Child Support Calculation Worksheet

IMPORTANT: THIS IS A PREPARATION GUIDE — NOT THE OFFICIAL COURT WORKSHEET

Ohio requires the use of official form JFS 07768 (Sole/Shared Parenting Worksheet) or JFS 07769 (Split Parenting Worksheet) for child support calculations.
This template provides the substantive content and calculation methodology to help you
prepare — but you must transfer your figures to the official worksheet before filing.
The official forms are available at https://jfs.ohio.gov.
Do not file this document directly with the court.

CHILD SUPPORT CALCULATION WORKSHEET

State of Ohio -- Income Shares Model

ORC Chapter 3119

Table of Contents

1. Case Information
2. Identification of Children
3. Gross Income Determination
4. Adjustments to Gross Income
5. Combined Adjusted Gross Income
6. Basic Child Support Obligation
7. Healthcare and Medical Support
8. Childcare Costs
9. Deviation Factors
10. Duration and Modification
11. Certification and Signatures
12. Sources and References

1. Case Information

Worksheet Type:

☐ Sole Residential Parent (JFS 07768)

☐ Split Parental Rights / Shared Parenting (JFS 07769)

2. Identification of Children

Total Number of Children Subject to This Order: [____]

Residential Parent / Legal Custodian (Obligee): ☐ Parent 1 ☐ Parent 2

Non-Residential Parent (Obligor): ☐ Parent 1 ☐ Parent 2

3. Gross Income Determination

3A. Annual Gross Income

3B. Imputed Income (If Applicable)

☐ Parent 1 voluntarily unemployed/underemployed -- Imputed annual income: $[________]

☐ Parent 2 voluntarily unemployed/underemployed -- Imputed annual income: $[________]

4. Adjustments to Gross Income

5. Combined Adjusted Gross Income

Combined Adjusted Annual Gross Income: $[________]

Parent 1's Percentage of Combined Income: [________]%

Parent 2's Percentage of Combined Income: [________]%

6. Basic Child Support Obligation

Self-Sufficiency Reserve

☐ Not applicable

☐ Obligor's income falls below the self-sufficiency reserve (ORC S 3119.01) -- minimum order applies

Adjusted monthly obligation: $[________]

7. Healthcare and Medical Support

7A. Health Insurance

Health insurance currently provided by: ☐ Parent 1 ☐ Parent 2 ☐ Neither

7B. Cash Medical Support

7C. Extraordinary Medical Expenses

☐ Separate order for extraordinary medical expenses to be issued

Allocation: Parent 1: [________]% / Parent 2: [________]%

8. Childcare Costs

☐ Child is over age 12 -- special circumstances justifying childcare: [________________________________]

9. Deviation Factors

☐ No deviation requested

☐ Deviation requested -- Check all applicable factors (ORC S 3119.23):

• ☐ Special and unusual needs of the child (physical or psychological)
• ☐ Other court-ordered payments
• ☐ Extended parenting time or extraordinary costs associated with parenting time
• ☐ Financial resources and earning ability of the child(ren)
• ☐ Relative financial resources and income disparity between households
• ☐ Obligee's income at or below 100% of the federal poverty level
• ☐ Benefits the child receives from a parent (Social Security, veterans')
• ☐ Ability of each parent to maintain adequate housing
• ☐ Parents' expenses (childcare, school tuition, medical/dental)
• ☐ Other relevant circumstances: [________________________________]

Requested deviation amount: $[________]/month

Justification: [________________________________]

10. Duration and Modification

Support Commencement Date: [__/__/____]

Termination Events:

• ☐ Child reaches age 18 (or 19 if still in high school)
• ☐ 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 Method: ☐ Income Withholding ☐ Ohio CSEA ☐ Direct Payment

11. Certification and Signatures

I declare under penalty of perjury under the laws of the State of Ohio that the foregoing information is true and correct to the best of my knowledge and belief.

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: [__/__/____]

12. Sources and References

• ORC Chapter 3119 (Child Support)
• ORC S 3119.01 (Definitions, including Self-Sufficiency Reserve)
• ORC S 3119.021 (Basic Child Support Schedule)
• ORC S 3119.05 (Worksheets)
• ORC SS 3119.22-3119.24 (Deviation from Schedule)
• ORC S 3119.27 (Health Insurance)
• ORC SS 3119.29-3119.303 (Cash Medical Support)
• ORC S 3119.79 (Modification)
• Ohio JFS Forms: JFS 07768 (Sole Residential Parent Worksheet), JFS 07769 (Split/Shared Parenting Worksheet)
• Ohio Department of Job and Family Services: https://jfs.ohio.gov/child-support

Ohio requires mandatory use of JFS worksheets. The health insurance maximum is 5% of annual gross income. Childcare costs are capped at the Ohio Child Care Market Rate Survey amounts with a presumptive age 12 limit. Deviations require specific written findings of fact per ORC S 3119.22.