INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM
12.902(e), CHILD SUPPORT GUIDELINES WORKSHEET (09/12)
When should this form be used?
You should complete this worksheet if child support is being requested in your case. If you know the
income of the other party, this worksheet should accompany your financial affidavit. If you do not
know the other party’s income, this form must be completed after the other party files his or her
financial affidavit, and serves a copy on you.
This form should be typed or printed in black ink. You should file the original with the clerk of the circuit
court in the county where your case is filed and keep a copy for your records.
What should I do next?
A copy of this form must be served on the other party in your case. Service must be in accordance with
Florida Rule of Judicial Administration 2.516.
Where can I look for more information?
Before proceeding, you should read “General Information for Self-Represented Litigants” found at the
beginning of these forms. The words that are in bold underline in these instructions are defined
there. For further information, see section 61.30, Florida Statutes.
Special notes...
If you want to keep your address confidential because you are the victim of sexual battery, aggravated
child abuse, aggravated stalking, harassment, aggravated battery or domestic violence, do not enter the
address, telephone, and fax information at the bottom of this form. Instead, file Request for
Confidential Filing of Address, Florida Supreme Court Approved Family Law Form 12.980(h).
The chart below contains the guideline amounts that you should use when calculating child support.
This amount is based on the number of children and the combined income of the parents, and it is
divided between the parents in direct proportion to their income or earning capacity. From time to
time, some of the amounts in the child support guidelines chart will change. Be sure you have the most
recent version of the chart before using it.
Because the guidelines are based on monthly amounts, it may be necessary to convert some income and
expense figures from other frequencies to monthly. You should do this as follows:
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet
(09/12)
If payment is twice per month Payment amount x 2 = Monthly amount
If payment is every two weeks Payment amount x 26 = Yearly amount due
Yearly amount ÷ 12 = Monthly amount
If payment is weekly Weekly amount x 52 = Yearly amount due
Yearly amount ÷ 12 = Monthly amount
If you or the other parent request that the court award an amount that is different than the guideline
amount, you must also complete and attach a Motion to Deviate from Child Support Guidelines, Florida
Supreme Court Approved Family Law Form 12.943.
Remember, a person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out
these forms, that person must give you a copy of a Disclosure from Nonlawyer, Florida Family Law Rules
of Procedure Form 12.900(a), before he or she helps you. A nonlawyer helping you fill out these forms
also must put his or her name, address, and telephone number on the bottom of the last page of every
form he or she helps you complete.
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet
(09/12)
CHILD SUPPORT GUIDELINES CHART
Combined
One
Two
Three
Four
Five
Six
Monthly
Child
Children
Children
Children
Children
Children
Available
Income
800.00
190
211
213
216
218
220
850.00
202
257
259
262
265
268
900.00
213
302
305
309
312
315
950.00
224
347
351
355
359
363
1000.00
235
365
397
402
406
410
1050.00
246
382
443
448
453
458
1100.00
258
400
489
495
500
505
1150.00
269
417
522
541
547
553
1200.00
280
435
544
588
594
600
1250.00
290
451
565
634
641
648
1300.00
