Form 4-SM-3 page 8
expenditures)
26.
Alimony or maintenance actually paid to non-party
spouse pursuant to court order or agreement
27.
Alimony or maintenance actually paid or to be
paid to party-spouse pursuant to court
order or agreement
28.
Child support actually paid pursuant to court order
or agreement for non-party child
29.
Family assistance
30.
Supplemental social security income
31.
N.Y.C. or Yonkers taxes
32.
Federal Insurance Contributions Act (FICA) taxes
33.
TOTAL DEDUCTIONS
$
Health Insurance: Insurance available?
yes
no
34.
NON-CUSTODIAL PARENT’S NET INCOME
$
35.
COMBINED PARENTAL INCOME (Line 17 plus line 34) $
Child Support Standards Act child support percentages [Family Court Act §§413(1)(b)(3), 413(1)(c)]:
17% of the combined parental income for one child;
25% of the combined parental income for two children;
29% of the combined parental income for three children;
31% of the combined parental income for four children;
No less than 35% of the combined parental income for five or more children.
Combined parental income up to $80,000 [Effective 1/31/2010: $130,000] to be multiplied by the
appropriate child support percentage and pro rated in the same proportion as each parent's income bears
to the combined parental income.