COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : EXHIBIT F Plaintiff(s) Calendar No. : JUDICIAL SUBPOENA WASHINGTON STATE : CHILD SUPPORT SCHEDULE : -against- Including: : Defendant(s) : . . . . . . . . . . . . . . . . . . . . . . . . .• . .Definitions .and. . . . . . . . . . . . . . . . . . . . . . . . . . Standards • Instructions • Economic THE PEOPLE OF THE STATE OF NEW YORKTable • Worksheets TO Effective Dates: Definitions & Standards GREETINGS: September 1, 2000 Instructions September 1, 2000 Economic Table that all business and excuses being laid aside, you and each of you attend before September 1, 2000 WE COMMAND YOU, September 1, 2000 , the HonorableWorksheets at the Court located at County of 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 Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. Witness, Honorable Court in County, , one of the Justices of the day of , 20 Administrative Office of the Courts State of Washington 1206 Quince Street SE (Attorney must sign above and type name below) P.O. Box 41174 Olympia, WA 98504-1174 Attorney(s) for Order forms--voice mail telephone number (360) 705-5328 Internet--download forms: http://www.courts.wa.gov/ Questions about the Instructions or Worksheets? Contact: Merrie Gough Tel. (360) 357-2128 Fax (360) 357-2127 Office webmaster@courts.wa.gov and P.O. Address E-mail merrie.gough@courts.wa.gov or Telephone No.: Child Support Hotline, State DSHS, 1 (800) 442-KIDS Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Calendar No. WASHINGTON STATE CHILD SUPPORT SCHEDULE : DEFINITIONS AND STANDARDS JUDICIAL SUBPOENA Plaintiff(s) -againstDEFINITIONS Unless the context clearly requires otherwise, these definitions apply to the standards following this section. : : Basic child support obligation: means the monthly child support obligation determined from the economic table based on the parties’ combined monthly net income and the number of children for whom support is owed. Defendant(s) determined for minors, to adult children who are dependent on their parents and for whom support is ordered pursuant to RCW 26.09.100. The provisions of RCW 26.19 for determining child support and reasons for deviation from the standard calculation shall be : applied in the same manner by the court, presiding officers and reviewing officers. : ...................................................... Child support schedule: means the standards, economic table, worksheets and instructions, as defined in chapter 26.19 RCW. 2. Written findings of fact supported by the evidence: An order for child support shall be supported by written findings of fact upon which the support determination is based and shall include reasons for any deviation from the standard calculation and reasons for denial of a party’s request for deviation from the standard calculation. RCW 26.19.035(2) 3. Completion of worksheets: Worksheets in the form developed by the Office of the Administrator for the Courts shall be completed under penalty of perjury and filed in every proceeding in which child support is determined. The court shall not accept incomplete worksheets or worksheets that vary from the worksheets developed by the Office of the Administrator for the Courts. Court: means a superior court judge, court commissioner and presiding and THE PEOPLE who THE STATEdetermine or enforce child reviewing officers OF administratively OF NEW YORK support orders. TO Deviation: means a child support amount that differs from the standard calculation. Economic table: means the child support table for the basic support obligation provided in RCW 26.19.020. GREETINGS: Instructions: means the instructions developed by the Office of the Administrator for the Courts pursuant to RCW 26.19.050 for use in WE COMMAND YOU, that all business and excuses being laidof the worksheets and order:you attend before aside, you and each of The court shall 4. Court review completing the worksheets. the Honorable at the Court review the worksheets and the order setting child support for the Standards: means the standards for determination of child support as adequacy of the reasons set forth for any deviation or denial of located at County of any for deviation and provided in chapter 26.19 RCW. in room , on the day of , 20 , at requesto'clock in the for the adequacy of the amount of noon, and at any recessed support ordered. Each order shall state the amount of child or adjourned means testify and give evidence support this action on using the of the Standard calculation:date, tothe presumptive amount of child as a witness in support calculated the part standard calculation and the amount of child support actually ordered. Worksheets shall be attached owed as determined from the child support schedule before the court to the decree or order or if filed separately shall be initialed or considers any reasons for deviation. signed by the judge and filed with the order. Support transfer payment: means the amount of money the court orders Your failure to or custodian for child support after INCOME STANDARDS one parent to pay to another parent comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this and deviations. issued determination of the standard calculation subpoena was If certainfor a maximum penalty of $50 and all damages sustained as a Consideration of all income: All income and resources of each expenses orof your are expected comply. result credits failure to to fluctuate and the order states a 1. formula or percentage to determine the additional amount or credit on an parent’s household shall be disclosed and considered by the court ongoing basis, the term “support transfer payment” does not mean the when the court determines the child support obligation of each additional amount or credit. Honorable parent. Only the income of the parents of of the Witness, , one of the Justices the children whose support is at issue shall be calculated for purposes of calculating Court in County, day of , 20 the basic support obligation. Income and resources of any other Worksheets: means the forms developed by the Office of the person shall not be included in calculating the basic support Administrator for the Courts pursuant to RCW 26.19.050 for use in obligation. determining the amount of child support. 2. (Attorney must sign Tax and type the preceding Verification of income: abovereturns forname below) two years and current paystubs shall be provided to verify income and deductions. Other sufficient verification shall be required for income and deductions which do not appear on tax returns or paystubs. Attorney(s) for 3. Income sources included in gross monthly income: Monthly gross income shall include income from any source, including: salaries; wages; commissions; deferred compensation; overtime; contract-related benefits; income from second jobs; dividends; interest; trust income; severance pay; annuities; capital gains; Office and P.O. Address pension retirement benefits; workers’ compensation; unemployment benefits; spousal maintenance actually received; bonuses; social security benefits and disability insurance benefits. APPLICATION STANDARDS 1. Application of the support schedule: The child support schedule shall be applied: a. in each county of the state; b. in judicial and administrative proceedings under titles 13, 26 and 74 RCW; c. in all proceedings in which child support is determined or modified; d. in setting temporary and permanent support; e. in automatic modification provisions or decrees entered pursuant to RCW 26.09.100; and f. in addition to proceedings in which child support is WSCSS-Schedule 9/2001 Page 1 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com , COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Veterans’ disability pensions: Veterans’ disability pensions or 6. regular compensation for disability incurred in or aggravated by service in the United States armed forces paid by the Plaintiff(s) Veterans’ Administration shall be disclosed to the court. The court may -againstconsider either type of compensation as disposable income for purposes of calculating the child support obligation. 