300
467
584
659
688
695
1350.00
310
482
603
681
735
743
1400.00
320
498
623
702
765
790
1450.00
330
513
642
724
789
838
1500.00
340
529
662
746
813
869
1550.00
350
544
681
768
836
895
1600.00
360
560
701
790
860
920
1650.00
370
575
720
812
884
945
1700.00
380
591
740
833
907
971
1750.00
390
606
759
855
931
996
1800.00
400
622
779
877
955
1022
1850.00
410
638
798
900
979
1048
1900.00
421
654
818
923
1004
1074
1950.00
431
670
839
946
1029
1101
2000.00
442
686
859
968
1054
1128
2050.00
452
702
879
991
1079
1154
2100.00
463
718
899
1014
1104
1181
2150.00
473
734
919
1037
1129
1207
2200.00
484
751
940
1060
1154
1234
2250.00
494
767
960
1082
1179
1261
2300.00
505
783
980
1105
1204
1287
2350.00
515
799
1000
1128
1229
1314
2400.00
526
815
1020
1151
1254
1340
2450.00
536
831
1041
1174
1279
1367
2500.00
547
847
1061
1196
1304
1394
2550.00
557
864
1081
1219
1329
1420
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines
Worksheet (09/12)
Combined
One
Two
Three
Four
Five
Six
Monthly
Child
Children
Children
Children
Children
Children
Available
Income
2600.00
568
880
1101
1242
1354
1447
2650.00
578
896
1121
1265
1379
1473
2700.00
588
912
1141
1287
1403
1500
2750.00
597
927
1160
1308
1426
1524
2800.00
607
941
1178
1328
1448
1549
2850.00
616
956
1197
1349
1471
1573
2900.00
626
971
1215
1370
1494
1598
2950.00
635
986
1234
1391
1517
1622
3000.00
644
1001
1252
1412
1540
1647
3050.00
654
1016
1271
1433
1563
1671
3100.00
663
1031
1289
1453
1586
1695
3150.00
673
1045
1308
1474
1608
1720
3200.00
682
1060
1327
1495
1631
1744
3250.00
691
1075
1345
1516
1654
1769
3300.00
701
1090
1364
1537
1677
1793
3350.00
710
1105
1382
1558
1700
1818
3400.00
720
1120
1401
1579
1723
1842
3450.00
729
1135
1419
1599
1745
1867
3500.00
738
1149
1438
1620
1768
1891
3550.00
748
1164
1456
1641
1791
1915
3600.00
757
1179
1475
1662
1814
1940
3650.00
767
1194
1493
1683
1837
1964
3700.00
776
1208
1503
1702
1857
1987
3750.00
784
1221
1520
1721
1878
2009
3800.00
793
1234
1536
1740
1899
2031
3850.00
802
1248
1553
1759
1920
2053
3900.00
811
1261
1570
1778
1940
2075
3950.00
819
1275
1587
1797
1961
2097
4000.00
828
1288
1603
1816
1982
2119
4050.00
837
1302
1620
1835
2002
2141
4100.00
846
1315
1637
1854
2023
2163
4150.00
854
1329
1654
1873
2044
2185
4200.00
863
1342
1670
1892
2064
2207
4250.00
872
1355
1687
1911
2085
2229
4300.00
881
1369
1704
1930
2106
2251
4350.00
889
1382
1721
1949
2127
2273
4400.00
898
1396
1737
1968
2147
2295
4450.00
907
1409
1754
1987
2168
2317
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines
Worksheet (09/12)
Combined
One
Two
Three
Four
Five
Six
Monthly
Child
Children
Children
Children
Children
Children
Available
Income
4500.00
916
1423
1771
2006
2189
2339
4550.00
924
1436
1788
2024
2209
2361
4600.00
933
1450
1804
2043
2230
2384
4650.00
942
1463
1821
2062
2251
2406
4700.00
951
1477
1838
2081
2271
2428
4750.00
959
1490
1855
2100
2292
2450
4800.00
968
1503
1871
2119
2313
2472
4850.00
977
1517
1888
2138
2334
2494
4900.00
986
1530
1905
2157
2354
2516
4950.00
993
1542
1927
2174
2372
2535
5000.00
1000
1551
1939
2188
2387
2551
5050.00
1006
1561
1952
2202
2402
2567
5100.00
1013
1571
1964
2215
2417
2583
5150.00
1019
1580
1976
2229
2432
2599
5200.00
1025
1590
1988
2243
2447
2615
5250.00
1032
1599
2000
2256
2462
2631
5300.00
1038
1609
2012
2270
2477
2647
5350.00
1045
1619
2024
2283
2492
2663
5400.00
1051
1628
2037
2297
2507
2679
5450.00
1057
1638
2049
2311
2522
2695
5500.00
1064
1647
2061
2324
2537
2711
5550.00
1070
1657
2073
2338
2552
2727
5600.00
1077
1667
2085
2352
2567
2743
5650.00
1083
1676
2097
2365
2582
2759
5700.00
1089
1686
2109
2379
2597
2775
5750.00
1096
1695
2122
2393
2612
2791
5800.00
1102
1705
2134
2406
2627
2807
5850.00
1107
1713
2144
2418
2639
2820
5900.00
1111
1721
2155
