Complaint For Divorce Page 35

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7.
The Court finds that health insurance that provides for the health care needs of the child
□ is/ □ is not reasonably available at a reasonable cost. If provided, it will be provided by
______________________________________________.
8.
(a)
The Court finds as set on the “Child Support Worksheet” and Schedule “D,” the
Presumptive Amount of Child Support for the Custodial Parent is $_________________
Presumptive Amount of Child Support for the Custodial Parent is
$_________________
(b)
The Court finds as set on the “Child Support Worksheet” and Schedule “D,” the
Presumptive Amount of Child Support due to the Non-custodial Parent is $_________________
(c)
The Court finds as set on the “Child Support Worksheet” and Schedule “D,” the
Presumptive Amount of Child Support due to the Custodial Parent is
$_________________
9.
The Court finds that the child receives benefits under Title II of the Federal Social
Security Act on the obligor’s account and the amount the child receives on a monthly basis is
$__________________
10. The Court has considered the existence of special circumstances and as set forth on the
“Child Support Worksheet” and Schedule “E,” has found the following special circumstances
marked with an [“X”] to be present in this case.
Note: Refer to Schedule “E” and, where applicable, “Special
Interrogatories” attached hereto for an explanation for the reasons for
the deviation, how the application of the Presumptive Amount of Child
Support would have been unjust and how the best interest of the child for
whom support is being determined will be served by a deviation from the
Presumptive Amount of Child Support.
_____ A. High Income
_____ B. Low Income
_____ C. Other Health-Related Insurance
_____ D. Life Insurance
_____ E. Child and Dependent Care Tax Credit
_____ F. Travel Expenses
_____ G. Alimony
_____ H. Mortgage
_____ I. Permanent Plan or Foster Care Plan
_____ J. Extraordinary Expenses
_____ K. Parenting Time
_____ L. Non-Specific Deviations (Other)
36

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