4. .. Income sources excluded from gross monthly income: The following income and resources shall be disclosed but shall not be included in gross income: income of a new spouse or income of other adults in the household; child support received from other relationships; gifts and prizes; temporary assistance for Defendant(s) .needy. . families;. . Supplemental. . Security . .Income; . .general . . . . . ... ..... ........ ..... ..... .... assistance and food stamps. Receipt of income and resources from temporary assistance for needy families, Supplemental Security Income, general assistance and food stamps shall not be a reason to deviate from the standard calculation. THE PEOPLE OF THE STATE OF NEW YORK . Index No. Calendar No. Imputation of income: The court shall impute income to a parent when : the parent is voluntarily unemployed or voluntarily JUDICIAL SUBPOENA underemployed. The court shall determine whether the parent is voluntarily underemployed or voluntarily unemployed based : upon that parent’s work history, education, health and age or any other relevant factors. A court shall not impute income to a parent who is gainfully employed on a full-time basis, unless the : court finds that the parent is voluntarily underemployed and finds that the parent is purposely underemployed to reduce the : parent’s child support obligation. Income shall not be imputed for an unemployable parent. Income shall not be imputed to a parent to the extent the parent is unemployed or significantly : .underemployed due to the parent’s efforts to comply with court.... ordered reunification efforts under chapter 13.34 RCW or under a voluntary placement agreement with an agency supervising the child. In the absence of information to the contrary, a parent’s imputed income shall be based on the median income of yearround full-time workers as derived from the United States Bureau of Census, current population reports, or such replacement report as published by the Bureau of Census. (See “Approximate Median Net Monthly Income” chart on page 5.) VA aid and attendant care: Aid and attendant care payments to prevent hospitalization paid by the Veterans Administration TOsolely to provide physical home care for a disabled veteran, and special compensation paid under 38 U.S.C. Sec. 314(k) through (r) to provide either special care or special aids, or both to assist ALLOCATION STANDARDS with routine daily functions shall be disclosed. The court may Basic child support: The basic child support obligation derived not include either aid or attendant care or special medical 1. GREETINGS: payments in gross income for purposes of compensation from the economic table shall be allocated between the parents calculating the child support obligation or for purposes of based on each parent’s share of the combined monthly net deviating fromCOMMAND YOU, that all business and excuses being laid aside, you and each of you attend before income. WE the standard calculation. , theOther aid and attendant care: Payments from any source, other the Honorable at 2. Court Health care expenses: Ordinary health care expenses are located at Countyveterans’ aid and attendance allowance or special medical of than included in the economic table. Monthly health care expenses compensation paid under theU.S.C. Sec. 314(k) through (r) for that 5 percent the support obligation recessed in room , on 38 day of , 20 , at exceedo'clock inof the basicnoon, and at anyshall be services provided by an attendant in case of a disability when the considered extraordinary health care expenses. Extraordinary or adjourned date, tothe hiringandthe services or an attendant testify of give evidence as a witness in healthaction on theshall be shared by the parents in the same this care expenses part of the disability necessitates shall be disclosed but shall not be included in gross income and shall not be a reason to deviate from the standard calculation. 5. proportion as the basic support obligation. 3. Day care and special child rearing expenses: Day care and Determination of net income: The following expenses shall be punishable as a contempt of court and will and longyou liable to special child rearing expenses, such as tuition make distance Your failure to comply with this subpoena is disclosed and deducted from gross monthly income to calculate transportation costs to and from for visitation thenet monthly whose behalf this state income was issued for a maximum are not included in thethe all damages sustained as a party on income: federal and subpoena taxes (see the penalty of $50 and parents table. These purposes, economic result of your failure tofederal insurance contributions act following paragraph); comply. expenses shall be shared by the parents in the same proportion as deductions (FICA); mandatory pension plan payments; the basic child support obligation. RCW 26.19.080 mandatory union or professional dues; state industrial insurance Witness, Honorable , one of the Justices of the The court may exercise its discretion to determine the necessity premiums; court-ordered spousal maintenance to the extent 4. actually thousand Court in paid; up to two County, dollars per year in voluntary , 20 for and the reasonableness of all amounts ordered in excess of day of the basic child support obligation. pension payments actually made if the contributions were made for the two tax years preceding the earlier of the tax year in which the parties separated with intent to live separate and apart LIMITATIONS STANDARDS or the tax year in which the parties filed for dissolution; and (Attorney must sign above and type name below) normal business expenses and self-employment taxes for self- 1. Limit at 45 percent of a parent’s net income: employed persons. Justification shall be required for any Neither parent’s total child support obligation may exceed 45 business expense deduction about which there is a disagreement. percent of net income except for good cause shown. Good cause Items deducted from gross income shall not be a reason to includes but is not limited to possession of substantial wealth, deviate from the standard calculation. Attorney(s) for children with day care expenses, special medical need, educational need, psychological need and larger families. Allocation of tax exemptions: The parties may agree which Income below six hundred dollars: When combined monthly net parent is entitled to claim the child or children as dependents for 2. income is less than six hundred dollars, a support order of not federal income tax exemptions. The court may award the less than twenty-five dollars per child per month shall be entered exemption or exemptions and order a party to sign the federal forOffice andunless the obligor parent establishes that it would each parent P.O. Address income tax dependency exemption waiver. The court may be unjust or inappropriate to do so in that particular case. The divide the exemptions between the parties, alternate the decision whether there is a sufficient basis to go below the exemptions between the parties or both. WSCSS-Schedule 9/2001 Page 2 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : presumptive minimum payment must take into consideration the best interests of the child and circumstances of each parent. Plaintiff(s) Such circumstances can include comparative hardship to the affected households, assets or liabilities, and earning capacity. .. 