Child Support Guidelines Worksheet Page 3

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III. CALCULATIONS OF THE GUIDELINE AMOUNT OF SUPPORT
A. Custodial parent’s net monthly income
$
Noncustodial parent’s net monthly income
$
B. Number of children for whom support is sought
Guideline percentage
%
C. Guideline amount of child support
$
IV. EXTRAORDINARY VISITATION ADJUSTMENT
(only if court -ordered visitation exceeds 127 overnights per year)
A. Guideline amount of child support
$
B. # of court-ordered visitation overnights with non-custodial parent
C. Extraordinary Visitation Adjustment Percentage:
%
If Line B above is 128-147 overnights
25% credit
If Line B above is 148-166 overnights
30% credit
If Line B above is 167 or more overnights 35% credit
D. Extraordinary Visitation Adjustment (Line A times C)
$
E.
Guideline Amount Adjusted for Extraordinary Visitation
$
(Line A minus Line D
V. SPECIAL FINDINGS
A. Income imputed to Petitioner/Respondent
B. Estimated income of Petitioner/Respondent.
C. Deviations made from Child Support Guidelines.
D. Requested amount of child support.
$
STATE OF IOWA, COUNTY OF
: ss:
I,
, do hereby swear or affirm that the foregoing statement is true,
complete and correct as I verify believe from all information available to me at this time.
Date:
(Petitioner/Respondent)

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