CIRCUIT COURT OF -- Select County -- ADAIR ANDREW ATCHISON AUDRAIN BARRY BARTON BATES BENTON BOLLINGER BOONE BUCHANAN BUTLER CALDWELL CALLAWAY CAMDEN CAPE GIRARDEAU CARROLL CARTER CASS CEDAR CHARITON CHRISTIAN CLARK CLAY CLINTON COLE COOPER CRAWFORD DADE DALLAS DAVIES DEKALB DENT DOUGLAS DUNKLIN FRANKLIN GASCONADE GENtrY GREENE GRUNDY HARRISON HENRY HICKORY HOLT HOWARD HOWELL IRON JACKSON JASPER JEFFERSON JOHNSON KNOX LACLEDE LAFAYETTE LAWRENCE LEWIS LINCOLN LINN LIVINGSTON MACON MADISON MARIES MARION MCDONALD MERCER MILLER MISSISSIPPI MONITEAU MONROE MONTGOMERY MORGAN NEW MADRID NEWTON NODAWAY OREGON OSAGE OZARK PEMISCOTT PERRY PETTIS PHELPS PIKE PLATTE POLK PULASKI PUTNAM RALLS RANDOLPH RAY REYNOLDS RIPLEY ST. CHARLES ST. CLAIR ST. FRANCOIS ST. LOUIS ST. LOUIS CITY STE. GENEVIEVE SALINE SCHUYLER SCOTLAND SCOTT SHANNON SHELBY STODDARD STONE SULLIVAN TANEY TEXAS VERNON WARREN WASHINGTON WAYNE WEBSTER WORTH WRIGHT     COUNTY,  MISSOURI CASE NO.   DIV/CT ROOM  Form 14 CHILD SUPPORT AMOUNT CALCULATION WORKSHEET In re the Matter of: Petitioner and Respondent

CHILDREN	DATE OF BIRTH	CHILDREN	DATE OF BIRTH
Child OneName:		Child FourName:
Child TwoName:		Child FiveName:
Child ThreeName:		Child SixName:

	Parent Receiving Support	Parent Paying Support	Combined
1.  MONTHLY GROSS INCOME a.  Court ordered maintenance being received by
2. ADJUSTMENTS (per month) a. Other court or administratively ordered child support being paid.
b. Court ordered maintenance being paid.
Add Number of Other Children in custody: c. Support obligation for other children in parent’s primary physical custody. Plus or Minus Support Received for Other Children	> 0 1 2 3 4 5 6 Child(ren)	0 1 2 3 4 5 6 Child(ren)
3. ADJUSTED MONTHLY GROSS INCOME       (Sum of lines 1 and 1a, minus lines 2a, 2b and 2c).
4. PROPORTIONATE SHARE OF COMBINED ADJUSTED MONTHLY GROSS INCOME (Each parent’s line 3 income divided by combined line 3 income).
5. BASIC CHILD SUPPORT AMOUNT    (From support chart using combined line 3 income). 1 2 3 4 5 6 CHILD(REN)
6. ADDITIONAL CHILD-REARING COSTS (per month) a. Reasonable work-related child care costs of the parent receiving support ($ )     less any child care tax credit ($ ).    ck if yes
b. Reasonable work-related child care costs of the parent paying support.
c. Health insurance costs for the children who are subjects of this proceeding.
d. Uninsured extraordinary medical costs. (Agreed by parents or ordered by court).
e. Other extraordinary child rearing costs. (Agreed by parents or ordered by court)
7. TOTAL ADDITIONAL CHILD-REARING COSTS (Sum of lines 6a, 6b, 6c, 6d and 6e).
8. TOTAL COMBINED CHILD SUPPORT COSTS (Sum of line 5 and combined line 7).
9. EACH PARENT’S SUPPORT OBLIGATION (Multiply line 8 by each parent’s line 4)
10. CREDIT FOR ADDITIONAL CHILD-REARING COSTS (Line 7 of parent paying support).
11. ADJUSTMENT FOR A PORTION OF THE AMOUNTS EXPENDED DURING PERIODS OF OVERNIGHT VISITATION OR CUSTODY.   (Multiply line 5 by Credit for Annual Overnight Stays  Less Than 36 36 To 72 73 To 91 92 To 109 --Custom-- 11% Credit 12% Credit 13% Credit 14% Credit 15% Credit 16% Credit 17% Credit 18% Credit 19% Credit 20% Credit 21% Credit 22% Credit 23% Credit 24% Credit 25% Credit 26% Credit 27% Credit 28% Credit 29% Credit 30% Credit 31% Credit 32% Credit 33% Credit
12. PRESUMED CHILD SUPPORT AMOUNT (Line 9 minus lines 10 and 11).
PREPARED BY:

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