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Child Support Computation Form. This is a Oklahoma form and can be use in District Court Statewide.
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Tags: Child Support Computation, Oklahoma Statewide, District Court
IN THE _____________________________________
STATE OF OKLAHOMA
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Dist. Ct. Case No.
OAH Case No:
OK IV-D FGN:
Obligor:
Custodial Person:
CHILD SUPPORT COMPUTATION
Calculation for number of children
Obligor (noncustodial parent) is
(Enter "mother" or "father")
A
1
2
3
4
5
6
B
7
8
Base monthly obligation
Gross monthly income
All sources, except child support received
and means-tested public assistance
Less court-ordered optional monthly
adjustment for marital debt
Less court-ordered monthly child support
and support alimony actually paid for others
Adjusted gross monthly income
Line 1 minus Line 2 and/or Line 3, if used
Percentage share of income
Line 4 for each parent divided by Line 4
combined
Base monthly obligation
Apply Line 4 combined to Child Support
Guideline Schedule and insert in Line 6
combined; then, Line 6 combined X Line 5
for each parent.
Father
Mother
%
%
Shared parenting adjustment, if used
Number of overnights with each parent
If less than 121 for obligor, skip to C.
Percentage with each parent
Line 7 for each parent divided by 365
Father
Mother
OKDHS revised 04-20-2007
03EN005E
Combined
100%
Combined
365
%
%
100%
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B
9
10
11
12
13
C
14
15
16
D
17
18
Shared parenting adjustment, if used
Shared parenting base obligation
Line 6 combined X 1.5
Each parent's share
Line 9 combined X Line 5 for each parent
Amount retained by each parent
Line 10 for each parent X Line 8 for
each parent
Offset amount
Line 10 minus Line 11 for each parent
Adjusted base monthly obligation
Subtract smaller amount from larger amount
on Line 12. If custodial person amount is
larger than obligor amount, enter $0 for
obligor.
Father
Mother
Combined
Health insurance premium
Monthly health insurance premium
Actual monthly premium amount for
each parent, for child(ren) included in
this calculation.
If none, enter $0 and skip to Line 17.
Monthly health insurance premium share
Line 14 combined premium amount X Line
5 for each parent
Adjusted premium share paid by obligor
Leave custodial person amount blank.
Subtract obligor Line 14 from obligor Line
15. Amount may be negative.
Father
Mother
Combined
Work and education-related
child care expenses
Monthly child care expenses for each
parent, for child(ren) included in this
calculation. Skip to line 18 if OKDHS
child care subsidy case.
OKDHS child care subsidy
Line 18f X Line 18b divided by Line 18a
a. Total children in custodial
person's child care subsidy case
b. Number of children of
these parents in custodial
person's child care subsidy case
c. Custodial person's actual
gross monthly income
Father
Mother
Combined
OKDHS revised 04-20-2007
03EN005E
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D
19
20
21
E
22
23
24
Work and education-related
child care expenses
d. Obligor base monthly
obligation amount
e. Amount treated as
custodial person's OKDHS
household income - Line 18c
plus Line 18d
f. Amount treated as
custodial person's family share
co-payment from OKDHS
Appendix C-4, page 2
Child care expense share
Line 17 combined or custodial person Line
18, X Line 5 for each parent
Adjusted child care contribution paid
by obligor.
Leave custodial person amount blank.
Subtract obligor Line 17 or 18 from obligor
Line 19. Amount may be negative.
Total monthly child support obligation
Add obligor Line 6 or Line 13 and Lines 16
and 20, if positive amounts. Subtract Lines
16 and 20, if negative amounts from
obligor Line 6 or Line 13.
Father
Mother
Combined
Other contributions, if agreed or ordered
Recurring monthly medical expenses
Line 22 combined X Line 5 for each parent
Other medical expenses percentage
share - Line 5
Visitation transportation costs
Line 24 combined X Line 5 for each parent
Father
Mother
Combined
%
%
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03EN005E
OKDHS revised 04-20-2007
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Payments shall commence on the
day of
are due on the same date of each month thereafter.
,
,
and
Guidelines were followed.
Deviation from child support guidelines by Court-Specific findings of Court
supporting each deviation:
Dated this
day of
,
.
JUDGE
APPROVED AS TO FORM:
Printed name
Printed name
Address
Address
Address
Address
Phone
Phone
Attorney for
Attorney for
OBA#
OBA#
Address
Address
Address
Address
Phone
Phone
State's Attorney, CSE, OKDHS
OBA#
Address
Phone
Address
OKDHS revised 04-20-2007
03EN005E
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