3. Calendar No. b. Nonrecurring income: The court may deviate from the standard calculation based on a finding that a particular : JUDICIAL SUBPOENA source of income included in the calculation of the basic support obligation is not a recurring source of income. : Depending on the circumstances, nonrecurring income may include overtime, contract-related benefits, bonuses or income from second jobs. Deviations for nonrecurring : income shall be based on a review of the nonrecurring income received in the previous two calendar years. c. Debt and high expenses: The court may deviate from the standard calculation after consideration of the following : . expenses: . i. Extraordinary debt not voluntarily incurred; ii. A significant disparity in the living costs of the parents due to conditions beyond their control; iii. Special needs of disabled children; or iv. Special medical, educational or psychological needs of the children. v. Costs anticipated to be incurred by the parents in compliance with court-ordered reunification efforts under chapter 13.34 RCW or under a voluntary placement agreement with an agency supervising the child. -against- Basic subsistence limitation: A parent’s support obligation shall not reduce his or her net income below the need standard for one person established pursuant to RCW 74.04.770, except for the presumptive minimum payment of twenty-five dollars per child per month or in cases where the court finds reasons for deviation. This section shall not be construed to require monthly Defendant(s) substantiation of income. (See www.nwjustice.org for the .“Washington State .Need Standard Chart.”) . . . . . . . . . . . . . . . . . . . ........... .............. Index No. : .... Income above five thousand and seven thousand dollars: In general setting support under this paragraph does not constitute a deviation. The economic table is presumptive for combined THE PEOPLE OF THE STATE OF five thousand dollars. monthly net incomes up to and including NEW YORK When combined monthly net income exceeds five thousand TOdollars, support shall not be set at an amount lower than the presumptive amount of support set for combined monthly net incomes of five thousand dollars unless the court finds a reason to deviate below that amount. The economic table is advisory but not presumptive for combined monthly net income that exceeds five thousand GREETINGS: seven dollars. When combined monthly net d. income exceeds thousand dollars, the court may set support at an advisory amount of support set for combined monthly WE COMMAND YOU, that allseven thousand excuses net incomes between five thousand and business and thedollars or the court may exceed the advisory amount of support the Honorable at for combined monthly net income of seven thousand dollars located at Countywritten findings of fact. of upon Residential schedule: The court may deviate from the standard calculation if the child spends a significant amount of time with the parent and obligated to make a support being laid aside, youwho iseach of you attend before transfer payment. The court may not deviate on that basis Court if the deviation will result in insufficient funds in the household receiving the support to meet the basic needs of in room , on the day of , 20 , at the child or if the child is receiving temporary assistance for o'clock in the noon, and at any recessed DEVIATION STANDARDS testify and give evidence as a witness in this needy families. part ofdetermining the amount of the or adjourned date, to action on the When consider evidence concerning the the deviation, the court shall increased expenses to a parent making support transfer 1. Reasons for deviation from the standard calculation include but payments resulting from the significant amount of time are not limited to the following: spent with that parent and shall consider the decreased a. Sources of incometo comply with this subpoena is punishable expenses, if any, toof court receiving the support resulting to Your failure and tax planning: The court may as a contempt the party and will make you liable from the significant amount deviate whose behalf this subpoenaconsideration offor a maximum penalty of $50 andof time the child sustained as a from the standard calculation after was issued the party on all damages spends with the parent making the support transfer payment. the following: result of your failure to comply. the parent who is married i. Income of a new spouse if e. Children from other relationships: The court may deviate to the new spouse is asking for a deviation based on from the standard calculation when either or both of the any other reason. Income of a new spouse is not, by Witness, Honorable for deviation; , the court have children parents beforeone of the Justices of the from other itself, a sufficient reason relationships to whom the parent owes a duty of support. ii. Court in Income of other adults in the household if the parent , 20 County, day of i. The child support schedule shall be applied to the who is living with the other adult is asking for a mother, father and children of the family before the deviation based on any other reason. Income of the court to determine the presumptive amount of support. other adults in the household is not, by itself, a ii. Children from other relationships shall not be counted sufficient reason for deviation; (Attorney must sign above and type name below)determining in the number of children for purposes of iii. Child support actually received from other the basic support obligation and the standard relationships; calculation. iv. Gifts; iii. When considering a deviation from the standard v. Prizes; calculation Attorney(s) for for children from other relationships, the vi. Possession of wealth, including but not limited to court may consider only other children to whom the savings, investments, real estate holdings and business parent owes a duty of support. The court may interests, vehicles, boats, pensions, bank accounts, consider court-ordered payments of child support for insurance plans or other assets; children from other relationships only to the extent vii. Extraordinary income of a child; or that the support is actually paid. viii. Tax planning considerations. A deviation for tax Office and P.O. Address planning may be granted only if the child would not receive a lesser economic benefit due to the tax planning. WSCSS-Schedule 9/2001 Page 3 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com , COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : iv. 2. .. 3. When the court has determined that either or both parents have children from other relationships, deviations under this section shall be Plaintiff(s) based on consideration of the total circumstances of both -againsthouseholds. All child support obligations paid, received and owed for all children shall be disclosed and considered. All income and resources of the parties before the court, new spouses, and other adults in the household shall be disclosed and considered as provided. The presumptive amount of support shall be determined according to the child support Defendant(s) schedule. .Unless . . . . . .reasons.for. deviation . . .set. forth .in. the .written . . 