Questionnaire: Child Support Calculation Information
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Questionnaire: Child Support Calculation Information
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The obligation to pay child support attaches to all parents, married, divorced, and never married. If you are in a cohabitation relationship that includes children, you and your partner are legally obligated to provide the necessaries for the child's well being, both while the relationship is intact and after it dissolves. If the relationship does end, legal guidelines in each state help establish the amount of child support that must be paid by the noncustodial parent. The guidelines vary from state to state, but they are all generally based on the parents' incomes and expenses and the needs of the children. Often, the guidelines calculate the child support amount as a percentage of the paying parent's income that increases with the number of children being supported. In some instances, the amount can deviate from the guidelines, if there are very good reasons for the deviation.
Judges will often review a financial statement completed by each parent that lists all sources and amounts of income and expense before issuing a child support order. The following form is intended to be a guide to help you and your attorney gather the necessary financial information.
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INFORMATION ABOUT
YOU | INFORMATION ABOUT
OTHER PARENT |
| Gross Monthly Income |
| | Source/Amount | Source/Amount |
| | _________/$________ | _________/$________ |
| | _________/$________ | _________/$________ |
| | _________/$________ | _________/$________ |
| TOTAL: | $________________ | $________________ |
| Deductions from Gross Income |
| State Income Tax | $____________________ | $____________________ |
| Federal Income Tax | $____________________ | $____________________ |
| Social Security | $____________________ | $____________________ |
| Self-employment Tax | $____________________ | $____________________ |
| Health Insurance | $____________________ | $____________________ |
| Union Dues | $____________________ | $____________________ |
| Pension/Retirement | $____________________ | $____________________ |
| Mandatory? | Yes ____ No ____ | Yes ____ No ____ |
| Support Orders | $____________________ | $____________________ |
| Other | $____________________ | $____________________ |
| TOTAL DEDUCTIONS: | $_______________ | $_______________ |
| NET MONTHLY INCOME: (Gross Income minus Total Deductions) |
| | $_______________ | $_______________ |
| Monthly Expenses |
| Rent or Mortgage | $_______________ | $_______________ |
| Utilities: |
| Telephone | $_______________ | $_______________ |
| Gas | $_______________ | $_______________ |
| Electricity | $_______________ | $_______________ |
| Water & Sewer | $_______________ | $_______________ |
| Garbage Collection | $_______________ | $_______________ |
| Cable Television | $_______________ | $_______________ |
| Cellular Phone | $_______________ | $_______________ |
| Internet Service | $_______________ | $_______________ |
| Property Taxes | $_______________ | $_______________ |
| Insurance: |
| Medical | $_______________ | $_______________ |
| Dental | $_______________ | $_______________ |
| Life | $_______________ | $_______________ |
| Disability | $_______________ | $_______________ |
| Long-term Care | $_______________ | $_______________ |
| Homeowners/Renters | $_______________ | $_______________ |
| Auto(s) | $_______________ | $_______________ |
| Recreational Vehicle | $_______________ | $_______________ |
| Debt Payments: |
| Vehicle #1 | $_______________ | $_______________ |
| Vehicle #2 | $_______________ | $_______________ |
| Home Equity Loan | $_______________ | $_______________ |
| Student Loan | $_______________ | $_______________ |
| Other Loans | $_______________ | $_______________ |
| Credit Card #1 | $_______________ | $_______________ |
| Credit Card #2 | $_______________ | $_______________ |
| Credit Card #3 | $_______________ | $_______________ |
| Educational Expenses: |
| For Self | $_______________ | $_______________ |
| For Children | $_______________ | $_______________ |
| Day Care: |
| For Children | $_______________ | $_______________ |
| For Parent(s) | $_______________ | $_______________ |
| Transportation Expenses: |
| Gasoline | $_______________ | $_______________ |
| Parking/Commuting | $_______________ | $_______________ |
| Vehicle Maintenance | $_______________ | $_______________ |
| Licenses | $_______________ | $_______________ |
| Food: |
| Groceries | $_______________ | $_______________ |
| Take-out Food | $_______________ | $_______________ |
| Restaurants | $_______________ | $_______________ |
| School Lunches | $_______________ | $_______________ |
| Clothing: |
| For Self | $_______________ | $_______________ |
| For Children | $_______________ | $_______________ |
| Repair and Cleaning | $_______________ | $_______________ |
| Household Expenses: |
| Cleaning Supplies | $_______________ | $_______________ |
| Cleaning Service | $_______________ | $_______________ |
| Yard Maintenance | $_______________ | $_______________ |
| Home Maintenance | $_______________ | $_______________ |
| Home Security | $_______________ | $_______________ |
| Home Improvements | $_______________ | $_______________ |
| Home Furnishings | $_______________ | $_______________ |
| Appliances | $_______________ | $_______________ |
| Uninsured Health-care Costs: |
| Medical (Self) | $_______________ | $_______________ |
| Medical (Children) | $_______________ | $_______________ |
| Dental (Self) | $_______________ | $_______________ |
| Dental (Children) | $_______________ | $_______________ |
| Prescriptions (Self) | $_______________ | $_______________ |
| Prescrips. (Children) | $_______________ | $_______________ |
| Non-prescrip. (Self) | $_______________ | $_______________ |
| Non-prescrip. (Child.) | $_______________ | $_______________ |
| Personal Expenses: |
| Grooming | $_______________ | $_______________ |
| Entertainment | $_______________ | $_______________ |
| Travel | $_______________ | $_______________ |
| Gifts | $_______________ | $_______________ |
| Hobbies | $_______________ | $_______________ |
| Babysitting | $_______________ | $_______________ |
| Pet-care Costs | $_______________ | $_______________ |
| Donations | $_______________ | $_______________ |
| Other Expenses | $________________ | $_______________ |
| | $_______________ | $_______________ |
| | $_______________ | $_______________ |
| | $_______________ | $_______________ |
| TOTAL EXPENSES: | $_______________ | $_______________ |
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