $ $ $ $$+ $$$ $ $ $ $ $ $ $ $ $ $ % $ $ % $ $ $ $ $ $ $$+ $$$ Mother Mother [ ] $ $ $ $ $ % % $ $ $ $ $ % % 1 childsupport-parents worksheet for child support amount.from Revised 10.01.10 American LegalNet, Inc. www.FormsWorkFlow.com