Friend Of The Court Income Worksheet To Calculate Child Support Per Michigan Child Support Formula
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FRIEND OF THE COURT INCOME WORKSHEET
TO CALCULATE CHILD SUPPORT PER MICHIGAN CHILD SUPPORT FORMULA
Each parent must fully complete and then return this form so support can be calculated. The
support determination will then be mailed to the parent requesting the custody change.
Date:______________________________
Case Number:_________________________________________________
_________________________________
Your Name_____________________________________
Other Parent’s Name
Your
Address______________________________________City_____________________State___________zip_______________
.
Name all Child(ren) whose custody is being changed & to whom: _________________________to_____________________,
(child’s name)
(mother or father)
_________________________ to _____________________,
_________________________ to _____________________.
(child’s name)
(mother or father)
(child’s name)
(mother or father)
As of 10-01-08, support is based on the number of overnights each parent has with the child(ren).
List each
child’s names and then specify the number of overnights with each parent. This is for all children even if custody is not
(
changing.
i.e. the FOC parenting time schedule is 78 overnights; week to week is 182.5 overnights @ parent )
Child’s name_____________________________________# overnights with mother______________# overnights with father_______________
Child’s name_____________________________________# overnights with mother______________# overnights with father_______________
Child’s name_____________________________________# overnights with mother______________# overnights with father_______________
Child’s name_____________________________________# overnights with mother______________# overnights with father_______________
Child’s name_____________________________________# overnights with mother______________# overnights with father_______________
Marital Status:
[
] Married
[
] Single
[
] Head Of Household
________________
How many other biological or legally adopted (not step-children) minor children do you have?
First and last name of other child(ren) and date of birth (1)___________________________(2)_____________________________
(3)______________________________ (4)__________________________________ (5)_________________________________
Gross income
per pay period $___________
[ ] weekly [ ] bi-weekly [ ] bi-monthly [ ] monthly
(before deductions)
2
job: Gross per pay period
nd
$__________________[ ] weekly [ ] biweekly [ ]bi-monthly [ ] monthly
Union dues paid monthly $________________ Mandatory retirement
$___________________per month
Specify any other mandatory withholdings:___________________________ $_______
per month
Identify any other means of income & monthly amount (i.e. SSI or soc sec disability) $____________________
Are you now receiving food stamps?___________Medicaid?_______________TANF grant?___________________
Total amount you pay per month for health insurance $__________________ or [
] Paid by employer
(total for all premiums paid for health insurance, dental, optical and/or prescription)
How many persons are covered by this policy [total number of adult(s) and children]
________________
List any other child support cases you have below:
County
Name/Docket Number
Monthly Obligation
Do you have child care expenses for the minor child(ren) in this case during the year [
] Yes
[
] No
Name(s) and date of births of child(ren) in daycare____________________________________________________
*List your expenses below to reflect the school year or if the minor child(ren) is not yet in school:
Hourly rate $___________
Hours used per week ___________
How many weeks per year ________
*List your child care expenses below for the minor child(ren) during the summer vacation:
Hourly rate $___________
Hours used per week ___________
How many weeks per year ________
Your Signature: _____________________________________________Date___________________
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