Number of Children Total Number of Children From This Relationship:

Overnight Information Enter the number of overnights per year each child spends with you:

Income information Enter your monthly gross income: Enter the other parent's monthly gross income:

Adjustments Enter any additional child related payments you are making: Pre-existing Child Support: Monthly Work Related Child Care Costs: Health Insurance Premiums (children): Extraordinary Expenses:

Enter any additional child related payments the other parent is making:

Pre-existing Child Support: Monthly Work Related Child Care Costs: Health Insurance Premiums (children): Extraordinary Expenses:

Other Children If you have responsibility for any other children not of this relationship, please enter the number of children here:

If the other parent has responsibility for any other children not of this relationship, please enter the number of children here:

	You	Other Parent	Combined
1. MONTHLY GROSS INCOME
1b. Minus pre-existing child support payment
1c. Minus responsibility for other children
2. MONTHLY ADJUSTED GROSS INCOME
3. PERCENTAGE SHARE OF INCOME
4. BASIC CHILD SUPPORT OBLIGATION
5. Adjustments
5a. Work Related Childcare Costs
5b. Health Insurance Premiums
5c. Extraordinary Expenses
5d. TOTAL ADJUSTMENTS
6. TOTAL CHILD SUPPORT OBLIGATION
7. EACH PARENT'S SUPPORT OBLIGATION
8. NONCUSTODIAL PARENT ADJUSTMENT
9. RECOMMENDED CHILD SUPPORT ORDER

	You	Other Parent	Combined
1. MONTHLY GROSS INCOME
1b. Minus pre-existing child support payment
1c. Minus responsibility for other children
2. MONTHLY ADJUSTED GROSS INCOME
3. PERCENTAGE SHARE OF INCOME
4. BASIC CHILD SUPPORT OBLIGATION
5. SHARED CUSTODY BASIC OBLIGATION
6. EACH PARENT'S PORTION OF SHARED CUSTODY SUPPORT OBLIGATION
7. OVERNIGHTS with each parent
8. PERCENTAGE with each parent
9. SUPPORT OBLIGATION FOR TIME WITH OTHER PARENT
10. Adjustments
10a. Work Related Childcare Costs
10b. Health Insurance Premiums
10c. Extraordinary Expenses
10d. TOTAL ADJUSTMENTS
11. EACH PARENT'S FAIR SHARE OF ADJUSTMENTS
12. ADJUSTMENTS PAID IN EXCESS OF FAIR SHARE
13. EACH PARENT'S ADJUSTED SUPPORT OBLIGATION
14. RECOMMENDED CHILD SUPPORT ORDER

	You	Other Parent	Combined
1. MONTHLY GROSS INCOME
1b. Minus pre-existing child support payment
1c. Minus responsibility for other children
2. MONTHLY ADJUSTED GROSS INCOME
3. PERCENTAGE SHARE OF INCOME
4. BASIC CHILD SUPPORT OBLIGATION
5a. SHARED CUSTODY ADJUSMENT
5b. SHARED CUSTODY ADJUSMENT
5c. SHARED CUSTODY ADJUSMENT
6a. PLAINTIFF'S SUPPORT FOR CHILDREN WITH DEFENDANT
6b. DEFENDANT'S SUPPORT FOR CHILDREN WITH PLAINTIFF
7. Adjustments
7a. Work Related Childcare Costs
7b. Health Insurance Premiums
7c. Extraordinary Expenses
7d. TOTAL ADJUSTMENTS
8. EACH PARENT'S FAIR SHARE OF ADJUSTMENTS
9. ADJUSTMENTS PAID IN EXCESS OF FAIR SHARE
10. EACH PARENT'S ADJUSTED SUPPORT OBLIGATION
11. RECOMMENDED CHILD SUPPORT ORDER

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