Form D - Child Support Worksheet B
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1
2The 18th Judicial District, Iberville, Pointe Coupee, West Baton Rouge Parishes
State of Louisiana
Form D
CHILD SUPPORT WORKSHEET B – R.S. 9:315.9
__________________________________
NO: _________________ DIV._________
(PETITIONER)
THE 18THJUDICIAL DISTRICT COURT
VERSUS
PARISH OF ________________________
__________________________________
STATE OF LOUISIANA
(DEFENDANT)
Names of Children
Date of Birth
Names of Children
Date of Birth
______________________ ________
______________________ ________
______________________ ________
______________________ ________
______________________ ________
______________________ ________
______________________ ________
______________________ ________
PETITIONER
DEFENDANT
COMBINED
1.
MONTHLY GROSS INCOME R.S. 9:315.2(A) $
$
a. Minus preexisting child support payment
-
-
b. Minus preexisting spousal support payment
-
-
2.
MONTHLY ADJUSTED GROSS INCOME
$
$
(line 1 minus 1a and 1b).
3.
COMBINED MONTHLY ADJUSTED
$
GROSS INCOME
(line 2 column A plus line 2
column B) La. R.S. § 9:315.2 (C)
4.
PERCENTAGE SHARE OF INCOME (
%
%
line 2
divided by line 3) La. R.S. § 9:315.2 (C)
5.
BASIC CHILD SUPPORT OBLIGATION
$
(compare line 3 to Child Support Schedule)
La. R.S. § 9:315.2(D)
6.
SHARED CUSTODY BASIC OBLIGATION
(line 5 times 1.5) La. R.S. §9: 315.9(B) (2)
7.
EACH PARTY’S THEORETICAL CHILD
$
$
SUPPORT OBLIGATION (multiply line 4
times line 6 for each party
La. R.S. § 9: 315.9(A)(3)
8
PERCENTAGE with each party
%
%
9.
BASIC CHILD SUPPORT OBLIGATION
$
$
FOR TIME WITH OTHER PARTY (cross
multiply line 7 for each party times line 8 for
the other party) La. R.S. § 9:1315.9(A) (3)
a. Net Child Care Costs
+
(Costs minus Federal Tax Credit)
b. Child’s Health Insurance Premium Cost
(La. R.S. §
+
9:315.4)
c. Extraordinary Medical Expenses (uninsured only;
+
agreed to by parties or by court order) La. R.S. § 9:315.5
d. Extraordinary Expenses (agreed to by parties or
+
by court order) La. R.S.§9:315.6
e. Optional: Minus extraordinary adjustments
-
(child’s income if applicable) La. R.S. § 9:315.7
10.
TOTAL EXPENSES/EXTRAORDINARY
$
ADJUSTMENTS (add lines 9a, 9b, 9c, and 9d;
subtract line 9e)
Page 1 of 2
Form D, Child Support Worksheet B
18THJDC Revised: May 2015
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