CHILD SUPPORT WORKSHEET
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1 CHILD SUPPORT WORKSHEET DHS, ex rel., o/b/o IN THE SUPERIOR COURT OF COBB COUNTY STATE OF Civil Action Case No.: 2015CV1234 Caitlyn B. Fardashian Jim Z Fardashian * Plaintiff, vs. * Defendant, IVD Case No.: Comments for Court: Initial Action Modification Date of Initial Child Support Order: : Caitlyn : Jim Included 1. Child Support Worksheet Enter amounts/data in yellow fields only. Calculations will automatically display in the appropriate white fields. Next to the numbers below, enter the Name and Birth Year of all children for whom child support is being determined in this case. * Name Birth Year Included * Name Kim Birth Year Khloe Bruce Kourtney Total Number of Children: 4 Noncustodial Parent Submitted by: Both Parties Nonparent Custodian Lines 12 and 14 are enterable fields; all other fields will automatically calculate and display amounts. 1. Monthly Gross Income Monthly Adjusted Income 2. From Schedule B, Line 9 or 14. Total 9, , , , Pro Rata Shares of Combined Income % % % 4. Basic Child Support Obligation (from the Table) 2, Pro rata shares of Basic Child Support Obligation 2, Adjustment for Work Related Child Care and Health Insurance Expenses From Schedule D, Line 5. Adjusted Child Support Obligation Total of Lines 5 & 6. Adjustment for Additional Expenses Paid. From Schedule D, Line 3. Presumptive Amount of Child Support Line 8 subtracted from Line 7. 2, , The amount on Line 9 is the Presumptive Child Support Amount. Child Support Worksheet CSC Standard Form Page 1 of 6
2 CHILD SUPPORT WORKSHEET 10. Deviations from Presumptive Child Support Amount Amounts from Schedule E, Line 14 will automatically display Subtotal (Line 9 plus Line 10) Social Security Payments (excludes Supplemental Security Income (SSI)) If a child receives Title II Social Security benefits as a dependent on a parent's account, enter that monthly amount here in that parent's column. If none, leave blank. (See User Guide.) 2, Final Monthly Child Support Amount (rounded to a whole number) If the amount on Line 12 is equal to or greater than Line 11, the child support responsibility is met and no further obligation is owed. 2, The amount on Line 13 is the Final Child Support Amount. Uninsured Health Expenses 14. Carry down percentages from Line 3; enter percentages agreed to; or enter percentages otherwise ordered by % % the Court. v Schedules Attached Not Applicable A Gross Income B Adjusted Income C Schedule C is not in use and is intentionally left blank D Additional Expenses E Deviations from Presumptive Amount v Print Instructions for the Child Support Worksheet and Schedules Names of Parties: Caitlyn B. Fardashian vs. Jim Z Fardashian Submitted by: Both Parties Today's date: 10/28/2016 Case #: 2015CV1234 Version 9.2 Child Support Worksheet CSC Standard Form Page 2 of 6
3 CHILD SUPPORT SCHEDULE A GROSS INCOME * Schedule A Gross Income The entry of income in this section is required to generate a Worksheet. If a parent receives TANF, click in box, check mark will appear; click again to remove check mark; otherwise leave blank. Do not include monthly TANF check amount as income. Convert all amounts to a monthly average. 1. (a) (b) (c) Combined Salary and Wages (Do not include meanstested public assistance, such as TANF or food stamps.) 2. Commissions, Fees, Tips 3. Income From SelfEmployment 4. Bonuses 5. Overtime Payments 6. Severance Pay 7. Recurring Income from Pensions or Retirement Plans 8. Interest Income 9. Income from Dividends 10. Trust Income 11. Income from Annuities 4, Capital Gains Social Security Disability or Retirement Benefits received as 13. income by a parent in this case. (Excludes SSI or payments for children) 14. Federal Veterans' Disability Benefits 15. Worker's Compensation Benefits 16. Unemployment Benefits 17. Judgments from Personal Injury or Other Civil Cases 18. Gifts (cash or other gifts that can be converted to cash) 19. Prizes / Lottery Winnings 20. Alimony & maintenance from persons not in this case 21. Assets which are used for support of family 22. Fringe Benefits (if significantly reduce living expenses) 23. Any Other Income, including Imputed Income (Do not include meanstested public assistance.) 5, * TOTAL GROSS MONTHLY INCOME 24. Total will automatically display here, on Line 1 of Worksheet, and Line 1 of Schedule B. 9, , Enter below explanations for the basis of Other Income, explain the basis for Other Income, including Imputed Income, as entered on Line 23 above for and/or. Use Schedule A to enter Gross Income of each parent. Enter amounts/data in yellow fields only. Calculations will automatically display in the appropriate white fields. Estimated amount collects in cash each month, not included in selfemployment income, consistent with family's lifestyle Names of Parties: Caitlyn B. Fardashian vs. Jim Z Fardashian Submitted by: Both Parties Today's date: 10/28/2016 Case #: 2015CV1234 Version 9.2 Child Support Schedule A CSC Standard Form Page 3 of 6
