CJ-D 305 12/13/18 FCSG
Case Name:
of 4page 3
Docket No.
Weekly Bi-weekly Monthly Other(specify)
However, the Court finds the presumptiveness of the guidelines has been rebutted because, after considering the best
interests of the child, the application of the guidelines would be unjust or inappropriate.
the parties agree and the Court has reviewed and approved their agreement dated
a child has ongoing special needs or aptitudes with financial consequences
a child has ongoing extraordinary mental, physical, or developmental needs with financial consequences
a parent
Name
has ongoing extraordinary mental, physical, or
developmental needs with financial consequences
Name
a parent has extraordinary expenses for health care
coverage
a parent has extraordinary travel or other expenses
related to parenting
a parent is absorbing a child care cost that is
disproportionate in relation to his or her income
a parent provides substantially less than one-third of the
parenting time for a child or children
the payor is incarcerated and has insufficient financial resources to pay support
application of the guidelines, particularly in low income cases, leaves a parent
without the ability to self support
application of the guidelines would result in a gross disparity in the standard of living between the two households such
that one household is left with an unreasonably low percentage of the combined available income
temporarily removed from the household in accordance with G. L. c. 119
application of the guidelines may adversely impact reunification of a parent and child where the child has been
interests of the child, considering the Principles of the Child Support Guidelines
absent deviation, application of the guidelines would lead to an order that is unjust, inappropriate or not in the best
deviation still exists, deviation continues to be in the child's best interest, and the guidelines amount would be unjust or
inappropriate under the circumstances
this is a modification of an order that deviated from the guidelines at the time it entered and the facts that gave rise to the
other:
guidelines is $
DEVIATION - Section IV. of the Child Support Guidelines
The specific circumstance of the case which justify departure from the guidelines are:
The guidelines are applicable in this case. The amount of the child support order that would result from the application of the
Name
Name
Name
Name