COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Approved, SCAO Index No. : STATE OF MICHIGAN JUDICIAL CIRCUIT COUNTY Calendar No. Original - Court 1st copy - Plaintiff 2nd copy - Defendant 3rd copy - Friend of the Court file CASE NO. : CHILD SUPPORT RECOMMENDATION JUDICIAL Plaintiff(s) WORKSHEET D -against- SUBPOENA : {print only the sections that are applicable} : Calculating Child Care Credit and Child Care Apportionment : Note - IRS Child Care Credit can only be claimed by one parent. For additional information see IRS Form 2441. Defendant(s) : ...................................................... Plaintiff 1. Parent's weekly child care expense. THE PEOPLE OF THE STATE be selected by user} {options of plaintiff or defendant toOF NEW YORK 2. Number of weeks of child care. TO 3. Defendant $ $ Multiply item 1. by item 2. for yearly child care expense. $ $ 4. Child care credit received on last year's IRS tax return. GREETINGS: (see below if credit not declared) $ $ 5. Subtract Item 4. from Item 3. for total actual the Honorable yearly child care expense. 6. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , at the Court $ $ located at County of in room on the day of , at o'clock in the noon, and at any recessed Divide item 5. by 52, for weekly child care expense. , 20 $ $ or adjourned date, to testify and give evidence as a witness in this action on the part of the Calculating Child Care Credit {calculation performed by system} To calculate child care tax credit, the following chart is used. Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to subpoena children: $4,800 maximum 1the party on whose behalf this 2 or more was issued for a maximum penalty of $50 and all damages sustained as a child: $2,400 maximum result of your failure to comply. a. If yearly child care expense (item 3. above) is greater than the maximum allowable expense (above chart), Witness, Honorable insert maximum allowable rate. Court in County, day of , one of the Justices of the , 20 If yearly child care expense (item 3. above) is less than the maximum allowable expense (above chart), insert the yearly child care expense. b. c. $ $ (Attorney must sign above and type name below) Insert applicable percentage from IRS form 2441 based on gross income from IRS form of parent incurring the child care cost. Attorney(s) for Multiply item a. by item b. for amount of credit allowed by IRS and insert in item 4. $ $ Office and P.O. Address Calculating Child Care Recommendation {calculation performed by system} 7. 8. Transfer the non-custodial parent's total adjusted net income from line 35. of Worksheet A. $ Telephone No.: {system will indicate whether non-custodial parent is plaintiff or defendant} $ Multiply the amount in item 6. by item 7. for recommended weekly child care order to be paid by non-custodial parent. {system will enter plaintiff or defendant} $ FOC 37 (12/95) Facsimile No.: E-Mail Address: Mobile Tel. No.: $ CHILD SUPPORT RECOMMENDATION WORKSHEET D American LegalNet, Inc. www.USCourtForms.com