Fill and Sign the Base Primary Support 250 X of Children Form

CASE NUMBER CHILD SUPPORT GUIDELINES WORKSHEET STATE OF HAWAI‘I FAMILY COURT OF THE ____________ CIRCUIT FC- NO. I ACKNOWLEDGE THAT THE ABOVE INFORMATION IS CORRECT . Father Date Mother Date For exceptional circumstances see attached Excepti onal Circumstance Form. For joint physical custody calculations or visitat ion 143 days or over per year, see Child Support Guidelines Worksheet For Joint Custody/Extensive V isitation and enter amounts on line 18For Court Use Only PLAINTIFF/PETITIONER Mother Father vs. DEFENDANT/RESPONDENT Mother Father This document was prepared by Plaintiff Defendant Atty. for Plaintiff Atty. for Defendant NameAddress City, State, Zip Telephone ATTACHMENT A-1 Line 1 BASE PRIMARY SUPPORT $250 X _______ (# of children) 2 Plus Monthly Child Care Expenses + 3 Plus Monthly Health/Dental Insurance for the Child(ren) + 4 PRIMARY SUPPORT NEED (add lines 1, 2 and 3) = FATHER(A) MOTHER(B) TOTAL(C) 5 Parents’ SOLA Income (from Table) + = 6 Less PRIMARY SUPPORT NEED (on line 4) - 7 Parents’ Net SOLA Income (line 5 - line 6) 8 SOLA Percentage, 10% per child, up to 30% x % 9 SOLA OBLIGATION (line 7 x line 8) 10 TOTAL SUPPORT NEED (line 4 + line 9) FATHER(A) MOTHER(B) TOTAL(C) 11 Monthly Gross Income = 12 Monthly Net Income (from Table) + = 13 Income Percentage (line 12(A) ÷ line 12(C)) or (line 12(B) ÷ line 12(C)) % % 14 Support Payable By Each Parent (line 10) x Parent’s (line 13) % 15 Less Monthly Child Care Expense for Parent Who Pays - 16 Less Monthly Health Insurance Cost for Parent Who Pays - 17 REMAINING CHILD SUPPORT PAYABLE BY EACH PARENT (Round to nearest $10.00) 18 Mother Father pays to Mother Father in child support for a total of $__________ per month ($___________ per child per month). Mother Father pays health insurance. Mother Father pays child care expenses. 0.00 0.00 0.00 0.00 0.00 0 0.00 0.00 0.00 0.00 0 0 0.00 0.00 $0 $0 CASE NUMBER CHILD SUPPORT GUIDELINES WORKSHEET FOR JOINT CUSTODY/EXTENSIVE VISITATION STATE OF HAWAI‘I FAMILY COURT OF THE ____________ CIRCUIT FC- NO. PLAINTIFF/PETITIONER Mother Father vs. DEFENDANT/RESPONDENT Mother Father This document was prepared by Plaintiff Defendant Atty. for Plaintiff Atty. for Defendant NameAddress City, State, Zip Telephone ATTACHMENT B LINE JOINT CUSTODY CALCULATION FATHER(A) MOTHER(B) (C) 1 SUPPORT (From Child Support Guidelines Worksheet Line 17) no less than $50/child 2 YEARLY SUPPORT OBLIGATION UNDER JOINT CUSTODY [Line 1(A) x 6 months] and [Line 1(B) x 6 months] 3 Difference between lines 2(A) and 2(B) (larger amount - lesser amount) 4 JOINT CUSTODY CHILD SUPPORT = [Line 3(C) ÷ 12] rounded to nearest $10.00 Enter this amount in either Line 4(A) or Line 4(B) for the parent who has the larger child support obligation from Line 1 above. EXTENSIVE VISITATION CALCULATION IF JOINT CUSTODY, STOP HERE AND ENTER AMOUNT FROM LINE 4(A) OR 4(B) OF THIS WORKSHEET TO CHILD SUPPORT GUIDELINES WORKSHEET LINE 18. The Custodial Parent is Father Mother. The Non-Custodial Parent is Father Mother. The Non-Custodial Parent has visitation of _______________ days per year. IF THE NON-CUSTODIAL PARENT HAS OVER 143 DAYS OF VISITATION PER YEAR COMPLETE LINES 5 - 11 BELOW. 5 REGULAR SUPPORT: Enter the child support obligation for the non- custodial parent from Line 1 above. 6 JOINT CUSTODY CHILD SUPPORT: Enter the amount from Line 4(A) or 4(B) above. 7 Difference: If the child support obligations in Lines 5 and 6 are for the same parent, then subtract Line 6 from Line 5 [Line 5 - Line 6] If the child support obligations in Lines 5 and 6 are for different parents, then add Lines 5 and 6. [Line 5 + Line 6] 8 ADJUSTMENT RATE [Line 7 ÷ 40 days] 9 NUMBER OF VISITATION DAYS OVER 143 DAYS PER YEAR x 10 CREDIT FOR DAYS EXCEEDING NORMAL SUPPORT [Line 8 x Line 9] = 11 EXTENSIVE VISITATION CHILD SUPPORT [NON-CUSTODIAL PARENT’S SUPPORT] [Line 5 - Line 10] Rounded to nearest $10.00. ENTER SUPPORT AMOUNT FROM LINE 11 OF THIS WORKSHEET ON LINE 18 ON THE CHILD SUPPORT GUIDELINES WORKSHEET. 0 0 0 0 0 $0 $0