COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : SUPERIOR COURT STATE OF MAINE , ss. Docket No. Plaintiff(s) -against- Index No. DISTRICT COURT : Calendar No. Location : JUDICIAL SUBPOENA Docket No. : Plaintiff vs. : SUPPLEMENTAL WORKSHEET : Defendant Defendant(s) : . . . . . . . . . . . . . . . . . . . . . . . . . .Supplemental. Child .Support .Worksheet ............ ..... ....... . (For use when parents provide substantially equal care. CV-040 must be prepared first.) 14. Higher income parent’s share of basic weekly support THE PEOPLE OF (line 7b) x OF NEW YORK (line 8) THE STATE = 14. TO 15. Enhanced weekly support entitlement (line 8) x 1.5 = 15. 16. Lower income parent’s share of enhanced weekly support entitlement GREETINGS: (line 7a) x (line 15) = 16. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before the Honorable at the Court 17. Higher income parent’s share of enhanced weekly support entitlement located at County of (line 7b) x (line 15) , = 17. in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the 18. Enhanced Support Obligation (line 17) - (line 16) = 18. 19. Presumptive Parental Support Obligation Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to Enter the whose from this 14 or line 18, whichever maximum penalty of $50 and all damages sustained as a = 19. the party onamountbehalf line subpoena was issued for a is less result of your failure to comply. 20. Additional expenses to be shared by parents in proportion to their incomes: Witness, Honorable , one of the Justices of the Expense in Court County, Weekly Amount day of Health Insurance (enter amount from line 9) Child Care (enter amount from line 10) Extraordinary Medical Expenses (enter amount from line 11) *HIP = higher income parent , 20 Parent Paying HIP Share* $ *LIP – lower income parent LIP Share* $ $ (Attorney must sign $ above and type name below) $ $ Attorney(s) for TOTAL: $ $ Adjustment for additional expenses = 20. _ Office and P.O. Address (If HIP pays the expense(s), subtract LIP share. If LIP pays the expense(s), add HIP share. Do not include on line 20 amount(s) HIP pays directly to a provider.) 21. Total weekly support obligation of HIP to be paid to LIP CV-040A, 11/03 Telephone No.: Facsimile No.: = 21.________ E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com