IN THE _____________________________ DISTRICT COURT ________________________________________ COUNTY, STATE OF UTAH ______________________________________ vs. WORKSHEET TO DETERMINE MOTHER'S OBLIGATION TO CHILDREN IN HER PRESENT HOME The Combined Child Support Obligation Table used for calculation is: ( ) 78B-12-301(1) and 78B-12-302(1) ( ) 78B-12-301(2) and 78B-12-302(2) Civil No. __________________________ MOTHER 1. 2a. 2b. 2c. 3. 4. OTHER PARENT NAME _________________________________ Enter the # of natural and adopted children of the mother and the other parent. Enter the mother's and other parent's gross monthly income. Refer to Instructions for definition. Enter previously ordered alimony that is actually paid. (Do not enter alimony ordered for this case.) Enter pre-existing ordered child support. (Do not enter obligations ordered for the children in this case.) Subtract Lines 2b and 2c from 2a. This is the Adjusted Monthly Gross Income for child support purposes. Take the COMBINED figure in Line 3 and the number of children in Line 1 to the Support Table. Find the Combined Support Obligation. Enter it here. Divide each parent's adjusted monthly gross in Line 3 by the COMBINED adjusted monthly gross in Line 3. Multiply Line 4 by Line 5 for each parent to obtain each parent's share of the Base Support Obligation. Enter the amount of the children's portion of the insurance premium actually paid. Enter the monthly work or training related child care expense for the children in Line 1. OTHER PARENT COMBINED $ _ _ $ _ _ $ $ $ $ % % 5. 6. 7. 8. $ $ $ $ $ 9. MOTHER'S SHARE OF BASE CHILD SUPPORT AWARD FOR THE CHILDREN IN LINE 1. Enter the amount for the mother from Line 6. MOTHER'S SHARE OF CHILDREN'S INSURANCE FOR THE CHILDREN IN LINE 1. Multiply Line 7 by .50, and enter the result here. MOTHER'S SHARE OF WORK OR TRAINING RELATED CHILD CARE EXPENSES FOR THE CHILDREN IN LINE 1. Multiply Line 8 by .50, and enter the result here. MOTHER'S SHARE OF TOTAL CHILD SUPPORT OBLIGATION TO THE CHILDREN IN LINE 1. Add Lines 9,10, and 11. This amount may be used to adjust the mother's gross income on the sole, split, or joint custody worksheets. 10. $ 11. $ 12. $ 6/09 American LegalNet, Inc. www.FormsWorkFlow.com INSTRUCTIONS FOR CHILDREN IN THE MOTHER'S HOME WORKSHEET Use this worksheet to determine the mother's obligation for natural or adopted children who live in her home and who are not children of the father listed on the Sole, Split, or Joint Custody Worksheets (primary worksheets). The mother may use this worksheet in modifying an existing child support award, setting a paternity award, or other appropriate circumstances where the mother has child support obligations for other children. Other Parent Name: The other parent may be a current spouse, partner, or an ex-spouse of the mother. Line 1. Enter the number of natural or adopted children of the mother and the other parent named on this worksheet. If the mother has children in her home by more than one father, complete a separate WORKSHEET TO DETERMINE MOTHER'S OBLIGATION TO CHILDREN IN HER PRESENT HOME for the children of each other parent. Line 2a. Enter the mother's and other parent's gross monthly income. U.C.A. 78B-12-203(1) states: "As used in the guidelines, `gross income' includes prospective income from any source, including earned and nonearned income sources which may include salaries, wages, commissions, royalties, bonuses, rents, gifts from anyone, prizes, dividends, severance pay, pensions, interest, trust income, alimony from previous marriages, annuities, capital gains, Social Security benefits, workers' compensation benefits, unemployment compensation, income replacement disability insurance benefits, and payments from `nonmeans-tested' government programs." U.C.A. 78B-12-203(2) states: "Income from earned income sources is limited to the equivalent of one full-time 40-hour job." Refer to U.C.A. 78B-12-203 for additional information about determining gross income. All income must be verified. Verification includes: year to date pay stubs, employer statements or records, the last year's tax return and documentation of non-earned income appropriate to the source. Line 2b. In the MOTHER'S column, enter the monthly alimony amount she is paying to a parent other than the one listed on this worksheet or the primary worksheet. In the OTHER PARENT'S column enter the monthly alimony that father is paying to someone other than the mother listed on this worksheet. Line 2c. In the MOTHER'S column, enter the court ordered child support she is ordered to pay for children other than the children listed on the primary worksheet. In the OTHER PARENT'S column list the amount that father is ordered to pay for children other than those listed on this worksheet. Line 7. In the combined column, enter the children's portion of insurance premium that is actually paid. To determine the children's portion divide the total premium by the number of persons covered by the policy and then multiply that number by the number of children listed on this worksheet that are covered by policy. Line 8. Enter the amount of work-related, reasonable, child care expenses for up to a full-time work week or training schedule. Line 9. Complete this line as directed. Line 10. Complete the calculation as directed. Line 11. Complete the calculation as directed. Line 12. Enter the amount on this line on Line 2d of the Sole Custody Worksheet, Line 3d of the Split Custody Worksheet or Line 2d of the Joint Custody Worksheet. American LegalNet, Inc. www.FormsWorkFlow.com