2429
2651
2833
5950.00
1116
1729
2165
2440
2663
2847
6000.00
1121
1737
2175
2451
2676
2860
6050.00
1126
1746
2185
2462
2688
2874
6100.00
1131
1754
2196
2473
2700
2887
6150.00
1136
1762
2206
2484
2712
2900
6200.00
1141
1770
2216
2495
2724
2914
6250.00
1145
1778
2227
2506
2737
2927
6300.00
1150
1786
2237
2517
2749
2941
6350.00
1155
1795
2247
2529
2761
2954
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines
Worksheet (09/12)
Combined
One
Two
Three
Four
Five
Six
Monthly
Child
Children
Children
Children
Children
Children
Available
Income
6400.00
1160
1803
2258
2540
2773
2967
6450.00
1165
1811
2268
2551
2785
2981
6500.00
1170
1819
2278
2562
2798
2994
6550.00
1175
1827
2288
2573
2810
3008
6600.00
1179
1835
2299
2584
2822
3021
6650.00
1184
1843
2309
2595
2834
3034
6700.00
1189
1850
2317
2604
2845
3045
6750.00
1193
1856
2325
2613
2854
3055
6800.00
1196
1862
2332
2621
2863
3064
6850.00
1200
1868
2340
2630
2872
3074
6900.00
1204
1873
2347
2639
2882
3084
6950.00
1208
1879
2355
2647
2891
3094
7000.00
1212
1885
2362
2656
2900
3103
7050.00
1216
1891
2370
2664
2909
3113
7100.00
1220
1897
2378
2673
2919
3123
7150.00
1224
1903
2385
2681
2928
3133
7200.00
1228
1909
2393
2690
2937
3142
7250.00
1232
1915
2400
2698
2946
3152
7300.00
1235
1921
2408
2707
2956
3162
7350.00
1239
1927
2415
2716
2965
3172
7400.00
1243
1933
2423
2724
2974
3181
7450.00
1247
1939
2430
2733
2983
3191
7500.00
1251
1945
2438
2741
2993
3201
7550.00
1255
1951
2446
2750
3002
3211
7600.00
1259
1957
2453
2758
3011
3220
7650.00
1263
1963
2461
2767
3020
3230
7700.00
1267
1969
2468
2775
3030
3240
7750.00
1271
1975
2476
2784
3039
3250
7800.00
1274
1981
2483
2792
3048
3259
7850.00
1278
1987
2491
2801
3057
3269
7900.00
1282
1992
2498
2810
3067
3279
7950.00
1286
1998
2506
2818
3076
3289
8000.00
1290
2004
2513
2827
3085
3298
8050.00
1294
2010
2521
2835
3094
3308
8100.00
1298
2016
2529
2844
3104
3318
8150.00
1302
2022
2536
2852
3113
3328
8200.00
1306
2028
2544
2861
3122
3337
8250.00
1310
2034
2551
2869
3131
3347
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines
Worksheet (09/12)
Combined
One
Two
Three
Four
Five
Six
Monthly
Child
Children
Children
Children
Children
Children
Available
Income
8300.00
1313
2040
2559
2878
3141
3357
8350.00
1317
2046
2566
2887
3150
3367
8400.00
1321
2052
2574
2895
3159
3376
8450.00
1325
2058
2581
2904
3168
3386
8500.00
1329
2064
2589
2912
3178
3396
8550.00
1333
2070
2597
2921
3187
3406
8600.00
1337
2076
2604
2929
3196
3415
8650.00
1341
2082
2612
2938
3205
3425
8700.00
1345
2088
2619
2946
3215
3435
8750.00
1349
2094
2627
2955
3224
3445
8800.00
1352
2100
2634
2963
3233
3454
8850.00
1356
2106
2642
2972
3242
3464
8900.00
1360
2111
2649
2981
3252
3474
8950.00
1364
2117
2657
2989
3261
3484
9000.00
1368
2123
2664
2998
3270
3493
9050.00
1372
2129
2672
3006
3279
3503
9100.00
1376
2135
2680
3015
3289
3513
9150.00
1380
2141
2687
3023
3298
3523
9200.00
1384
2147
2695
3032
3307
3532
9250.00
1388
2153
2702
3040
3316
3542
9300.00
1391
2159
2710
3049
3326
3552
9350.00
1395
2165
2717
3058
3335
3562
9400.00
1399
2171
2725
3066
3344
3571
9450.00
1403
2177
2732
3075
3353
3581
9500.00
1407
2183
2740
3083
3363
3591
9550.00
1411
2189
2748
3092
3372
3601
9600.00
1415
2195
2755
3100
3381
3610
9650.00
1419
2201
2763
3109
3390
3620
9700.00
1422
2206
2767
3115
3396
3628
9750.00
1425
2210
2772
3121
3402
3634
9800.00
1427
2213
2776
3126
3408
3641
9850.00
1430
2217
2781
3132
3414
3647
9900.00
1432
2221
2786
3137
3420
3653
9950.00
1435
2225
2791
3143
3426
3659
10000.00
1437
2228
2795
3148
3432
3666
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines
Worksheet (09/12)
IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,
IN AND FOR COUNTY, FLORIDA
Case No.:
Division:
,
Petitioner,
and
,
Respondent.
