CHILD SUPPORT CALCULATION WORKSHEET

State of Vermont

Court: [________________________________] Superior Court, Family Division
County: [________________________________]
Docket No.: [________________________________]
Judge/Magistrate: [________________________________]

TABLE OF CONTENTS

1. Party and Children Identification
2. Calculation Model
3. Gross Income Determination
4. Adjustments to Income
5. Child Support Obligation Formula
6. Healthcare Expenses
7. Childcare Expenses
8. Extraordinary Expenses
9. Deviation Factors
10. Duration and Termination
11. State-Specific Notes

1. PARTY AND CHILDREN IDENTIFICATION

Parent A (Obligor):
- Full Name: [________________________________]
- Date of Birth: [__/__/____]
- Employer: [________________________________]

Parent B (Obligee):
- Full Name: [________________________________]
- Date of Birth: [__/__/____]
- Employer: [________________________________]

Children Subject to This Order:

Custody Arrangement:
☐ One parent has primary physical custody
☐ Shared Physical Custody (each parent has child 30%+ of the time)
☐ Split Custody

2. CALCULATION MODEL

Model: Income Shares per 15 V.S.A. § 656
Number of Children: [____]

3. GROSS INCOME DETERMINATION

4. ADJUSTMENTS TO INCOME

5. CHILD SUPPORT OBLIGATION FORMULA

Step 1: Combined Available Income: $[________]

Step 2: Basic Child Support Obligation from VT Guidelines (for [__] children): $[________]

Step 3: Each Parent's Percentage:
- Parent A: $[________] / $[________] = [____]%
- Parent B: $[________] / $[________] = [____]%

Step 4: Each Parent's Share:
- Parent A: $[________] x [____]% = $[________]
- Parent B: $[________] x [____]% = $[________]

Step 5: Shared Custody Adjustment (if applicable — each parent has 30%+ time):
☐ Not applicable
☐ Cross-credit calculation applied

Base Child Support Amount: $[________] per month

6. HEALTHCARE EXPENSES

☐ Uninsured medical expenses divided proportionally: Parent A [____]% / Parent B [____]%

7. CHILDCARE EXPENSES

8. EXTRAORDINARY EXPENSES

9. DEVIATION FACTORS

☐ No deviation requested
☐ Deviation requested based on:

☐ Financial resources of the child
☐ Financial resources of parents
☐ Standard of living during the marriage
☐ Physical and emotional health of the child
☐ Educational needs of the child
☐ Extraordinary travel expenses for visitation
☐ Other: [________________________________]

Deviation Amount: $[________] per month
Written Justification: [________________________________]

10. DURATION AND TERMINATION

Child support continues until the earliest of:
- Child reaches age 18
- Child is otherwise emancipated
- Further order of the court

11. STATE-SPECIFIC NOTES

• Office of Child Support (OCS): Can help establish, modify, and enforce support orders.
• Maintenance Supplement: The court may order a maintenance supplement in addition to child support (separate from spousal maintenance).
• Military Families: Special considerations apply under 15 V.S.A. § 656 for parents in the military.
• Income Imputation: Court may impute income based on earning capacity.
• Self-Support Reserve: Guidelines ensure the obligor retains income for basic needs.

SUMMARY OF CHILD SUPPORT OBLIGATION

Paid by [________________] to [________________]: $[________] per month

Prepared By: [________________________________]
Date: [__/__/____]
VT Bar No.: [________]

Sources and References:
- Vermont Judiciary — Child Support
- Vermont Office of Child Support
- 15 V.S.A. §§ 650–670