Child Support Guidelines Worksheet
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THE STATE OF NEW HAMPSHIRE
JUDICIAL BRANCH
Court Name:
Case Name:
Case Number:
(if known)
CHILD SUPPORT GUIDELINES WORKSHEET
Child's name
DOB
Child's name
DOB
1. Total number of children
2. Obligor’s reasonable medical support
3. Obligee’s reasonable medical support
obligation
obligation
(4% monthly gross income)
(4% monthly gross income)
PAYMENT CALCULATIONS
OBLIGOR
OBLIGEE
COMBINED
Note: All income and expenses must be converted to monthly amounts
(Column 1)
(Column 2)
(Column 3)
(multiply weekly amounts by 4.33: bi-weekly amounts by 2.17).
4.
Monthly gross income
$
$
5A. Court/Admin. ordered support for other children
$
$
5B. 50% of actual self-employment taxes paid
$
$
5C. Mandatory retirement
$
$
5D. Actual state income taxes paid
$
$
5E. Allowable child care expenses (obligor)
$
(See LINE 5E instructions)
5F. Medical support for children (obligor)
$
0.00
5G. Total deductions
$
$
0.00
(Add lines 5A through 5F)
6.
Adjusted monthly gross income
0.00
0.00
$
(Subtract line 5G from line 4)
$
$
0.00
7A. Child support guideline amount
(From Guideline Calculation Table)
$
7B. Guideline percentage
(From Guideline Calculation Table)
%
8A. Allowable child care expenses (obligee)
$
(See LINE 8A instructions)
8B. Medical support for children (obligee)
$
8C. Total allowable obligee expenses
0.00
(Add line 8A and 8B)
$
9.
Total adjusted monthly gross income
0.00
0.00
$
$
0.00
$
0.00%
100.00%
10. Proportional share of income
0.00
0.00
11. Parental support obligation
$
$
(Line 10 times line 7A)
ABILITY TO PAY CALCULATION
12. Self-support reserve
$
(From Guideline Calculation Table)
0.00
13. Income available for support
$
(Subtract line 12 from line 9, column 1)
14. Monthly support payable
(Enter the smaller of line 11, column 1 or line 13, column 1. If line 13,
50.00
$
column 1 is less than $50.00, then a minimum order of $50.00 is entered.)
15. Presumptive child support obligation
Frequency (check one):
(If weekly, divide line 14 by 4.33; if bi-weekly, divide line 14 by 2.17;
Weekly
Bi-Weekly
if monthly, enter same amount as in line 14.)
Monthly
$
** ROUND THE RESULT TO THE NEAREST WHOLE DOLLAR **
Prepared by:
Title:
Date:
NHJB-2101-FS (04/01/2014)
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