Hawaii Child Support Guidelines Worksheet

State of Hawaii Family Court Child Support Forms

SIMPLIFIED CHILD SUPPORT GUIDELINES WORKSHEET

STATE OF HAWAII

FAMILY COURT OF THE CIRCUIT

CASE NUMBER

PLAINTIFF/PETITIONER Mother Father

VS.

DEFENDANT/RESPONDENT Mother Father

This document was prepared by

Plaintiff Defendant Atty. For Plaintiff Atty. For Defendant

Name

Address

City, State, Zip

Telephone

I/We certify that:

1. The Custodial Parent is father mother.

2. The Custodial Parent is caring for at least one of the parties’ children under the age of three in the home and not in a day care.

3. The Custodial Parent’s only income is from needs-based public assistance such as welfare, TANF, general issues assistance, food stamps, SSI, Section 8 Housing, WIC and/or Pell Grant.

4. The Custodial Parent is not working.

5. The non-custodial parent who is responsible for the child support payments (payor parent) has a total gross monthly income of not more than $1450 per month.

6. No income is to be imputed to either parent.

Non-Custodial Parent’s Gross Income per month $

Number of Children covered under this case for which child support is being calculated

CHILD SUPPORT PER THE SIMPLIFIED CHILD SUPPORT CALCULATIONS TABLE:

TOTAL AMOUNT PER CHILD $

TOTAL AMOUNT OF CHILD SUPPORT PER MONTH $

I ACKNOWLEDGE THAT THE ABOVE INFORMATION IS CORRECT

For Court Use Only

SIMPLIFIED CHILD SUPPORT CALCULATION TABLE

(Refer to the table in the PDF for income brackets and child support values.)

This attachment contains a fixed reference table and is not converted into editable fields.

CHILD SUPPORT GUIDELINES WORKSHEET

CASE NUMBER

PLAINTIFF/PETITIONER Mother Father

VS.

DEFENDANT/RESPONDENT Mother Father

This document was prepared by

Plaintiff Defendant Atty. for Plaintiff Atty. for Defendant

Name

Address

City, State, Zip

Telephone

Line 1 BASE PRIMARY SUPPORT

2 Plus Monthly Child Care Expenses

3 Plus Monthly Health/Dental Insurance for the Child(ren)

4 PRIMARY SUPPORT NEED

FATHER (A) MOTHER (B) TOTAL (C)

5 Parent’s SOLA Income (from Table)

6 Less PRIMARY SOURCE NEED (from Line 4)

7 Parent’s Net SOLA Income

8 SOLA Percentage, 10% per child, up to 30%

9 SOLA OBLIGATION

10 TOTAL SUPPORT NEED

11 Monthly Gross Income

12 Monthly Net Income (from Table)

13 Income Percentage

14 Support Payable By Each Parent

15 Less Monthly Child Care Expenses for Parent Who Pays

16 Less Monthly Health Insurance Cost Parent Who Pays

17 REMAINING CHILD SUPPORT PAYABLE BY EACH PARENT

18 Mother pays to Father Father pays to Mother in child support for a total of $ per month ($ per child per month).

Mother pays health insurance. Father pays health insurance. Mother pays child care expenses. Father pays child care expenses.

I ACKNOWLEDGE THAT THE ABOVE INFORMATION IS CORRECT.

For exceptional circumstances see attached Exceptional Circumstances Form.

For joint physical custody calculations or visitation 143 days or over per year, see Child Support Guidelines Worksheet For Joint Custody/Extensive Visitation and enter amounts on line 18.

For Court Use Only

CHILD SUPPORT GUIDELINES WORKSHEET FOR JOINT CUSTODY/ EXTENSIVE VISITATION

CASE NUMBER

PLAINTIFF/PETITIONER Mother Father

VS.

DEFENDANT/RESPONDENT Mother Father

This document was prepared by

Plaintiff Defendant Atty. for Plaintiff Atty. for Defendant

Name

Address

City, State, Zip

Telephone

LINE 1 SUPPORT

2 YEARLY SUPPORT OBLIGATION UNDER JOINT CUSTODY

3 Difference between lines 2(A) and 2(B)

4 JOINT CUSTODY CHILD SUPPORT

The Custodial Parent is Father Mother. The Non-Custodial Parent is Father Mother.

The Non-Custodial Parent has visitation of days per year.

5 REGULAR SUPPORT

6 JOINT CUSTODY CHILD SUPPORT

7 Difference

8 ADJUSTMENT RATE

9 NUMBER OF VISITATION DAYS OVER 143 DAYS PER YEAR

10 CREDIT FOR DAYS EXCEEDING NORMAL SUPPORT

11 EXTENSIVE VISITATION CHILD SUPPORT

ENTER SUPPORT AMOUNT FROM LINE 11 OF THIS WORKSHEET LINE 18 ON THE CHILD SUPPORT GUIDELINES WORKSHEET.

For Court Use Only

EXCEPTIONAL CIRCUMSTANCES FORM

Attached to SIMPLIFIED CHILD SUPPORT GUIDELINES CHILD SUPPORT GUIDELINES

CASE NUMBER

The Court should deviate from the Total Monthly Child Support Obligation as calculated because of the following exceptional circumstances:

I hereby declare, under penalty of perjury, that I have examined the statement regarding exceptional circumstances and to the best of my knowledge and belief it is true, correct and complete.

Dated: Hawaii, .