Maine Child Support Worksheet - Divorce Source
SUPERIOR COURT STATE OF MAINE DISTRICT COURT
,ss. Location
Docket No. Docket No.
Plaintiff
vs. CHILD SUPPORT WORKSHEET
Defendant
1. a. Primary care provider (parent children live with most of the time): Plaintiff Defendant Both
If parents provide substantially equal care, higher income parent should be shown as the non-primary care provider.
b. Parent providing health insurance for the children: Plaintiff Defendant Neither
2. Child’s Name Date of Birth Child’s Name Date of Birth
Yearly Amounts Primary Care Provider Non-Primary Care Provider
Self-support reserve
Below poverty level
Combined Income
3. Gross income $ $
4. Minus other obligations
a. Support paid to former spouse a. a.
b. Support paid for other children b. b.
c. Other children living with non-primary care
provider (See instructions on reverse side.)
c.
5. Total of 4a, b, & c
6. Adjusted Yearly Gross Income
(Subtract line 5 from line 3)
a. b. c.
7. Share of Gross Income
(Divide each parent’s income by combined income)
a.
%
b.
%
(Add 6a & 6b)
8. Basic weekly support for all children up to 18 years (or up to 19 years if still in high school) (See instructions on reverse.)
a. Total number of children
b. Number of children ages 0-11 multiplied by amount from table = $
c. Number of children ages 12-17 multiplied by amount from table = $
Total (add 8b and 8c): 8.
9. Weekly health insurance cost for children
Name & amount per child per week $
$
Total: 9.
10. Weekly child care expenses
Name & amount per child per week $
$
Total: 10.
11. Extraordinary medical expenses
Name & amount per child per week $
$
Total: 11.
*If parents provide substantially equal care, continue calculations on supplemental worksheet.
12. TOTAL WEEKLY / BIWEEKLY SUPPORT OBLIGATION (Add lines 8, 9, 10 and 11.) 12.
13.WEEKLY / BIWEEKLY PARENTAL SUPPORT OBLIGATION:
a. Primary Care | b. Non-Primary Care
Provider spends directly $ | Provider’s support obligation $
(Multiply line 7a by line 12) | (Multiply line 7b by line 12)
| Health insurance adjustment -
| (See instructions on reverse side)
| Non-Prim. Care Provider pays as support
Date: Prepared by:
FM-040, Rev. 02/09 (Attorney for) (Plaintiff) (Defendant) (Judge) (Magistrate) (Mediator) (Attorney for) (Plaintiff) (Defendant) (Judge) (Magistrate) (Mediator)
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