Free Legal Forms for New York Divorce and Family Court

SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF _______

SALLY SMITH, )

Plaintiff, )

Index No. _______

- against- )

) CHILD SUPPORT WORKSHEET

SAM SMITH, )

Defendant. )

STATE OF NEW YORK )

) ss.:

COUNTY OF _______ )

This worksheet is submitted by Plaintiff, who is the [custodial/noncustodial] parent in the abovecaptioned action. All numbers used are YEARLY figures; weekly or monthly amounts have been converted to annualized numbers. [References are to DRL Section 240(1b)].

FATHER MOTHER

STEP 1 MANDATORY PARENTAL INCOME

1. Gross [total] income [as reported on most recent ______ ______

Federal tax return, or as computed in accordance

with Internal Revenue Code and regulations] [(b)(95)(i)]:

The following items MUST be added if not already

included in Line 1:

2. Investment income [(b)(5)(ii)]: ______ ______

3. Workers' compensation [(b)(5)(iii)(A)]: ______ ______

4. Disability benefits [(b)(5)(iii)(B)]: ______ ______

5. Unemployment insurance benefits [(b)(5)(iii)(C)]: ______ ______

6. Social Security benefits [(b)(5)(iii)(D)]: ______ ______

7. Veterans' benefits [(b)(5)(iii)(E)]: ______ ______

8. Pension/retirement income [(b)(5)(iii)(F)]: ______ ______

9. Fellowships and stipends [(b)(5)(iii)(G)]: ______ ______

10. Annuity payments [(b)(5)(iii)(H)]: ______ ______

11. If self-employed, depreciation greater than ______ ______

straightline depreciation used in determining

business income or investment credit

[(b)(5)(vi)(A)]:

12. If selfemployed, entertainment and travel allowances ______ ______

deducted from business income to the extent the

allowances reduce personal expenditures

[(b)(5)(vi)(B)]:

13. Former income voluntarily reduced to avoid child ______ ______

support [(b)(5)(v)]:

14. Income voluntarily deferred [(b)(5)(iii)]: ______ ______

List how you obtained the defendant's income for these

calculations: _________________________________________________________

A. TOTAL MANDATORY INCOME: ______ ______

STEP 2 NONMANDATORY PARENTAL INCOME

15. Income attributable to nonincome producing assets ______ ______

[(b)(5)(iv)(A)]:

16. Employment benefits that confer personal economic ______ ______

benefits (such as meals, lodging, memberships, autos, etc.) [(b)(5)(iv)(B)]:

17. Fringe benefits of employment [(b)(5)(iv)(C)]: ______ ______

18. Money, goods and services provided by relatives and ______ ______

friends [(b)(5)(iv)(D)]:

B. TOTAL NONMANDATORY INCOME: ______ ______

C. TOTAL INCOME (add Line A + Line B) ______ ______

STEP 3 DEDUCTIONS

19. Expenses of investment income listed on line 2 ______ ______

[(b)(5)(ii)]:

20. Unreimbursed business expenses that do not reduce ______ ______ personal expenditures [(b)(5)(vii)(A)]:

21. Alimony or maintenance actually paid to a former ______ _____

spouse: [(b)(5)(vii)(B)]:

22. Alimony or maintenance paid to the other parent but ______ ______ only if child support will increase when alimony stops [(b)(5)(vii)(C)]:

23. Child support actually paid to other children the ______ ______ parent is legally obligated to support [(b)(5)(vii)(D)]:

24. Public assistance [(b)(5)(vii)(E)]: ______ ______

25. Supplemental security income [(b)(5)(vii)(F)]: ______ ______

26. New York City or Yonkers income or earnings taxes ______ ______ actually paid [(b)(5)(vii)(G)]:

27. Social Security taxes (FICA) actually paid [(b)(5)(vii)(H)]: ______ ______

D. TOTAL DEDUCTIONS: ______ ______

E. FATHER'S INCOME (Line C minus Line D): ______

F. MOTHER'S INCOME (Line C minus Line D) ______

STEP 4 [(b)(4)]

G. COMBINED PARENTAL INCOME (Line E + Line F): ______

STEP 5 [(b)(3) and (c)(2)]

MULTIPLY Line G (up to $80,000) by the proper percentage (17% for 1 child, 25% for 2 children, 29% for 3 children, 31% for 4 children, or 35% (minimum) for 5 or more children) and insert in Line H.

H. COMBINED CHILD SUPPORT: ______

STEP 6 [(c)(2)]

I. DIVIDE the noncustodial parent's amount on Line E or Line F: _________

by the amount of Line G: ______

to obtain the percentage allocated to the noncustodial

parent: ______

STEP 7 [(c)(2)]

J. MULTIPLY line H by Line I: ______

STEP 8 [(c)(3)]

K. DECIDE the amount of child support to be paid on any combined parental income exceeding $80,000 per year using the percentages in STEP 5 _________

or the factors in STEP 11C or both:

L. ADD Line J and Line K: ______

This is the amount of child support to be paid by the noncustodial parent to the custodial parent for all costs of the children, except for child care expenses, health care expenses, and college, postsecondary, private, special, or enriched education.