3. . . . . . . specific . . . . . . . . . . . are . . . . . . . . . . . findings of fact and are supported by the evidence, the court shall order each parent to pay the amount of support determined by using the standard calculation. THE PEOPLE OF THE STATE OF NEW YORK any The court shall enter findings that specify reasons for deviation or any denial of a party’s request for any deviation from the standard calculation made by the court. The court shall TOnot consider reasons for deviation until the court determines the standard calculation for each parent. Index No. Calendar No. discretion when determining whether and for how long to award post-secondary educational support based upon consideration of : JUDICIAL SUBPOENA factors that include but are not limited to the following: age of the child; the child’s needs; the expectations of the parties for their :children when the parents were together; the child’s prospects, desires, aptitudes, abilities or disabilities; the nature of the post-secondary education sought and the parent’s level of : education, standard of living and current and future resources. Also to be considered are the amount and type of support that the child :would have been afforded if the parents had stayed together. : . .The .child .. . must enroll in an accredited academic or vocational school, must be actively pursuing a course of study commensurate with the child’s vocational goals and must be in good academic standing as defined by the institution. The courtordered post-secondary educational support shall be automatically suspended during the period or periods the child fails to comply with these conditions. 5. The child shall also make available all academic records and grades to both parents as a condition of receiving post-secondary educational support. Each parent shall have full and equal access to the post-secondary education records as provided by statute (RCW 26.09.225). 5. 4. 4. The court shall not order the payment of post-secondary When reasons exist for deviation, the court shall exercise discretion in considering the extent to which the factors would GREETINGS: obligation. affect the support Agreement of COMMAND by itself that all reason for any WE the parties is not YOU, adequate business and deviations from the standard calculations. educational expenses beyond the each twenty-third birthday, excuses being laid aside, you and child’s of you attend before except for exceptional circumstances, such as mental, physical or , at the Court emotional disabilities. the Honorable located at County of POST-SECONDARY EDUCATION STANDARDS The both and at any recessed in room , on the day of , 20 6. , at court shall direct that either ornoon,parents’ payments for o'clock in the 1. The child support schedule shall be advisory and not mandatory post-secondary educational expenses are made directly to the or adjourned date,educational support. to testify and give evidence as a witness in educational institution part of the If direct payments are not this action on the if feasible. for post-secondary 2. feasible, then the court in its discretion may order that either or both parents’ payments are made directly to the child if the child does not reside with either parent. If the child resides with one of the parents, the court may direct that the make you liable punishable as a contempt of court and will parent making the to support transfer payments make the to the for a maximum penaltybeen $50 andthepaymentstransfer child or to as a of receiving all damages sustained the parent who has support payments. When considering whether to order support for post-secondary educational expenses, the court shall determine whether the child is in fact dependent and is relying upon the parents for the Your failure to comply with this subpoena is reasonable necessities of life. The court shall exercise its the party on whose behalf this subpoena was issued result of your failure to comply. Witness, Honorable Court in County, , one of the Justices of the day of , 20 (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address WSCSS-Schedule 9/2001 Page 4 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Calendar No. WASHINGTON STATE CHILD SUPPORT SCHEDULE : INSTRUCTIONS FOR WORKSHEETS SUBPOENA JUDICIAL Plaintiff(s) Fill in the names and ages of only -againstthose children whose support is at issue. :Approximate Median : PART I: BASIC CHILD SUPPORT OBLIGATION Net Monthly Income MALE age FEMALE :$1,363 15-24 25-34 35-44 45-54 55-64 65 + $1,222 $1,807 $1,957 $2,051 $1,904 $1,940 Pursuant to INCOME STANDARD #1: Consideration of $2,154 all income, “only the income of the parents of the children Defendant(s) :$2,610 . . . . . . . . at . . . . . . . . . . . . . . . . . . . . . . . . . whose. support.is . . issue shall be calculated. for .purposes . . . . . . . . . . . . . . . $2,846 of calculating the basic support obligation.” (See page 1.) Pursuant to INCOME STANDARD #2: Verification of income, “tax returnsOF the preceding two years and THE PEOPLE for THE STATE OF NEW YORK current paystubs are required for income verification purposes. Other sufficient verification shall be required TO for income and deductions which do not appear on tax returns or paystubs.” (See page 1.) GROSS MONTHLY INCOME GREETINGS: $2,880 $2,828 U.S. Bureau of the Census, Money Income in the United States: 1998, Current Population Reports, Median Income of People by Selected Characteristics: 1998, Full-Time, Year-Round Workers, Table 7. [Net income has been determined by subtracting FICA (7.65 percent) and the tax liability for a single person (one withholding allowance).] Gross monthly income is defined under INCOME STANDARD WEIncome sources included in gross #3: COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable atLINE 1a, Wages and Salaries: Enter the average the Court monthly income. (See page 1.) located at County of monthly total of all salaries, wages, contract-related Income exclusions are defined under INCOME benefits,at bonuses. in room , on the day of , 20 , income from secondthe andnoon, and at any recessed o'clock in jobs STANDARD #4: Income sources excluded from gross as a witness in this action on the part of the or adjourned date, to testify and give evidence monthly income. (See page 2.) Excluded income must LINE 1b, Interest and Dividend Income: Enter the be disclosed and listed in Part VI of the worksheets. average monthly total of dividends and interest income. Monthly Average of Income: Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to • If income varies during the year, divide the annual the party on whose behalf this subpoena was issued LINE maximum penalty of Enter the all damages sustained as a for a 1c, Business Income: $50 and average total of the income by 12. monthly income from self-employment. result of your failure to comply. • If paid weekly, multiply the weekly income by 52 and divide by 12. LINE 1d, Spousal Maintenance Received: Enter the Witness, Honorable , one of the Justices of the • If paid every other week, multiply the two-week monthly amount of spousal maintenance actually income received. Court inby 26 and divide by 12. County, day of , 20 • If paid twice a month (bi-monthly), multiply the bimonthly income by 24 and divide by 12. LINE 1e, Other Income: Enter the average monthly total of other income. (Other income includes, but is not (Attorney must sign above and annuities, capital If a parent is unemployed, underemployed or the income limited to: trust income, severance pay, type name below) of a parent is unknown, refer to “INCOME STANDARD gains, pension retirement benefits, workers #6: Imputation of income.” (See page 2.) compensation, unemployment benefits, social security benefits and disability insurance benefits.) Attorney(s) for In the absence of