4 SelfEmployment Calculator SelfEmployment Calculator O.C.G.A (f)(1)(B) states, "Income from selfemployment includes income from, but not limited to, business operations, work as an independent contractor or consultant, sales of goods or services, and rental properties, less ordinary and reasonable expenses necessary to produce such income. Income from selfemployment, rent, royalties, proprietorship of a business, or joint ownership of a partnership, limited liability company, or closely held corporation is defined as gross receipts minus ordinary and reasonable expenses required for selfemployment or business operations." Guidance: To calculate SelfEmployment Income, you may use this SelfEmployment Calculator OR you may enter SelfEmployment income on Schedule A, Line 3. If you use this SelfEmployment calculator, enter amounts below in yellow fields only. Calculations will automatically display in the appropriate fields. If there is more than one owner in a business, ONLY include the selfemployment income for a parent associated with this child support calculation. 1) Description of Business Landscaping 2) Name of Business Diversified Landscaping 3) Type of Business (Sole Proprietorship, LLC, Partnership, S Corp., Rental Income) Sole Proprietorship 4) Gross Receipts (A) ) Cost of Sales (B) ) Equals Gross Profit (AB=C) ) Business Expenses Business Income (per month) 7(a) Compensation to owner (b) Other salaries and wages (c) Advertising/promotion (d) Car and truck expenses (e) Depreciation (f) Employee benefits (including medical insurance) (g) Insurance business (h) Interest (i) Office supplies and expenses (j) Rent or lease building (k) Rent or lease equipment (l) Taxes and licenses (including payroll taxes) (m) Travel and entertainment (n) Utilities (o) Legal and professional (p) Supplies, repairs & maint, telephone & internet (q) Home office ) Total Business Expenses (D) ) Net Income (C D = E) ) Add back expenses included above that are not deductible for child support. See O.C.G.A (f)(1)(B). Compensation to owner (Do not include this amount on Line 1 of Schedule A as it is included here with selfemployment income.) Excessive promotional, travel, vehicle or personal living expenses Home office expenses Equipment depreciation, accelerated depreciation, tax credits Other ) Total NonDeductible Expenses (F) ) Total SelfEmployment Income (E + F) ) To continue, click box at right; answers display on Schedule A, Line Answer(s) from the Selfemployment Calculator will display on Schedule A, Line 3 as a positive number for a profit, or as a zero for a loss. Use the box below to enter notes related to self employment income as indicated above. 20% auto is personal; all travel and meals are personal; legal is divorce not business, cell phone is for entire family added back 50%; telephone and internet is for family added back 50% Names of Parties: Caitlyn B. Fardashian vs. Jim Z Fardashian Submitted by: Both Parties Today's Date: 10/28/2016 Case #: 2015CV1234 Version 9.2 Child Support SelfEmployment Calculator CSC Standard Form Page 4 of 6
5 CHILD SUPPORT SCHEDULE B ADJUSTED INCOME Schedule BAdjusted Income Enter amounts/data in yellow fields only. Calculations will automatically display in the appropriate white fields. (a) (b) 1. Total Gross Monthly Income from Schedule A, Line 24 9, Self Employment Tax Adjustment 2. Enter monthly SelfEmployment Income on which parent paid Self Employment Taxes for FICA & Medicare 2, FICA (Line 2 multiplied by.062) Medicare tax (Line 2 multiplied by ) Total of Lines 3 & Line 5 subtracted from Line 1 9, Adjustment for Preexisting Child Support Orders Being Paid for Other Children Enter the required information and the amount actually paid monthly. (Do not include arrears payments.) Court Name Court Case # Child Name Birth Year Date of Initial Order Preexisting Child Support Amount Paid by Preexisting Child Support Amount Paid by 7(a) 7(b) 7(c) 7(d) 8. Total Adjustment for Preexisting Child Support Orders for each parent Line 8 is subtracted from Line 6. If a discretionary adjustment is being claimed for other 9. qualified children living in the home, continue at Line 10; otherwise, the answer on Line 9 9, will automatically display on Line 2 of the Child Support Worksheet. Child Support Schedule B CSC Standard Form Page 5 of 6
6 CHILD SUPPORT SCHEDULE B ADJUSTED INCOME Discretionary Adjustment to Income for Other Qualified Children Living in Parent's Home The Court has the discretion to consider an Adjustment to Income for qualified children under this section for the purpose of reducing a parent s gross income, if failure to consider an adjustment would cause substantial hardship to the parent. If the Court considers an Adjustment to Income under this section, then the Court must also consider whether this Adjustment to Income is in the best interest of the child(ren) in this action Adjustment may be considered only for children who meet ALL FIVE of the following requirements: A. The parent is legally responsible for the qualified child (Stepchildren do not qualify); B. The qualified child lives in the parent's home; C. The parent is actually supporting the qualified child; D. The qualified child is not subject to a preexisting child support order; and E. The qualified child is not currently before the court to set, modify or enforce child support. Adjustment for other QUALIFIED children pursuant to the five factors listed above Name(s) Birth Year Enter Checkmark if is Claiming Credit Enter Checkmark if is Claiming Credit 10. Click the checkbox until a check mark appears to include 10(a). QUALIFIED children for whom adjustment is claimed, and automatic calculation will display. Enter a comment here explaining why you have included an Other Qualified Child in the Current Court Case. (a) (b) 11. Amount from Line 6 for the parent(s) seeking adjustment and a Theoretical child support order. Basic Child Support Obligation (from table) automatically displays for 12. number of children on Line 10 and income on Line 11, for parent seeking the adjustment % of the amount on Line 12 for the parent seeking the adjustment. 14. If this adjustment is allowed, Line 13 will be subtracted from Line 9 and this amount will automatically display on Line 2 of the Worksheet. Names of Parties: Caitlyn B. Fardashian vs. Jim Z Fardashian Submitted by: Both Parties Today's date: 10/28/2016 Case #: 2015CV1234 Version 9.2 Child Support Schedule B CSC Standard Form Page 6 of 6
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