CHILD SUPPORT CALCULATION WORKSHEET
State of California -- Statewide Uniform Guideline
Cal. Fam. Code SS 4050-4076
Table of Contents
- Case Information
- Identification of Children
- Gross Income Determination
- Deductions from Gross Income
- Net Monthly Disposable Income
- Guideline Formula Calculation
- Additional Child Support (Add-Ons)
- Deviation Factors
- Duration and Modification
- Certification and Signatures
- Sources and References
1. Case Information
| Field | Entry |
|---|---|
| Court Name | [________________________________] |
| Case Number | [________________________________] |
| Petitioner (Parent 1) | [________________________________] |
| Respondent (Parent 2) | [________________________________] |
| Date of Worksheet | [__/__/____] |
| Prepared By | [________________________________] |
2. Identification of Children
| # | Full Legal Name | Date of Birth | Age | Currently Residing With |
|---|---|---|---|---|
| 1 | [________________________________] | [__/__/____] | [____] | [________________________________] |
| 2 | [________________________________] | [__/__/____] | [____] | [________________________________] |
| 3 | [________________________________] | [__/__/____] | [____] | [________________________________] |
| 4 | [________________________________] | [__/__/____] | [____] | [________________________________] |
Total Number of Children Subject to This Order: [____]
3. Gross Income Determination
3A. Monthly Gross Income
| Income Source | Parent 1 ($) | Parent 2 ($) |
|---|---|---|
| Wages, Salary, Tips | [________] | [________] |
| Commissions / Bonuses | [________] | [________] |
| Overtime | [________] | [________] |
| Self-Employment Income (receipts minus operating expenses) | [________] | [________] |
| Unemployment / Disability Benefits | [________] | [________] |
| Workers' Compensation | [________] | [________] |
| Social Security Benefits | [________] | [________] |
| Pensions / Retirement | [________] | [________] |
| Dividends / Interest | [________] | [________] |
| Rental Income | [________] | [________] |
| Spousal Support Received | [________] | [________] |
| Trust Income | [________] | [________] |
| Annuity Payments | [________] | [________] |
| Other Income: [________________] | [________] | [________] |
| TOTAL MONTHLY GROSS INCOME | [________] | [________] |
3B. Imputed Income (If Applicable)
☐ The court has found Parent 1 voluntarily unemployed/underemployed -- Imputed income: $[________]/month
☐ The court has found Parent 2 voluntarily unemployed/underemployed -- Imputed income: $[________]/month
4. Deductions from Gross Income
4A. Mandatory Deductions
| Deduction | Parent 1 ($) | Parent 2 ($) |
|---|---|---|
| State Income Tax | [________] | [________] |
| Federal Income Tax | [________] | [________] |
| FICA (Social Security / Medicare) | [________] | [________] |
| State Disability Insurance (SDI) | [________] | [________] |
| Mandatory Union Dues | [________] | [________] |
| Mandatory Retirement Contributions (condition of employment) | [________] | [________] |
| Health Insurance Premiums (parent only) | [________] | [________] |
| Health Insurance Premiums (children of this order) | [________] | [________] |
| Court-Ordered Support Paid to Non-Parties | [________] | [________] |
| Job-Related Expenses (per Fam. Code S 4059(d)) | [________] | [________] |
| TOTAL MANDATORY DEDUCTIONS | [________] | [________] |
4B. Hardship Deductions (Fam. Code SS 4070-4073)
| Hardship Item | Parent 1 ($) | Parent 2 ($) |
|---|---|---|
| Extraordinary Health Expenses | [________] | [________] |
| Uninsured Catastrophic Losses | [________] | [________] |
| Minimum Basic Living Expenses of Minor Children from Other Relationships | [________] | [________] |
| TOTAL HARDSHIP DEDUCTIONS | [________] | [________] |
5. Net Monthly Disposable Income
| Calculation | Parent 1 ($) | Parent 2 ($) |
|---|---|---|
| Total Monthly Gross Income (from 3A) | [________] | [________] |
| Less: Total Mandatory Deductions (from 4A) | ([________]) | ([________]) |
| Less: Total Hardship Deductions (from 4B) | ([________]) | ([________]) |
| NET MONTHLY DISPOSABLE INCOME | [________] | [________] |
TN (Total Net Monthly Disposable Income of Both Parents): $[________]
HN (High Earner's Net Monthly Disposable Income): $[________]
6. Guideline Formula Calculation. K is derived from a statutory table based on the number of children and the combined income allocated to support. H% is the approximate percentage of time the high earner has primary physical responsibility for the children.]