information to the contrary, a parent’s imputed income shall be based on the following table. LINE 1f, Total Gross Monthly Income: Add the monthly income amounts for each parent (lines 1a through 1e) and enter the totals on line 1f. Office and P.O. Address WSCSS-Schedule 9/2001 Page 5 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : MONTHLY DEDUCTIONS FROM GROSS INCOME Index No. : Calendar No. If the combined income on line 4 is less than $600, skip to line 7. : Allowable monthly deductions from gross income are defined JUDICIAL SUBPOENA Plaintiff(s) under INCOME STANDARD #5: Determination of net LINE 5, Basic Child Support Obligation: In the work -againstincome. (See page 2.) area provided on line 5, enter the basic support obligation : amounts determined for each child. Add these amounts Monthly Average of Deductions: If a deduction is annual or together and enter the total in the box on line 5. (To : varies during the year, divide the annual total of the deduction determine a per child basic support obligation, see the by 12 to determine a monthly amount. following economic table instructions.) : LINE 2a, Income Taxes: Enter the monthly amount ECONOMIC TABLE INSTRUCTIONS Defendant(s) : actually . . . . .for .state .and. federal. income. taxes..(The . . . . . . . . . . . . . . . . . . . owed . . . . . . . . . . . . . . . . . . . . . . . . amount of income tax withheld on a paycheck may not be the To use the Economic Table to determine an individual actual amount of income tax owed due to tax refund, etc. It is support amount for each child: appropriate to consider tax returns from prior years as indicating the actual amount of income tax owed if income • Locate in the left-hand column the combined monthly THE PEOPLE OF THE STATE OF NEW YORK has not changed.) net income amount closest to the amount entered on line 4 of Worksheet (round up when the combined TO LINE 2b, FICA/Self Employment Taxes: Enter the total monthly net income falls halfway between the two monthly amount of FICA, Social Security, Medicare and amounts in the left-hand column); Self-employment taxes owed. • locate on the top row the family size for the number of LINE 2c, State Industrial Insurance Deductions: Enter GREETINGS: children for whom child support is being determined the monthly amount of state industrial insurance (when determining family size for the required deductions. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before worksheets, do not include children from other , the Honorable at the relationships); and Court LINE 2d, Mandatory Union/Professional Dues: Enter the located at County ofof mandatory union or professional dues. monthly cost in room , on the day of , 20 • ,circle the two numbers in the columns listed any recessed at o'clock in the noon, and at below the family action onare across from the net income size that the part of the or 2e, Pension Plan Payments: Enter evidence as a witness in this LINE adjourned date, to testify and givethe monthly cost amount. The amount in the “A” column is the basic of pension plan payments. (For information regarding support amount for a child up to age 11. The amount limitations on the allowable deduction of voluntary pension in the “B” column is the basic support amount for a plan payments, refer to INCOME STANDARD #5: child as a contempt of court DeterminationYour failure to See page with this subpoena is punishable12 years of age or older. and will make you liable to of net income. comply 2.) the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a LINE 2f, Spousal Maintenance Paid: Enter the monthly result of your failure to comply. amount of spousal maintenance actually paid pursuant to a court order. Witness, Honorable LINE 2g, in Expenses: Court Normal BusinessCounty, If self-employed, day of enter the amount of normal business expenses. (Pursuant to INCOME STANDARD #5: Determination of net income, “justification shall be required for any business expense deduction about which there is a disagreement.” See page 2.) LINE 2h, Total Deductions From Gross Income: Add the monthly deductions for each parent (lines 2a through 2g) and enter the totals on line 2h. LINE 3, Monthly Net Income: For each parent subtract total deductions (line 2h) from total gross monthly income (line 1f) and enter these amounts on line 3. LINE 6, Proportional Share of Income: Divide the monthly net income for each parent (line 3) by the combined monthly net income (line 4) and enter these , entries on Justices of the amounts on line 6. (Theone of the line 6 when added together should equal 1.00.) , 20 LINE 7, Each Parent’s Basic Child Support Obligation: Multiply the total basic child support obligation (amount (Attorney must sign above share proportion in box on line 5) by the income and type name below)for each parent (line 6) and enter these amounts on line 7. (The amounts entered on line 7 added together should equal the amount entered on line 5.) Attorney(s) for If the combined monthly net income on line 4 is less than $600, enter on line 7 each parent’s support obligation, which is the presumptive minimum amount of $25 multiplied by the number of children. Then skip to line 15(a) and enter the Office same amount. and P.O. Address LINE 4, Combined Monthly Net Income: Add the parents’ monthly net incomes (line 3) and enter the total on line 4. WSCSS-Schedule 9/2001 Page 6 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : PART II: HEALTH CARE, DAY CARE, AND SPECIAL CHILD REARING EXPENSES : Calendar No. DAY CARE AND SPECIAL CHILD REARING EXPENSES Plaintiff(s) Pursuant to ALLOCATION STANDARD #4: “the court may -againstexercise its discretion to determine the necessity for and the reasonableness of all amounts ordered in excess of the basic child support obligation.” (See page 2.) Index No. : JUDICIAL SUBPOENA LINE 9a, Day Care Expenses: Enter average monthly day care costs. : LINE 9b, Education Expenses: Enter the average : monthly costs of tuition and other related educational expenses. : Pursuant to ALLOCATION STANDARD #2: Health care expenses and #3: Day care and special child rearing expenses, extraordinary health care, day care and special child rearing LINE Defendant(s) 9c, Long Distance Transportation Expenses: Enter : expenses.shall .be.shared. by the. parents .in .the same . . . . . . . . . . the.average monthly costs of long distance travel incurred .... ... . .... .... ..... . ...... .. ...... proportion as the basic support obligation. (See page 2.) pursuant to the residential or visitation schedule. NOTE: The court order should reflect that extraordinary health care, day care and special child rearing expenses not LINE 9d, Other Special Expenses: Identify any other listed should be apportioned by the same percentage as the special expenses and enter the average monthly cost of THE PEOPLE OF THE STATE OF NEW YORK basic child support obligation. each. TO Monthly Average of Expenses: If a health care, day care, or special child rearing expense is annual or varies during the year, divide the annual total of the expense by 12 to determine a monthly amount. LINE 9e, Total Day Care and Special Expenses: Add the monthly expenses for each parent (lines 9a through 9d) and enter these totals on line 9e. GREETINGS: LINE 10, Combined Monthly Total of Day Care and Special Expenses: Add the parents’ total expenses (line 9e) WE COMMAND YOU, that all business and excuses being total aside, you and each of you attend before and enter this laid on line 10. LINE 8a, Monthly Health Insurance Premiums Paid Forat the , the Honorable Court Child(ren): of the monthly amount paid by each parent LINE 11, Total Extraordinary