Form 14 Child Support Amount Calculation Worksheet

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CIRCUIT COURT OF _____________________________COUNTY, MISSOURI
CASE NO. _______________________DIV/CT ROOM ____________________
Form 14 CHILD SUPPORT AMOUNT CALCULATION WORKSHEET
In re the Matter of:
Petitioner and
Respondent
CHILDREN
DATE OF BIRTH
CHILDREN
DATE OF BIRTH
Child One
Child Four
Child Two
Child Five
Child Three
Child Six
Parent Receiving
Parent Paying Support
Combined
Support
1. MONTHLY GROSS INCOME
$
$
a. Court ordered maintenance being received.
$
$
2. ADJUSTMENTS (per month)
( $
) ( $
)
a. Other court or administratively ordered
child support being paid.
b. Court ordered maintenance being paid.
( $
) ( $
)
c. Support obligation for other children in parent's
( $
) ( $
)
primary physical custody.
3. ADJUSTED MONTHLY GROSS INCOME
$
$
$
(Sum of lines 1 and 1a, minus lines 2a, 2b and 2c).
4. PROPORTIONATE SHARE OF COMBINED
%
%
ADJUSTED MONTHLY GROSS INCOME
(Each parent's line 3 income divided by combined
line 3 income).
5. BASIC CHILD SUPPORT AMOUNT
$
(From support chart using combined line 3
income).
6. ADDITIONAL CHILD-REARING COSTS
$
(per month)
a. Reasonable work-related child care costs of the
parent receiving support ($
)
less any child care tax credit ($
).
b. Reasonable work-related child care costs of the
$
parent paying support.
c. Health insurance costs for the children who are
$
$
subjects of this proceeding.
d. Uninsured extraordinary medical costs.
$
$
(Agreed by parents or ordered by court).
e. Other extraordinary child rearing costs.
$
$
(Agreed by parents or ordered by court)
7. TOTAL ADDITIONAL CHILD-REARING
$
$
$
COSTS (Sum of lines 6a, 6b, 6c, 6d and 6e).
8. TOTAL COMBINED CHILD SUPPORT
$
COSTS (Sum of line 5 and combined line 7).
9. EACH PARENT'S SUPPORT OBLIGATION
$
$
(Multiply line 8 by each parent's line 4)
10. CREDIT FOR ADDITIONAL CHILD-
( $ )
REARING COSTS (Line 7 of parent paying
support).
11. ADJUSTMENT FOR A PORTION OF THE
( $ )
AMOUNTS EXPENDED DURING PERIODS
OF OVERNIGHT VISITATION OR CUSTODY.
(Multiply line 5 by ___________ %).
12. PRESUMED CHILD SUPPORT AMOUNT
$
(Line 9 minus lines 10 and 11).
PREPARED BY:

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