Last updated: 5/17/2022
Worksheet 5-Deviations To Child Support Guidelines
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Description
Worksheet 5 DEVIATIONS TO CHILD SUPPORT GUIDELINES This worksheet may be completed by the court and filed with the clerk in the event of a deviation or deviations under § 4-203 of the child support guidelines. Mother 1. Net income of the parties as computed under worksheet 1 Combined monthly income Percent contribution of each Monthly support for child(ren) from table 1 Health insurance premium Total obligation Each parent's monthly share Each parent's credit for health premium actually paid Each parent's final share of the obligation Further deviations (specify) a. reason 1 ______________ b. reason 2 ______________ c. reason 3 ______________ d. 11. Total $ _______ _______ % $ _______ $ _______ _______ % Father $ _______ 2. 3. 4. $ _______ $ _______ $ _______ $ _______ $ _______ 5. 6. 7. 8. $ _______ $ _______ $ _______ $ _______ $ _______ 9. 10. $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ Each parent's monthly share (line 9 above) (+/-) Line 10d Adjusted child support $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ 12. 13. Dated: _________________________ Judge County Case No. CI__-_____ Worksheet 5 adopted Dec. 23, 1992; amended effective Sept. 1, 2002; amended March 18, 2009; amended July 13, 2011, effective September 1, 2011. American LegalNet, Inc. www.FormsWorkFlow.com