STEP 9 SPECIAL NUMERICAL FACTORS

CHILD CARE EXPENSES

M. Cost of child care resulting from custodial parent's:

___ working; ___ attending elementary education; ___

attending secondary education; ___ attending higher education; ___ attending vocational

training leading to employment: [(c)(4)] ___ seeking work [(c)(6)]: __________

N. MULTIPLY Line M by Line I: ______

This is the amount the noncustodial parent must contribute to the custodial parent for child care.

HEALTH EXPENSES [(c)(5)]

O. Reasonable future health care expenses not covered by insurance:

P. MULTIPLY Line O by Line I: ______

This is the amount the noncustodial parent must contribute to the custodial parent for health care or pay directly to the health care provider.

Q. EDUCATIONAL EXPENSE If appropriate, see STEP 11(b) [(c)(7)]. ______

STEP 10 LOW INCOME EXEMPTIONS [(d)]

R. Insert amount of noncustodial parent's income from Line E or Line F: __________

S. Add amount on Lines L, N, P, and Q (This total is "basic child support"): __________

T. SUBTRACT Line S from Line R: ______

If Line T is more than the selfsupport reserve for this current year, then the low income exemptions do not apply and child support remains as determined in STEPS 8 and 9. If so, go to STEP 11. The selfsupport reserve is 135% of the official Federal poverty level for a single person household as promulgated by the U.S. Dept. of Health and Human Services and modified on April 1st of each year. If Line T is less than the Federal poverty level for this current year, then complete Lines U, V, and W.

U. Insert amount of noncustodial ______

parent's income from Line E or

Line F:

V. Selfsupport reserve ______

W. Subtract Line V from Line U: ______

If Line W is more than $300 per year, the Line W is the amount of basic child support. If Line W is less than $300 per year, then basic child support must be a minimum of $300 per year. The defendant may attempt to show that [he/she] cannot pay this minimum amount. If Line T is greater than Federal poverty level for 1997, butis less than the selfsupport reserve, then complete Lines X, Y, and Z.

X. Insert amount of noncustodial parent's income from Line E or Line F: ________

Y. Selfsupport reserve: ______

Z. SUBTRACT Line Y from Line X: ______

If Line Z is more than $600 per year, then Line Z is the amount of basic child support. If Line Z is less than $600 per year, then basic child support must be a minimum of $600 per year. The defendant may attempt to show that [he/she] cannot pay the minimum amount.

STEP 11 NONNUMERICAL FACTORS

(a) NONRECURRING INCOME [(e)]

A portion of nonrecurring income, such as life insurance proceeds, gifts and inheritances or lottery winnings, may be allocated to child support. The law does not mention a specific percentage for such nonrecurring income. Such support is not modified by the low income exemptions. Enter any relevant information: _____________________________________________.

(b) EDUCATIONAL EXPENSES [(c)(7)]

New York's child support law does not contain a specific percentage method to determine how parents should share the cost of education of their children. Traditionally, the courts have considered both parents'complete financial circumstances in deciding

who pays how much. The most important elements of financial circumstances are income, reasonable expenses, and financial resources such as savings and investments. Enter any relevant information.

Section 240(1b) of the Domestic Relations Law lists 10 factors that should be considered in deciding on the amount of child support for (i) combined incomes of more than

$80,000 per year or (ii) to vary the numerical result of these steps because the result is "unjust or inappropriate."

These factors are:

1. The financial resources of the parents and the child.

2. The physical and emotional health of the child and [his/her] special needs and aptitudes.

3. The standard of living the child would have enjoyed if the marriage or household was not dissolved.

4. The tax consequences to the parents.

5. The nonmonetary contributions the parents will make toward the care and wellbeing of the child.

6. The educational needs of the parents.

7. The fact that the gross income of one parent is substantially less than the gross income of the other parent.

8. The needs of the other children of the noncustodial parent for whom the noncustodial parent isproviding support, but only (a) if Line 22 is not deducted; (b) after considering the financial resources of any other person obligated to support the other children; and (c) if the resources available to support the other children are less then the resources available to support the children involved in this matter.

9. If a child is not on public assistance, the amount of extraordinary costs of visitation (such as out of state travel) or extended visits (other than the usual two to four week summer visits), but only if the custodial parent's expenses are substantially reduced by the visitation involved.

10. Any other factor the court decides is relevant.

Enter any relevant information: __________________________________________

________________________________________________________________________

_______________________________________________________________________.

NONJUDICIAL DETERMINATION OF CHILD SUPPORT [(h)]

Outside of the court, parents are free to agree to any amount of support, so long as they sign a statement that they have been advised of the provisions of Section 240(1b) of the Domestic Relations Law. However, the court cannot approve agreements of less than $300 per year. This minimum is not per child, meaning that the minimum for three (3) children is $300 per year, not $900 per year. In addition, the courts retain discretion over awards of child support.

The foregoing have been carefully read by the undersigned, who states that they are true and correct.

____________________________________________

Plaintiff

STATE OF NEW YORK )

) ss.:

COUNTY OF _______ )

I, _______, being duly sworn, depose and say that: I am the Plaintiff in this action; I have read this Child Support Worksheet and I know its contents; they are true to my own knowledge, except as to the matters stated to be upon information and belief, and as to those I believe them to be true.

____________________________________________

Plaintiff

Sworn to before me on

_______, ___

Notary Public