Child Support Computation Worksheet Split Parental Rights And Responsibilities
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WORKSHEET-SPLIT PARENTAL RIGHTS
CODE: P072
IN THE COURT OF COMMON PLEAS OF FRANKLIN COUNTY, OHIO
DIVISION OF DOMESTIC RELATIONS AND JUVENILE BRANCH
CHILD SUPPORT COMPUTATION WORKSHEET SPLIT PARENTAL RIGHTS AND RESPONSIBILITIES
NAMES OF PARTIES:
CASE NO.
JUDGE
Number of minor children:
Number of minor children with
MOTHER
FATHER
COLUMN I
COLUMN II
COLUMN III
FATHER
MOTHER
COMBINED
1. a.
Annual gross income from employment or, when determined
appropriate by the court or agency, average annual gross
income from employment over a reasonable period of years.
(Exclude overtime, bonuses, self-employment income,
or commissions). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$___________ $___________
b.
Amount of overtime, bonuses, and commissions:
FATHER
MOTHER
Year 3
(Three years ago). . . . . . . . .
$___________ $___________
Year 2
(Two years ago). . . . . . . . . .
$___________ $___________
Year 1
(Last calendar year) . . . . . . .
$___________ $___________
AVERAGE:
$___________ $___________ $___________ $___________
(Include in Column I and/or Column II the average of the three years or the year 1 amount, whichever is less, if there exists
a reasonable expectation that the total earnings from overtime and/or bonuses during the current calendar year will meet or exceed
the amount that is the lower of the average of the three years or the year 1 amount. If, however, there exists a reasonable
expectation that the total earnings from overtime/bonuses during the current calendar year will be less than the lower of the average
of the three years or the year 1 amount, include only the amount reasonably expected to be earned this year.)
2. For self-employment income:
a. Gross receipts from business. . . . . . . . . . . . . . . . . . . . . . . . . .
$___________ $___________
b. Ordinary and necessary business expenses . . . . . . . . . . . . . . .
$___________ $___________
c. 5.6% of adjusted gross income or the actual marginal difference
between the actual rate paid by the self-employed individual and
the F.I.C.A. rate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$___________ $___________
d. Adjusted gross income from self-employment (Subtract the
sum of 2b and 2c from 2a). . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$___________ $___________
3. Annual income from interest and dividends
(whether or not taxable). . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$___________ $___________
4. Annual income from unemployment compensation. . . . . . . . . . . . .
$___________ $___________
5. Annual income from workers' compensation, disability insurance
benefits, or Social Security Disability/Retirement benefits . . . . . . . .
$___________ $___________
6. Other annual income (identify)
. . . . .
$___________ $___________
(e5360 Split 2-2013)
FORM 22 03/01
PAGE 1 OF 4
J-210/E (Rev. 10/08)
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