Nebraska Child Support Guidelines Worksheet 2 SPLIT CUSTODY CALCULATION 1. Child’s Name Custody (F or M) Show combined monthly share from line 7, worksheet 1, divided by total number of children ________________ ______ __________________ _______ _______ ________________ ______ __________________ _______ _______ ________________ ______ __________________ _______ _______ ________________ ______ __________________ _______ _______ ________________ ______ __________________ _______ _______ ________________ ______ __________________ _______ _______ ________________ ______ __________________ _______ _______ 2. 3. 4. Show each parent’s share (apply percent from line 6, worksheet 1) Father Mother Total amount owned to father by mother (mother’s share from above for children in father’s custody) ______________ Total amount owed to mother by father (father’s share from above for children in mother’s custody) ______________ Support to be paid by mother/father (difference between lines 2 and 3) ______________ (mother/father) Additional Adjustment for Child(ren)’s health insurance premium Father Mother Combined 5. Child(ren) health insurance premium* (from line 8, worksheet 1) 6. Combined health insurance premium(s) 7. Each parent’s share of premium (line 6 from worksheet 1 times line 6 above) ______ _______ Amount of premium paid (line 5) ______ _______ 8. ______ _______ ______ - 6.9 American LegalNet, Inc. www.FormsWorkflow.com Nebraska Child Support Guidelines 9. Amount owed to other parent for premium (line 7 minus line 8, if negative amount enter $0) 10.a. Which parent owes basic support on line 4? 10.b. Which parent owes support for health insurance on line 9? 10.c. Does the same parent owe support on lines 10a and 10b? 11. Total support to be paid by parent on line 10a (if YES on line 10c, line 4 plus line 9; if NO on line 10c, line 4 minus line 9) ______ _______ ____________ (mother/father) ____________ (mother/father) ____________ (Yes/No) ____________ * The parent requesting an adjustment for health insurance premiums must submit proof of the cost of the premium for the child(ren). Worksheet 2 amended effective July 1, 2007; worksheet 2 amended October 24, 2007. - 6.10 American LegalNet, Inc. www.FormsWorkflow.com