Fill and Sign the Part 1 Basic Support Form

SHARED RESPONSIBILITY STATE OF NEW MEXICO JUDICIAL DISTRICTCOUNTY OF Petitioner,vs.No Respondent. MONTHLY CHILD SUPPORT OBLIGATION Mother FatherCombinedPart 1 — Basic Support:1. Gross Monthly Income$ $ =$ 2. Percentage of Combined Income (Each parent's income divided by combined income) %+ %= 100% 3. Number of Children 4. Basic Support from Schedule (Use combined income from Line1)$ 5. Shared Responsibility Basic Obligation (Line 4 x 1.5)$ 6. Each Parent's Share (Line 5 x each parent's Line 2)$ $ 7. Number of 24 hour days with each parent (Must total 365) + = 365 8. Percentage with each parent (Line 7 divided by 365) %+ %100% 8. Amount retained (Line 6 x Line 8 for each parent)$ $ 10. Each Parent's Obligation (subtract Line 9 from Line 6)$ $ 11. Amount Transferred (subtract smaller amount on Line 10 from larger amount on Line 10.) Parent with larger amount on Line 10 pays other parent the difference $ MotherFatherCombinedPart 2 — Additional Payments:12. Children's Health and Dental Insurance Premium$ +$ =$ 13. Work-Related Child Care$ +$ =$ 14. Additional Expenses$ +$ =$ 15. Total Additional Payments (Add Lines 12, 13 and 14 for each parent and for combined column)$ +$ =$ 16. Each Parent's Obligation (Combined Column Line 15 x each parent's Line 2)$ $ 17. Amount transferred (Subtract each parent's Line 16 from his Line 15). Parent with "minus" figure pays that amount to other parent $ $ Part 3 — Net Amount Transferred:18.Combine Lines 11 and 17 by addition if same parent pays on both lines, otherwise by subtraction $ PAYS EACH MONTH$ __________________________________ ____________________________________Petitioner's Signature Respondent's SignatureDate ________________________