Child Support Worksheet
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4TITLE IV
Chapter: 35 Chapter Title: ALIMONY AND CHILD SUPPORT MATTERS
ANCILLARY TO CIVIL DIVORCE
PROCEEDINGS
Rule No: 35.2
Child Support Worksheet
1st Judicial District
EXHIBIT A. INCOME AND EXPENSE AFFIDAVIT
Court
Parish of Caddo
______________________________
NUMBER __________
Adopted effective
VERSUS
FIRST JUDICIAL DISTRICT COURT
Jan. 1, 1994.
______________________________
CADDO PARISH, LOUISIANA
ASSIGNMENT: SECTION _____
AFFIDAVIT
BEFORE ME personally came and appeared the undersigned, who did depose and say that the following
is a true and correct statement of affiant's monthly income and expenses:
Income and Expenses on a Per Month Basis
A. Total Gross Monthly Income
_______
B. Itemized Payroll Deductions
_______
Total Monthly Payroll Deductions
_______
C. Total Net Monthly Income
_______
D. Total Monthly Expenditures
_______
Self
Child
Child
Total
1. Housing
_______________________________
2. Food
_______________________________
3. Household Supplies
_______________________________
4. Drug Bill
_______________________________
5. Dental Care
_______________________________
6. Doctor Bills
_______________________________
7. Utilities:
Gas
_______________________________
Electricity
_______________________________
Water
_______________________________
Telephone
_______________________________
8. Insurance
_______________________________
9. Clothing
_______________________________
10. Laundry & Cleaning
_______________________________
11. Grooming Necessities
& Personal Items
_______________________________
12. Education Expenses
(School, lunch, books, etc.)
_______________________________
13. Recreation and Special Lessons _____________________________
14. Vacation
_______________________________
15. Gifts (Christmas, Birthdays, etc.) _____________________________
16. Auto Expenses
_______________________________
17. Income Taxes and Accounting Fee ___________________________
18. Child Care Expenses
_______________________________
19. Fixed Obligations (Garnishments, Bank
Loans, Finance Company, etc.) _______________________________
20. Miscellaneous Expenses
_______________________________
_________________________ _______________________________
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