Health Care, Day Care and located at County List for in room health care insurance for the child(ren) of the , on the day of , 20 Special Expenses: Add in the , at o'clock the extraordinaryand at any recessed noon, health care relationship. (When determining an insurance premium payments (line 8f)on the combined monthly total of day to the part of the or adjourned date, to testify and give evidence as a witness in this action amount, do not include the portion of the premium paid by an care and special expenses (line 10) and enter this amount employer or other third party and/or the portion of the on line 11. premium that covers the parent or other household members.) LINE 12, as a Parent’s of court and will make you Your failure to comply with this subpoena is punishableEach contemptObligation For Extraordinaryliable to LINE 8b, Uninsured Monthly Health Care Expenses Paid Health Care, Day Care And Special Expenses: Multiply and Forthe party on whose behalf this subpoena waseach Child(ren): List the monthly amount paid by issued for a maximum penalty of $50 care,all damages sustained as a the total extraordinary health day care, and special result of your failure to comply. expenses not parent for the child(ren)’s health care expense amount (line 11) by the income proportion for reimbursed by insurance. each parent (line 6) and enter these amounts on line 12. HEALTH CARE EXPENSES Witness, Honorable LINE 8c, Total Monthly Health Care Expenses: For each Court in County, day of parent add the health insurance premium payments (line 8a) to the uninsured health care payments (line 8b) and enter these amounts on line 8c. LINE 8d, Combined Monthly Health Care Expenses: Add the parents’ total health care payments (line 8c) and enter this amount on line 8d. , one of the Justices of the PART III: GROSS CHILD SUPPORT OBLIGATION , 20 LINE 13, Gross Child Support Obligation: For each parent add the basic child support obligation (line 7) to the obligation for extraordinary healthname below)care and (Attorney must sign above and type care, day special expenses (line 12). Enter these amounts on line 13. PART IV: CHILD SUPPORT CREDITS Attorney(s) for LINE 8e, Maximum Ordinary Monthly Health Care: Multiply the basic support obligation (line 5) times .05. LINE 8f, Extraordinary Monthly Health Care Expenses: Subtract the maximum monthly health care deduction (line 8e) from the combined monthly health care payments (line 8d) and enter this amount on line 8f. (If the resulting answer is “0” or a negative number, enter a “0”.) WSCSS-Schedule 9/2001 Child support credits are provided in cases where parents make direct payments to third parties for the cost of goods and services which are included in the standard calculation support obligation (e.g., payments to an insurance company Office and P.O. or a day care provider). Address Page 7 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : LINE 14a, Monthly Health Care Expenses Credit: Enter the total monthly health care expenses amounts from line 8c for each parent. Index No. : equal the amountCalendar No. person’s column. in the paying PART VI: : ADDITIONAL FACTORS FOR JUDICIAL SUBPOENA CONSIDERATION Plaintiff(s) LINE 14b, Day Care And Special Expenses Credit: Enter -againstthe total day care and special expenses amounts from line 9e for each parent. : Pursuant to INCOME STANDARD #1: Consideration of all income, “all income and resources of each parent’s household : shall be disclosed and considered by the court when the court determines the child support obligation of each parent.” (See : page 1.) LINE 14c, Other Ordinary Expense Credit: If approval of another ordinary expense credit is being requested, in the space provided, specify the expense and enter the Defendant(s) : average . . . . . . . . . . .in.the .column.of.the .parent to . . . . . . . LINE.16. a-h, Household Assets: Enter the estimated . . . . monthly cost . . . . . . . . . . . . . . . . . . .... . .. receive the credit. (It is generally assumed that ordinary present value of assets of the household. expenses are paid in accordance with the child’s residence. If payment of a specific ordinary expense does not follow this LINE 17, Household Debt: Describe and enter the assumption, the parent paying STATE OF NEW YORK amount of liens against assets owned by the household THE PEOPLE OF THE for this expense may request approval of an ordinary expense credit. This credit is and/or any extraordinary debt. discretionary with the court.) TO OTHER HOUSEHOLD INCOME LINE 14d, Total Support Credits: For each parent, add the entries on lines 14 a through c and enter the totals on LINE 18a, Income of Current Spouse: If a parent is line 14d. currently married to someone other than the parent of the GREETINGS: child(ren) for whom support is being determined, list the PART V: STANDARD CALCULATION/ name and enter the income of the present spouse. PRESUMPTIVE TRANSFER PAYMENT all business and excuses being laid aside, you and each of you attend before WE COMMAND YOU, that LINE 18b, Income of Other Adults In The Household: , the Honorable at the Court LINE 15a, if combined monthly income on line 4 is below located at County of parent enter the amount from line 7 on line List the names and enter the incomes of other adults $600, for each in room , on the day of , 20 residing in the household. the , at o'clock in noon, and at any recessed 15a. If the court does not deviate from the standard or adjourned date, to testify and give evidence calculation, the transfer payment should equal the as a witness in this action on the part of the LINE 18c, Income of Children: If the amount is amount in the paying person’s column. Skip to Part VI. considered to be extraordinary, list the name and enter the income of children residing in the home. LINE 15b, if combined income on line 4 is $600 or more, for each parent subtract the total support credits (line is punishable as a contempt of court and will make you liable to Your failure to comply with this subpoena LINE 18d, Income from Support: List the name of 14d) from the gross child support obligation (line 13) and for a maximum penalty ofChild and all damages sustained as a the party on whose behalf this subpoena was issued $50 the child(ren) for whom support is received and enter the enter the of your failure to comply. result resulting amounts on line 15b. amount of the support income. LINE 15c, Multiply line 3 by .45. If that amount is less Witness, Honorable than 15(b) enter that amount on line 15(c). If the amount is equal to or greater than County, leave line 15(c) line 15(b) Court in day of blank. You do not qualify for the 45% net income limitation standard. LINE 15d, Subtract the standard need amount (page 3, Basic subsistence limitation) from the amount on Line 3 for each parent. If that amount is less than Line 15(b) enter that amount or $25 per child, whichever is greater, on line 15(d). If that amount is equal to or greater than line 15(b) leave line 15(d) blank. You do not qualify for a need standard limitation. LINE 18e, Income from Assistance Programs: List the , one of the Justices of the program and enter the amount of any income received , 20 from assistance programs. (Assistance programs include, but are not limited to: temporary assistance for needy families, SSI, general assistance, food stamps and aid and attendance allowances.) above and type name below) (Attorney must sign LINE 18f, Other Income: Describe and enter the amount of any other income of the household. (Include income Attorney(s) for from gifts and prizes on this line.) LINE 15e, Enter the lowest amount from lines 15(b), 15(c) and 