Child Support Worksheet - Kansas

Rev. 07/2012 by KSJC
2 of 2
Case No.
MOTHER FATHER
4. Health and Dental Insurance Premium $ + $
=
5. Work-Related Child Care Costs
Formula: Amt. – ((Amt. X %) + (.25 x (Amt. x %)))
for each child care credit =
Example: 200 – ((200 x .30%) + (.25 x (200 x .30%)))
6. Parents’ Total Child Supp ort Obligation
(Line D.3. plus Lines D.4. & D.5.)
7. Parental Child Support Obligation
(Line D.2. times Line D.6. for each parent)
8. Adjustment for Insurance and Child Care (-)
(Subtract for actual payment made for items
D.4. and D.5.)
9. Basic Parental Child Sup port Obligation
(Line D.7. minus Line D.8.;
Insert on Line F.1. below)
E. CHILD SUPPORT ADJUSTMENTS
AMOUNT ALLOWED
APPLICABLE N/A CATEGORY MOTHER FATHER
1. Long Distance Parenting Time Costs (+/-) (+/-)
2. Parenting Time Adjustment (if b. %___) (+/-) (+/-)
3. Income Tax Considerations (+/-) (+/-)
4. Special Needs/Extraordinary Exp. (+/-) (+/-)
5. Agreement Past Majority (+/-) (+/-)
6. Overall Financial Condition (+/-) (+/-)
7. TOTAL (Insert on Line F.2. below)
F. DEVIATION(S) FROM REBUTTABLE PRESUMPTION AMOUNT
AMOUNT ALLOWED
MOTHER FATHER
1. Basic Parental Child Sup port Obligation
(Line D.9. from above)
2. Total Child Support Adjustments (+/-)
(Line E.7. from above)
3. Adjusted Subtotal (Line F.1. +/- Line F.2.)
4. Equal Parenting Time Obligation
(EPT worksheet Line 12 or 14)
5. Enforcement Fee Allowance** Percentage %
(Applied only to Nonresidential Parent) Flat Fee $
((Line F.3. x Collection Fee %) x .5)
or (Monthly Flat Fee x .5) (+) (+)
6. Net Parental Child Support Obligation
(Line F.3. + Line F.4.)
**Parent with nonprimary residency. Use local percentage.
Judge/Hearing Officer Signature
Date Signed
Prepared By Date Approved
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