Worksheet A - Child Support Obligation: Sole Physical Care

ADVERTISEMENT

Denver Juvenile Court
District Court
____________________________________ County, Colorado
Court Address:
In Re:
The Marriage of:
Parental Responsibilities concerning:
Petitioner:
and
COURT USE ONLY
Co-Petitioner/Respondent:
Attorney or Party Without Attorney (Name and Address):
Case Number:
Phone Number:
E-mail:
FAX Number:
Atty. Reg. #:
Division:
Courtroom:
WORKSHEET A – CHILD SUPPORT OBLIGATION: SOLE PHYSICAL CARE
Children
Date of Birth
Children
Date of Birth
Check box of parent with 273 or more overnights per
Combined
Mother
Father
year*
1. Monthly Gross Income
$
$
a. Plus maintenance received
+
+
b. Minus maintenance paid
-
-
c. Minus ordered child support payments for other children
pursuant to §14-10-115(6)(a), C.R.S.
-
-
d.
Minus
legal
responsibility
for
children
not
of
this
marriage/relationship pursuant to §14-10-115(6)(b)(I), C.R.S.
-
-
**
-
-
e. Minus ordered post-secondary education contributions
2. Monthly Adjusted Gross Income
$
$
$
(If either the paying
parent’s income or Combined Income is less than $850.00, enter
$50.00 on line 11 for paying parent.)
3. Percentage Share of Income
(Each parent’s income from
%
%
line 2 divided by Combined Income)
4
Basic Combined Obligation
$
. a.
(Apply line 2 Combined
column to Child Support Schedule)
b. Each parent’s share of basic support obligation (Each parent’s
$
$
percentage from line 3 times combined obligation in 4a)
5. Low-Income Adjustment
$
$
(If paying parent’s income in line
2 is less than $1850.00, see Low-income Worksheet on page 2)
6. Adjustments
(Expenses paid directly by each parent)
a. Work-related Child Care Costs - Actual costs minus Federal Tax
$
$
Credit pursuant to §14-10-115(9), C.R.S.
b. Education-related Child Care Costs pursuant to §14-10-115(9),
$
$
C.R.S.
c. Health Insurance premium costs – Children’s portion only
$
$
pursuant to §14-10-115(10), C.R.S. (See page 2 for calculation
worksheet)
d. Extraordinary Medical Expenses - Uninsured only pursuant to
$
$
§14-10-115(10), C.R.S.
JDF 1820M R1/08 WORKSHEET A – CHILD SUPPORT OBLIGATION: SOLE PHYSICAL CARE
Page 1 of 2

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Legal
Go
Page of 2