Family Court Of The State Of New York County Of Page 9
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9Form 4-SM-3 page 9
Appendix B
Itemization of Income and Deductions of Custodial
and Non-Custodial Parents
[FCA §§413( l)(a), 413(1) (b), 413(1)(c), 413(1)(f)]
1.
Petitioner's
weekly
monthly expenses are: [itemize]:
2.
Petitioner's
weekly
monthly sources of income are: [itemize]:
3.
Respondent's
weekly
monthly expenses are: [itemize]:
4. Respondent's
weekly
monthly sources of income are: [itemize]:
5. The
weekly
monthly needs of the following children are: [itemize as to each child]:
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