Temporary Hearing Background Information {SCCA-459}

) ) COUNTY OF ______________________ ) ) ) Plaintiff, ) vs. ) ) ) Defendant. ) 1. 2. 3. Child's Name 1. 2. 3. STATE OF SOUTH CAROLINA IN THE FAMILY COURT ____JUDICIAL CIRCUIT TEMPORARY HEARING BACKGROUND INFORMATION PROVIDED BY: _________________________________ Docket No. ___________________________ Date of Marriage: Date of Separation: Unemancipated Children: __________________ __________________ Date of Birth Child's Name 4. 5. 6. Date of Birth 4. Gross Monthly Incomes (indicate if imputed): Husband/Father: Wife/Mother: $________________ (__________ imputed) $________________ (__________ imputed) 5. If child support is a contested issue, complete the following, using monthly amounts: Father Mother ________ ________ ________ ________ ________ A. Previously Ordered Alimony OR Child Support: B. Other Children in the Home: C. Health Insurance Premium for Children: D. Regularly Occurring Extraordinary Med. Exp.: E. Gross Work-Related Child Care Expense: ________ ________ ________ ________ ________ SCCA 459 (11/2012) American LegalNet, Inc. www.FormsWorkFlow.com 6. The following are issues that are settled or contested as indicated on a temporary basis: Contested Paternity Custody Visitation Child Support Alimony Use of Property Attorney's Fees and Costs Vehicles Health insurance Other: _________________________________________________________ ______ ______ ______ ______ Settled 7. 8. Attached is a completed and signed Financial Declaration. If child support is a contested issue, attach a child support calculation pursuant to the South Carolina Department of Social Services Child Support Guidelines. ________________________________ Attorney for the Plaintiff/Defendant SCCA 459 (11/2012) American LegalNet, Inc. www.FormsWorkFlow.com