Fillable Child Support Worksheet (Kansas Judicial Branch)

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Child Support Worksheet (Kansas Judicial Branch)

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1
Child Support Worksheet
IN THE JUDICIAL DISTRICT
COUNTY, KANSAS
IN THE MATTER OF:
and CASE NO.
CHILD SUPPORT WORKSHEET OF (name)
PARTY NAME PARTY NAME
A. INCOME COMPUTATION – WAGE EARNER
1. Domestic Gross Income $ $
(Insert on Line C.1. below)*
B. INCOME COMPUTATION – SELF-EMPLOYED
1. Self-Employment Gross Income
2. Reasonable Business Expenses (-)
3. Domestic Gross Income
(Insert on Line C.1. below)*
C. ADJUSTMENTS TO DOMESTIC GROSS INCOME
1. Domestic Gross Income
2. Court-Ordered Child Support Paid (-)
3. Court-Ordered Maintenance Paid ______% (-)
4. Court-Ordered Maintenance Received ________% (+)
5. Child Support Income
(Insert on Line D.1. below)
D. COMPUTATION OF CHILD SUPPORT
1. Child Support Income +
=
2. Proportionate Shares of Combined Income % %
(Each parent’s income divided by combined income)
3. Gross Child Support Obligation**
(Using the combined income from Line D.1.,
find the amount for each child and enter total for
all children)
Age of Children 0-5 6-11 12-18 Total
Number Per Age Category
Total Amount + + =
* Cost of Living Differential Adjustment? Yes No
**Multiple Family Application? Yes No
Parenting Time Adjustment Yes No _________%
Income Beyond the Child Support Schedule calculation used Yes No
2
Case No. PARTY NAME PARTY NAME
4. Proportionate Share (Line D.3 x Line D.2) _____________ _____________
5. Parenting Time Adjustment ______% x Line D.4 (-) _____________ _____________
6. Proportionate Shares after Parenting Time Adjustment _____________ _____________
7. Health and Dental Insurance Premium $ + $
8. Proportionate Shares Health Insurance Premium _____________ _____________
9. Work-Related Child Care Costs
Formula: Amt. – (Amt. x %)
for each child care credit
Example: 200 – (200 x 30%)
10. Proportionate Shares Work-Related Child Care Costs ____________ _____________
11. Proportionate Child Support Obligation for Each Parent _____________ _____________
(Line D.6 + D.8 + D.10)
12. Credit for Insurance or Work-Related Child Care Paid (-) ____________ _____________
13. Basic Parental Child Support Obligation
((Line 11-Line D.12); Insert on Line F.1. below)
E. CHILD SUPPORT ADJUSTMENTS
APPLICABLE N/A CATEGORY PARTY NAME PARTY NAME
1. Long Distance Parenting Time Costs (+/-) (+/-)
2. Income Tax Considerations (+/-) (+/-)
3. Special Needs (+/-) (+/-)
4. Agreement Past Majority (+/-) (+/-)
5. Overall Financial Condition (+/-) (+/-)
6. TOTAL (Insert on Line F.2. below)
3
F. DEVIATION(S) FROM REBUTTABLE PRESUMPTION AMOUNT
AMOUNT ALLOWED
PARTY NAME PARTY NAME
1. Basic Parental Child Support Obligation
(Line D.13. from above)
2. Total Child Support Adjustments (+/-)
(Line E.6. from above)
3. Adjusted Subtotal (Line F.1. +/- Line F.2.)
4. Equal Parenting Time Obligation
( EPT Worksheet or Shared Expense Formula) ______________ ___________
5. a Ability to Pay Calculation
Child Support Income (D.1) ______ - Poverty Guidelines for Household of One _____ = ______
5. b. Subtotal (lesser amount of F.3 and F.5.a) ___________ ____________
6. Social Security Dependent Benefits (-) _________ (-) ______________
6. b. Final Subtotal __________ ______________
7. Enforcement Fee Allowance** Percentage %
(Applied only to Nonresidential Parent) Flat Fee $
((Line F.3. x Collection Fee %) x .5)
or (Monthly Flat Fee x .5) (+) (+)
8. Net Parental Child Support Obligation
(Line 5.b. + Line F.4.)
**Parent paying support.
Prepared By (Signature) Judge/Hearing Officer Signature
Prepared By (Print Name)
Date Submitted Date Approved
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Child Support Worksheet (Kansas Judicial Branch)

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Completed 20 March 2021

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