22. OBLIGATION AFTER ADJUSTMENTS TO CHILD SUPPORT:
a. FATHER: LINE 18a PLUS LINE 21a MINUS LINE 21c (IF THE
AMOUNT ON LINE 21c IS GREATER THAN OR EQUAL TO THE
AMOUNT ON LINE 21a OR IF 21a AND 21c ARE NOT APPLICA-
BLE--ENTER THE NUMBER ON LINE 18a IN COL I)
................
$.....................
b. MOTHER: LINE 18b PLUS LINE 21b MINUS LINE 21d (IF THE
AMOUNT ON LINE 21d IS GREATER THAN OR EQUAL TO THE
AMOUNT ON LINE 21b OR IF 21b AND 21d ARE NOT APPLICA-
BLE--ENTER THE NUMBER ON LINE 18b IN COL. II)
..............
$.....................
23. ACTUAL ANNUAL OBLIGATION:
a. (LINE 22a OR, WHICHEVER LINE CORRESPONDS TO THE PAR-
ENT WHO IS THE OBLIGOR) ............................................................... $...................
b. ANY NON-MEANS-TESTED BENEFITS, INCLUDING SOCIAL
SECURITY AND VETERANS' BENEFITS, PAID TO AND RE-
CEIVED BY A CHILD OR A PERSON ON BEHALF OF THE CHILD
DUE TO DEATH, DISABILITY, OR RETIREMENT OF THE PAR-
ENT ............................................................................................................. $...................
c. ACTUAL ANNUAL OBLIGATION (SUBTRACT LINE 23b FROM
LINE 23a) .................................................................................................... $...................
24.a. DEVIATION FROM SOLE RESIDENTIAL PARENT SUPPORT AMOUNT SHOWN ON LINE 23c IF AMOUNT
WOULD BE UNJUST OR INAPPROPRIATE: (SEE SECTION 3119.23 OF THE REVISED CODE.) (SPECIFIC
FACTS AND MONETARY VALUE MUST BE STATED.)
............................................................................................................................................................................................................
............................................................................................................................................................................................................
............................................................................................................................................................................................................
............................................................................................................................................................................................................
b. DEVIATION FROM SHARED PARENTING ORDER: (SEE SECTIONS 3119.23 AND 3119.24 OF THE REVISED
CODE.) (SPECIFIC FACTS INCLUDING AMOUNT OF TIME CHILDREN SPEND WITH EACH PARENT,
ABILITY OF EACH PARENT TO MAINTAIN ADEQUATE HOUSING FOR CHILDREN, AND EACH PARENTS
EXPENSES FOR CHILDREN MUST BE STATED TO JUSTIFY DEVIATION.)
............................................................................................................................................................................................................
............................................................................................................................................................................................................
............................................................................................................................................................................................................
............................................................................................................................................................................................................
25. FINAL FIGURE (THIS AMOUNT REFLECTS FINAL ANNUAL
CHILD SUPPORT OBLIGATION; LINE 23c PLUS OR MINUS ANY
AMOUNTS INDICATED IN LINE 24a OR 24b) .................................
$..................
FATHER/MOTHER,
OBLIGOR
26. FOR DECREE: CHILD SUPPORT PER MONTH (DIVIDE OBLI-
GOR'S ANNUAL SHARE, LINE 25, BY 12) PLUS ANY PROCESSING
CHARGE..................................................................................................... $...................
PREPARED BY:
COUNSEL .........................................................................
PRO SE:
...............................................................
(FOR MOTHER/FATHER)
CSEA. ..................................................................................
OTHER:
......................................................................
WORKSHEET HAS BEEN REVIEWED AND AGREED TO:
......................................................................................................................
..................................................................
MOTHER
DATE
......................................................................................................................
........................................................................
FATHER
DATE
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03/2005