15(d) on line 15(e). If the court does not deviate from the standard calculation, the transfer payment should LINE 19, Nonrecurring Income: Describe and enter the amount of any income included in the calculation of gross WSCSS-Schedule 9/2001 Page 8 Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. income (LINE 1f) which is nonrecurring. (Pursuant to DEVIATION STANDARD #1b: Nonrecurring income,” depending on the circumstances, nonrecurring income may Plaintiff(s) include overtime, contract-related benefits, bonuses or -againstincome from second jobs”. See page 3.) : Calendar No. : JUDICIAL SUBPOENA LINE 20, Child Support Paid for Other Children: List the names and ages and enter the amount of child support paid for other children. : : : LINE 21, Other Children Living in Each Household: List Defendant(s) : the.names and .ages . . . . . . . . . .other than those.for . . . . . . . . . . . . . . . . . . . . . . . . . . . of children, . . . . . . . . . . . . . . whom support is being determined, who are living in each household. LINE 22, Other Factors For STATE OF NEW YORK THE PEOPLE OF THE Consideration: In the space provided list any other factors that should be considered in determining the child support obligation. (For TO information regarding other factors for consideration, refer to DEVIATION STANDARDS. See page 3.) Nonparental Custody Cases: When the children do not reside GREETINGS: with either parent, the household income and resources of the children’s custodian(s) should be listed on line 22. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at County of 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 Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. Witness, Honorable Court in County, , one of the Justices of the day of , 20 (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address WSCSS-Schedule 9/2001 Page 9 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. WASHINGTON STATE CHILD SUPPORT SCHEDULE Calendar No. ECONOMIC TABLE : MONTHLY BASIC SUPPORT OBLIGATION PER CHILD (KEY: A = AGE 0-11 B = AGE :12-18) Plaintiff(s) JUDICIAL SUBPOENA Combined Monthly One Child Two Children Three Children Four Children Five Children Net Family Family Family Family -against- A Family B :B Income A B A A B A B For income less than $600, the obligation is based upon the resources and living expenses of each household. Minimum support shall not be less than $25 per child per month except when allowed by RCW 26.19.065(2). : 106 600 133 164 103 127 86 73 90 63 78 700 155 191 120 148 100 124 85 105 74 91 800 177 218 137 170 115 97 120 84 104 : 142 900 199 246 154 191 129 159 109 135 95 118 1000 220 272 171 211 143 177 121 149 105 130 1100 242 299 188 232 157 194 133 164 116 143 Defendant(s) : 211 144 179 126 156 .1200 . . . . . . . . . . 264. . . . . .326 . . . . . . 205. . . . . . 253. . . . . . 171. . . . . . 228 ... .. .. .. .. .. 1300 285 352 221 274 185 156 193 136 168 1400 307 379 238 294 199 246 168 208 147 181 1500 327 404 254 313 212 262 179 221 156 193 1600 347 428 269 333 225 278 190 235 166 205 1700 367 453 285 352 238 294 201 248 175 217 1800 387 478 300 371 251 310 212 262 185 228 THE PEOPLE OF THE STATE OF NEW YORK 1900 407 503 316 390 264 326 223 275 194 240 2000 427 527 331 409 277 342 234 289 204 252 2100 447 552 347 429 289 358 245 303 213 264 TO 2200 467 577 362 448 302 374 256 316 223 276 2300 487 601 378 467 315 390 267 330 233 288 2400 506 626 393 486 328 406 278 343 242 299 2500 526 650 408 505 341 421 288 356 251 311 2600 534 661 416 513 346 428 293 362 256 316 2700 542 670 421 520 351 435 298 368 259 321 2800 679 427 527 356 440 301 372 262 324 GREETINGS: 549 2900 556 686 431 533 360 445 305 376 266 328 3000 561 693 436 538 364 449 308 380 268 331 3100 566 699 439 543 367 453 310 383 270 WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend334 before 3200 569 704 442 546 369 457 312 386 272 336 the Honorable 573 3300 708 445 549 at the 371 459 Court 314 388 273 339 3400 574 710 446 372 460 315 389 274 340 located at 551 County of 3500 575 711 447 552 373 461 316 390 275 341 3600 577on the 712 553 , 20 374 at 462 o'clock in the 317 391 276 342 in room , day 448 of , noon, and at any recessed 3700 578 713 449 554 375 463 318 392 277 343 or adjourned date, to testify and give 452 evidence as a witness in this action on the part of the 3800 581 719 558 377 466 319 394 278 344 3900 596 736 463 572 386 477 326 404 284 352 4000 609 753 473 584 395 488 334 413 291 360 4100 623 770 484 598 404 500 341 422 298 368 4200 638 788 495 611 413 511 350 431 305 377 4300 651 805 506 625 422 522 357 441 311 385 Your failure to comply with this subpoena is punishable as a contempt of court and will 317 you392 make liable to 4400 664 821 516 637 431 532 364 449 4500 677 525 649 438 542 458 323 400 the party on whose behalf 836 subpoena was issued for a maximum penalty 371 $50 and all damages sustained as a this of 4600 689 851 535 661 446 552 377 467 329 407 result of your failure to comply. 4700 701 866 545 673 455 562 384 475 335 414 4800 713 882 554 685 463 572 391 483 341 422 4900 726 897 564 697 470 581 398 491 347 429 5000 738 912 574 708 479 592 500 353 437 Witness, Honorable ,404 of the Justices of the one 5100 751 928 584 720 487 602 411 509 359 443 5200 763 County, 943 593 732 494 611 418 517 365 451 Court in day of , 20 5300 776 959 602 744 503 621 425 525 371 458 5400 788 974 612 756 511 632 432 533 377 466 5500 800 989 622 768 518 641 439 542 383 473 5600 812 1004 632 779 527 651 446 551 389 480 5700 825 1019 641 791 535 661 452 559 395 488 (Attorney must sign above and type name 401 below) 5800 837 1035 650 803 543 671 459 567 495 5900 850 1050 660 815 551 681 466 575 407 502 6000 862 1065 670 827 559 691 473 584 413 509 6100 875 1081 680 839 567 701 479 593 418 517 6200 887 1096 689 851 575 710 486 601 424 524 6300 899 1112 699 863 583 721 493 609 430 532 Attorney(s) for 6400 911 1127 709 875 591 731 500 617 436 539 6500 924 1142 718 887 599 740 506 626 442 546 6600 936 1157 728 899 607 750 513 635 448 554 6700 949 1172 737 911 615 761 520 643 454 561 6800 961 1188 747 923 623 770 527 651 460 568 6900 974 1203 757 935 631 780 533 659 466 575 7000 986 1218 767 946 639 790 540 668 472 583 Office and P.O. Address In general setting support under this paragraph does not constitute a deviation. The economic table is presumptive for combined monthly net incomes up to and including five thousand dollars. When combined monthly net income exceeds five thousand dollars, support shall not be set at an amount lower than the presumptive amount of support set for combined monthly net income of five thousand dollars unless the court finds a reason to deviate below that amount.Telephone No.: The economic table is advisory but not presumptive for combined monthly net income that exceeds five thousand dollars. When combined monthly net income exceeds seven thousand Facsimile No.: dollars, the court may set support at an advisory amount of support set for combined monthly net incomes between five thousand and E-Mail Address: seven thousand dollars or the court may exceed the advisory amount of support set for combined monthly net incomes of seven Mobile Tel. No.: thousand dollars upon written findings of fact. WSCSS-Schedule 9/2001 Page 1 American LegalNet, Inc. www.USCourtForms.com , COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : : Plaintiff(s) -against- Calendar No. JUDICIAL SUBPOENA : : : Defendant(s) : ...................................................... Washington State Child Support Schedule THE PEOPLE OF THE STATE OF NEW YORK Worksheets (CSW) TO Mother _______________________________ Father ______________________________ County _______________________ GREETINGS: _____________________ Superior Court Case Number WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Children and Ages: , the Honorable at the Court Part of located at County I: Basic Child Support Obligation (See Instructions, Page 5) 1. in room Gross Monthly Income of , on the day , 20 , at o'clockFather in the noon,Motherany recessed and at a. date, to testify and give evidence as a witness in this action on the part of the $ Wages and Salaries $ or adjourned b. Interest and Dividend Income $ $ c. Business Income $ $ d. Spousal Maintenance Received $ $ Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to e. Other Income $ $ the party on whoseTotal Gross subpoena was issued for a maximum penalty of $50 and all damages sustained as a behalf this Monthly Income f. (add lines 1a result of your failure to comply. through 1e) $ $ 2. Monthly Deductions from Gross Income a. $ , one of the Justices of the $ Witness, Income Taxes (Federal and State) Honorable b. FICA (Soc.Sec.