Child Support Guideline Worksheet - Rhode Island
DR-30 (Rev. 7/07) Page 1 of 2
STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS
FAMILY COURT
CHILD SUPPORT
GUIDELINE WORKSHEET
COUNTY
CIVIL ACTION-FILE NO.
PLAINTIFF
VS. DEFENDANT
PLAINTIFF SOC. SEC. NO. DEFENDANT SOC. SEC. NO.
To be filed with complaints on divorce, bed & board, miscellaneous complaints and when answer or modification is filed.
Number of Children:
Plaintiff
Defendant Combined
1. Monthly Gross Income $ $ XXX
2. Required Deductions:
a. Preexisting Child Support Payments
-
-
XXX
b. Health Insurance Premiums
XXX
or Medical Cash Contributions:
-
-
c. Additional Minor Dependants
-
-
3. Optional Adjustments in the Discretion of the Court
a. Pension/Retirement Payments
-
-
XXX
b. Life Insurance Premium Payments
-
-
XXX
c. Parent’s Extraordinary Medical Exp.
-
-
XXX
d. Income Tax Exemptions Adjustment
±
±
XXX
e. Payments of Assigned Marital Debts
-
-
XXX
4. Monthly Adjusted Gross Income (line 1minus
lines 2 and 3) $ $ $
5. Percentage Sha re of I nco me (line 4 parent’s
income divided by line 4 combined income)
100%
6. Basic Child Support Obligation (apply line 4
combined income to child support table)
XXX
XXX
7. Work-Related Child Care Costs (actual costs
minus federal tax credit)
XXX
XXX
8. Total Child Support Obligation
XXX
XXX
$
%
(add lines 6 and 7)
9. Parent’s Chi l d Sup p ort O bl i gat i on (f o r each parent,
line 5 percentage X line 8) $ $ XXX
10. Recommended Child Support Order (enter
line 9 amount for non-custodial parent
l
leave other column blank) $ $ XXX
11. Basic Child Support Amount Ordered: $ $
12. Cash Medical Ordered $ $
13. TOTAL AMOUNT ORDERED: $
per
$
(add lines 11 and 12)
wl./bi-wk./mo.
Prepared and presented by/for plaintiff:
DATE
by/for defendant:
DATE
Prepared and presented by Office of Child Support Enforcement (if applicable)
DATE
Approved and presented Enter
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