Child Support Guidelines Worksheet

Enter the requested information in the fields provided. If changes are necessary for a section you had already completed, it’s best to start over to ensure that the the calculations are still correct.

Father

Mother

Total

1. Present Net Monthly Income

Enter the amount from line number 27, Section I of Florida Family Law Rules of Procedure Form 12.902(b) or (c), Financial Affidavit.

Father:

Mother:

Total:

2. Basic Monthly Obligation

Indicate how many minor children are common to the parties.

Full Amount:

3. Percent of Financial Responsibility

Father:

Mother:

4. Share of Basic Monthly Obligation

Father:

Mother:

5a. 100% of Monthly Child Care Costs

[Child care costs should not exceed the level required to provide quality care from a licensed source. See section 61.30(7), Fla. Stat. for more information.]

5b. Total Monthly Child(ren)’s Health Insurance Cost

[This is only amounts actually paid for health insurance on the child(ren).]

5c. Total Monthly Child(ren)’s Noncovered Medical, Dental and Prescription Medication Costs

5d. Total Monthly Child Care & Health Costs

6. Additional Support Payments

Father:

Mother:

7a. Monthly Child Care Payments Actually Made

Father:

Mother:

7b. Monthly Health Insurance Payments Actually Made

Father:

Mother:

7c. Other Payments/Credits Actually Made for Any Noncovered Medical, Dental and Prescription Medication Expenses of the Child(ren) Not Ordered to be Separately Paid on a Percentage Basis

[See § 61.30 (8), Florida Statutes]

Father:

Mother:

8. Total Support Payments Actually Made

Father:

Mother:

9. Minimum Child Support Obligation For Each Parent*

Father:

Mother:

*The parent who exercises time-sharing less than 20% pays the other parent.

Substantial Time-Sharing (Gross Up Method) If each parent exercises time-sharing at least 20 percent of the overnights in the year (73 overnights in the year), complete numbers 10 through 21.

Note: If one parent does not exercise time-sharing at least 20%, then the figure in number 9 above sets forth the child support amount and it is not necessary to complete Numbers 10 through 21.

10. Basic Monthly Obligation Multiplied by 150%

11. Increased Basic Obligation For Each Parent

Father:

Mother:

12. Number of Overnight Stays With Each Parent

The total between the two must equal 365.

Father:

Mother:

13. Parent’s Support Multiplied by Other Parent’s Percentage of Overnights

Father:

Mother:

14a. Total Monthly Child Care Costs

[Child care costs should not exceed the level required to provide quality care from a licensed source. See section 61.30(7), Fla. Stat. for more information.]

14b. Total Monthly Child(ren)’s Health Insurance Cost

[This is only amounts actually paid for health insurance on the child(ren).]

14c. Total Monthly Child(ren)’s Noncovered Medical, Dental and Prescription Costs.

14d. Total Monthly Child Care & Health Costs

15. Additional Support Payments

Father:

Mother:

16a. Monthly Child Care Payments Actually Made

Father:

Mother:

16b. Monthly Health Insurance Payments Actually Made

Father:

Mother:

16c. Other Payments/Credits Actually Made For Any Noncovered Medical, Dental and Prescription Medication Expenses of the Child(ren) Not Ordered to be Separately Paid on a Percentage Basis. [See § 61.30 (8), Florida Statutes]

Father:

Mother:

17. Total Support Payments actually made.

Father:

Mother:

18. Total Additional Support Transfer Amount

Father:

Mother:

19. Total Child Support Owed from Father to Mother

20. Total Child Support Owed from Mother to Father

21. Actual Child Support to be Paid

Father:

Mother:

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