6A. Time-Share Percentage
| Parent | Approximate % of Time with Children |
|---|---|
| Parent 1 | [________]% |
| Parent 2 | [________]% |
H% (High Earner's Time-Share Percentage): [________]%
6B. K Factor Determination
Number of Children: [____]
| Number of Children | K Factor (Total Net Disposable Income Allocated) |
|---|---|
| 1 child | One child plus K adjustments per S 4055(b)(3) |
| 2 children | Two children plus K adjustments per S 4055(b)(4) |
| 3+ children | Three or more children per S 4055(b)(5) |
K Value Used: [________]
6C. Guideline Amount
CS = K [ HN - (H%)(TN) ]
CS = [________] x [ $[________] - ([________]% x $[________]) ]
CS = $[________] per month
6D. Low-Income Adjustment (Fam. Code S 4057.5)
☐ Not applicable
☐ Applicable -- The obligor's net disposable income is below the low-income threshold
Adjusted guideline amount after low-income adjustment: $[________]/month
7. Additional Child Support (Add-Ons)
| Add-On Expense | Monthly Cost ($) | Parent 1 Share ($) | Parent 2 Share ($) |
|---|---|---|---|
| Work-Related Childcare (S 4062(a)(1)) | [________] | [________] | [________] |
| Uninsured Healthcare Costs (S 4062(a)(2)) | [________] | [________] | [________] |
| Educational Costs or Special Needs (S 4062(b)) | [________] | [________] | [________] |
| Travel for Visitation (S 4062(b)) | [________] | [________] | [________] |
| Other: [________________] | [________] | [________] | [________] |
| TOTAL ADD-ONS | [________] | [________] | [________] |
8. Deviation Factors
☐ No deviation requested
☐ Deviation requested -- Check all applicable factors:
- ☐ Extraordinarily high income where guideline amount exceeds children's reasonable needs
- ☐ A parent is not contributing to the needs of the children commensurate with custodial time
- ☐ Special circumstances render application of the formula unjust or inappropriate
- ☐ Different time-sharing arrangements for different children
- ☐ Equal time-sharing with asymmetric housing-cost burdens
- ☐ Children with special medical or other needs
- ☐ Other: [________________________________]
Requested deviation amount: $[________]/month
Justification: [________________________________]
9. Duration and Modification
Support Commencement Date: [__/__/____]
Anticipated Termination Events:
- ☐ Child reaches age 18 (or 19 if still in high school full-time)
- ☐ Child becomes emancipated
- ☐ Child marries
- ☐ Child enters military active duty
- ☐ Child dies
- ☐ Other: [________________________________]
Total Monthly Child Support Amount: $[________]
Payable by: ☐ Parent 1 ☐ Parent 2
Payment frequency: ☐ Monthly ☐ Bi-monthly ☐ Per pay period
10. Certification and Signatures
I declare under penalty of perjury under the laws of the State of California that the foregoing information is true and correct to the best of my knowledge.
Parent 1:
Signature: [________________________________]
Printed Name: [________________________________]
Date: [__/__/____]
Parent 2:
Signature: [________________________________]
Printed Name: [________________________________]
Date: [__/__/____]
Attorney for Parent 1 (if applicable):
Signature: [________________________________]
Bar Number: [________________________________]
Date: [__/__/____]
Attorney for Parent 2 (if applicable):
Signature: [________________________________]
Bar Number: [________________________________]
Date: [__/__/____]
11. Sources and References
- California Family Code SS 4050-4076 (Statewide Uniform Guideline)
- California Family Code S 4055 (Guideline Formula)
- California Family Code S 4057 (Presumption of Correctness)
- California Family Code S 4057.5 (Low-Income Adjustment)
- California Family Code S 4058 (Annual Gross Income Definition)
- California Family Code S 4059 (Deductions from Gross Income)
- California Family Code SS 4060-4064 (Net Disposable Income Computation)
- California Family Code SS 4062, 4066-4069 (Additional Child Support / Add-Ons)
- California Family Code SS 4070-4073 (Hardship Deductions)
- Judicial Council Forms: FL-150 (Income and Expense Declaration), FL-155 (Financial Statement)
- California Courts Self-Help: https://www.courts.ca.gov/selfhelp-support.htm
This worksheet is intended as a calculation aid and does not replace the official judicial forms required by the California courts. The income of a subsequent spouse or nonmarital partner is generally not considered except in extraordinary cases of extreme hardship (Fam. Code S 4057.5).
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