+Medicare)/Self-Employment $ $ Court in County, day of , 20 Taxes c. State Industrial Insurance Deductions $ $ d. Mandatory Union/Professional Dues $ $ (Attorney must sign above and type name below) e. Pension Plan Payments $ $ f. Spousal Maintenance Paid $ $ g. Normal Business Expenses $ $ h. Total Deductions from Gross Income Attorney(s) for (add lines 2a through 2g) $ $ 3. Monthly Net Income (line 1f minus 2h) $ $ 4. Combined Monthly Net Income (add father’s and mother’s monthly net incomes fromOffice and P.O. Address line $ 3) (If combined monthly net income is less than $600, skip to line 7.) WSCSS-Worksheets (CSW) 9/2000 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : : 5. Basic Child Support Obligation (enter total amount in box -------Plaintiff(s) →) Calendar No. JUDICIAL SUBPOENA : $ : -against- Child #1__________________ Child #3 6. Index No. Father Proportional Share of Income : (each parent’s net income from line 3 divided by line 4) . Defendant(s) : . . .7. . . . . . Each.Parent’s. Basic.Child .Support Obligation. . . . . . . . . . .... ...... .... .... .............. (multiply each number on line 6 by line 5) (If combined net monthly income on line 4 is less than $600, enter each parent’s support obligation of $25 per child. Number of children: ________. Skip to line 15a and enter this amount.) THE PEOPLE OF THE STATE OF NEW YORK Mother $ . $ Part II: Health Care, Day Care, and Special Child Rearing Expenses (See Instructions, Page 7) Health Care Expenses TO8. a. Monthly Health Insurance Premiums Paid for $ $ Child(ren) b. Uninsured Monthly Health Care Expenses Paid for $ $ Child(ren) GREETINGS: c. Total Monthly Health Care Expenses (line 8a YOU, that $ $ WE COMMANDplus line 8b)all business and excuses being laid aside, you and each of you attend before d. Combined Monthly Health Care Expenses , the Honorable at the Court (add father’s and mother’s totals from line 8c) $ located at County of e. Maximum Ordinary Monthly Health Care in room , on the day of , 20 , at o'clock in the noon, and at any recessed (multiply line 5 times .05) $ or adjourned date, to testify and give evidence as a witness in this action on the part of the f. Extraordinary Monthly Health Care Expenses (line 8d minus line 8e., if “0” or negative, enter “0”) $ 9. Day Care and Special Child Rearing Expenses a. failure to comply with this subpoena is punishable as a contempt of court and will make you liable to Day Care Expenses $ $ Your b.whoseEducation Expenses was issued for a maximum penalty of $50 and all damages sustained as a $ $ the party on behalf this subpoena c. failure to comply. Transportation Expenses Long Distance $ $ result of your d. Other Special Expenses (describe) $ $ $ $ Witness, Honorable , one of the Justices of the $ $ Court in e. County, day of , 20 Total Day Care and Special Expenses (Add lines 9a through 9d) $ $ 10. Combined Monthly Total Day Care and Special Expenses (add father’s and mother’s day care and special (Attorney must sign above and type name below) $ expenses from line 9e) 11. Total Extraordinary Health Care, Day Care, and Special Expenses Attorney(s) for $ (line 8f plus line 10) 12. Each Parent’s Obligation for Extraordinary Health Care, Day Care, $ $ and Special Expenses (multiply each number on line 6 by Office and P.O. Address line 11) Part III: Gross Child Support Obligation 13. Gross Child Support Obligation (line 7 plus line 12) $ $ Part IV: Child Support Credits (See Instructions, Page 7) Telephone No.: Facsimile No.: WSCSS-Worksheets (CSW) 9/2000 E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : 14. : Child Support Credits Plaintiff(s) a. Monthly Health Care Expenses Credit -againstb. Day Care and Special Expenses Credit c. Other Ordinary Expenses Credit (describe) Calendar No. JUDICIAL SUBPOENA $ $ $ $ Total Support Credits (add lines 14a through 14c) $ $ $ $ Standard Calculation a. Amount from line 7 if line 4 is below $600. Skip to Part $ $ $ $ $ $ $ $ $ $ : : : d. Defendant(s) : . . .Part .V:. .Standard.Calculation/Presumptive .Transfer. Payment (See Instructions, Page 8) ... . ....... ..................... ...... ....... 15. Father Mother VI. THE PEOPLELine 13 minus line OF NEW YORK $600 (see below if b. OF THE STATE 14d, if line 4 is over appl.) TO Limitation standards adjustments c. Amount on line 15b adjusted to meet 45% net income limitation d. Amount on line 15b adjusted to meet need standard limitation GREETINGS: e. Enter the lowest amount of lines 15b, 15c or 15d: WE COMMAND YOU, that all business (See Instructions, Page 8) Part VI: Additional Factors for Considerationand excuses being laid aside, you and each of you attend before , the16. Honorable at the Court Father’s Household Assets Mother’s (List of Household Household located at County the estimated present value of all major household assets.) in room a. ,Real Estate day of on the , 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 $ b. Stocks and Bonds $ c. Vehicles $ $ d. Boats $ $ e. failure to comply with this subpoena is punishable as a contempt of court and will make you liable to Pensions/IRAs/Bank Accounts $ $ Your f. $ $ the party on whoseCash this subpoena was issued for a maximum penalty of $50 and all damages sustained as a behalf result of your failure to comply. g. Insurance Plans $ $ h. Other (describe) $ $ Witness, Honorable , one of the Justices of the $ $ Court in County, day of , 20 $ $ 17. Household Debt (List liens against household assets, extraordinary debt.) $ $ (Attorney must sign above and type name below) $ $ $ $ $ for $ Attorney(s) $ $ 18. Other Household Income a. Income Of Current Spouse (if not the other parent of this action) Office and P.O. Address $ Name $ ________________________________________ Name WSCSS-Worksheets (CSW) 9/2000 $ $ Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : ________________________________________ Plaintiff(s) b. Income Of Other Adults In Household -against- Name _______________________________________ : JUDICIAL SUBPOENA : $ $ $ $ $ $ $ $ $ $ $ : Name ________________________________________ c. Calendar No. $ : Income Of Children (if considered extraordinary) Defendant(s) : . . . . . . . . . . . . . . . .Name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .... _______________________________________ Name _______________________________________ THE PEOPLE OF THE STATE OF NEW YORK d. Income From Child Support Name ________________________________________ TO Name ________________________________________ GREETINGS: Father’s Mother’s Other Household Income (continued) WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Hou