NOTICE OF FILING CHILD SUPPORT GUIDELINES WORKSHEET
PLEASE TAKE NOTICE, that {name} _______, is filing his/her
Child Support Guidelines Worksheet attached and labeled Exhibit 1.
CERTIFICATE OF SERVICE
I certify that a copy of this Notice of Filing with the Child Support Guidelines Worksheet was
[check all used]: ( ) e-mailed ( ) mailed ( ) faxed ( ) hand delivered to the person(s) listed
below on {date} __________.
Other party or his/her attorney:
Name: _____________________________
Address: ____________________________
City, State, Zip: _______________________
Fax Number: _________________________
E-mail Address(es): _____________________
Signature of Party or his/her Attorney
Printed Name: _________________________
Address: ____________________________
City, State, Zip: _______________________
Fax Number: _________________________
E-mail Address(es): _____________________
Florida Bar Number: ____________________
Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (09/12)
CHILD SUPPORT GUIDELINES WORKSHEET
1. Present Net Monthly Income
Enter the amount from line 27, Section I of
Florida Family Law Rules of Procedure Form
12.902(b) or (c), Financial Affidavit.
2. Basic Monthly Obligation
There is (are) {number}_____ minor child(ren)
common to the parties.
Using the total amount from line 1, enter the
appropriate amount from the child support
guidelines chart.
3. Percent of Financial Responsibility
Divide the amount on line 1A by the total
amount on line 1 to get Father’s percentage of
financial responsibility. Enter answer on line 3A.
Divide the amount on line 1B by the total
amount on line 1 to get Mother’s percentage of
financial responsibility. Enter answer on line 3B.
4. Share of Basic Monthly Obligation
Multiply the number on line 2 by the
percentage on line 3! to get Father’s share
of basic obligation. Enter answer on line 4A.
Multiply the number on line 2 by the
percentage on line 3 to get Mother’s share
of basic obligation. Enter answer on line 4B.
A. FATHER
%
B. MOTHER
%
Additional Support Health Insurance, Child Care & Other
5. a. 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), Florida
Statutes, for more information.]
b. Total Monthly hild(ren)’s Health Insurance
Cost
[This is only amounts actually paid for
health insurance on the child(ren).]
Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (09/12)
CHILD SUPPORT GUIDELINES WORKSHEET
A. FATHER
B. MOTHER
c. Total Monthly hild(ren)’s Noncovered
Medical, Dental and Prescription
Medication Costs
d. Total Monthly Child Care & Health Costs
[Add lines 5a + 5b +5c].
6. Additional Support Payments
Multiply the number on line 5d by the
percentage on line 3! to determine the Father’s
share. Enter answer on line 6A. Multiply the
number on line 5d by the percentage on line 3B
to determine the Mother’s share.
Enter answer on line 6B.
7. a. Monthly child care payments actually made
Statutory Adjustments/Credits
b. Monthly health insurance payments actually
made
any noncovered medical, dental and
prescription medication expenses of the
child(ren) not ordered to be separately paid
on a percentage basis.
(See section 61.30 (8), Florida Statutes)
Other payments/credits actually made for c.
8. Total Support Payments actually made
(Add 7a though 7c)
9. MINIMUM CHILD SUPPORT OBLIGATION FOR
EACH PARENT
[Line 4 plus line 6; minus line 8]
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 Nos. 10 through 21
A. FATHER
B. MOTHER
TOTAL
10. Basic Monthly Obligation x 150%
[Multiply line 2 by 1.5]
Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (09/12)
CHILD SUPPORT GUIDELINES WORKSHEET
A. FATHER
B. MOTHER
11. Increased Basic Obligation for each parent.
Multiply the number on line 10 by the
percentage on line 3A to determine the
Father’s share. Enter answer on line 11!.
Multiply the number on line 10 by the
percentage on line 3B to determine the
Mother’s share. Enter answer on line 11B.
12. Percentage of overnight stays with each parent.
The child(ren) spend(s) ______overnight stays
with the Father each year. Using the number
on the above line, multiply it by 100 and divide
by 365. Enter this number on line 12A.
The child(ren) spend(s) _____ overnight stays
with the Mother each year. Using the number
on the above line, multiply it by 100 and divide
by 365. Enter this number on line 12B.
%
%
13. Parent’s support multiplied by other Parent’s
percentage of overnights.
[Multiply line 11A by line 12B. Enter this
number in 13A. Multiply line 11B by line 12A.
Enter this number in 13B.]
Additional Support Health Insurance, Child Care & Other
14. a. 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),
Florida Statutes, for more information.]
b. Total Monthly hild(ren)’s Health Insurance
Cost
[This is only amounts actually paid for health
insurance on the child(ren).]
c. Total Monthly hild(ren)’s Noncovered
Medical, Dental and Prescription
Medication Costs.
d. Total Monthly Child Care & Health Costs
[Add lines 14a + 14b + 14c.]
Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (09/12)
CHILD SUPPORT GUIDELINES WORKSHEET
A. FATHER
B. MOTHER
15. Additional Support Payments.
Multiply the number on line 14d by the
percentage on line 3A to determine the
Father’s share. Enter answer on line 15!.
Multiply the number on line 14d by the
percentage on line 3B to determine the
Mother’s share. Enter answer on line 15.
S
16. a. Monthly child care payments actually
made
tatutory Adjustments/Credits
b. Monthly health insurance payments
actually made
c. 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 section 61.30(8), Florida Statutes]
17. Total Support Payments actually made
[Add 16a though 16c]
18. Total Additional Support Transfer Amount
[Line 15 minus line 17; enter any negative
number as zero)
19. Total Child Support Owed from Father to
Mother [Add line 13A plus line 18A]
20. Total Child Support Owed from Mother to
Father [Add line 13B plus line 18B]
21. Actual Child Support to Be Paid.
[Comparing lines 19 and 20, Subtract the
smaller amount owed from the larger amount
owed and enter the result in the column for
the parent that owes the larger amount of
support]
$
ADJUSTMENTS TO GUIDELINES AMOUNT. If you or the other parent is requesting the Court to award a
child support amount that is more or less than the child support guidelines, you must complete and file
Motion to Deviate from Child Support Guidelines, Florida Supreme Court Approved Family Law Form
12.943.
Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (09/12)
[check one only]
a. ____ Deviation from the guidelines amount is requested. The Motion to Deviate from Child
Support Guidelines, Florida Supreme Court Approved Family Law Form 12.943, is attached.
b. ____ Deviation from the guidelines amount is NOT requested. The Motion to Deviate from
Child Support Guidelines, Florida Supreme Court Approved Family Law Form 12.943, is not
attached.
IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW:
[fill in all blanks] This form was prepared for the: {choose only one} ( ) Petitioner ( ) Respondent
This form was completed with the assistance of:
{name of individual} ,
{name of business} _________________________________________________________________,
{address} ____________________________________________________________________,
{city} _____________________,{state} ,______ {telephone number}________________________.
Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (09/12)