2006 Ohio Revised Code - [3119.02.3] 3119.023.Computation worksheet for split parental rights and responsibilities.
[§ 3119.02.3] § 3119.023. Computation worksheet for split parental rights and responsibilities.
When a court or child support enforcement agency calculates the amount of child support to be paid pursuant to a court child support order in a proceeding in which the parents have split parental rights and responsibilities with respect to the children who are the subject of the child support order, the court or child support enforcement agency shall use a worksheet that is identical in content and form to the following:
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CHILD SUPPORT COMPUTATION WORKSHEET
SPLIT PARENTAL RIGHTS AND RESPONSIBILITIES
Name of parties ..............................................................
Case No ......................................................................
Number of minor children .....................................................
Number of minor children with mother .................... father ............
Column I Column II Column III
Father Mother Combined
INCOME
1.a. Annual gross income from employment or, when determined appropriate by the court or agency, average annual gross income from employment over a reasonable period of years. (Exclude overtime, bonuses,
self-employment income, or commissions) ....................$ .............. $ ..............
b. Amount of overtime, bonuses, and commissions (year 1 representing the most recent year)
Father Mother
Yr. 3 $ .................... Yr. 3 $ ....................
(Three years ago) (Three years ago)
Yr. 2 $ .................... Yr. 2 $ ....................
(Two years ago) (Two years ago)
Yr. 1 $ .................... Yr. 1 $ ....................
(Last calendar year) (Last calendar year)
Average $ .................... $ ....................
(Include in Col. I and/or Col. II the average of the three years or the year 1 amount, whichever is less, if there exists a reasonable expectation that the total earnings from overtime and/or bonuses during the current calendar year will meet or exceed the amount that is the lower of the average of the three years or the year 1 amount. If, however, there exists a reasonable expectation that the total earnings from overtime/bonuses during the current calendar year will be less than the lower of the average of the 3 years or the year 1 amount, include only the amount reasonably expected to be earned this year.) $ .............. $ ..............
2. For self-employment income:
a. Gross receipts from business ............$ .............. $ ..............
b. Ordinary and necessary business expenses $ .............. $ ..............
c. 5.6% of adjusted gross income or the actual marginal difference between the actual rate paid by the self-employed individual and the F.I.C.A. rate ... $ .............. $ ..............
d. Adjusted gross income from self-employment (subtract the
sum of 2b and 2c from 2a) ...................................$ .............. $ ..............
3. Annual income from interest and dividends (whether or not
taxable) ....................................................$ .............. $ ..............
4. Annual income from unemployment compensation .............................................................$ .............. $ ..............
5. Annual income from workers' compensation, disability
insurance benefits, or social security disability/retirement benefits .............................................................$ .............. $ ..............
6. Other annual income (identify) ............$ .............. $ ..............
7. Total annual gross income (add lines 1a, 1b, 2d, and 3-6) .............................................................$ .............. $ ..............
ADJUSTMENTS TO INCOME
8. Adjustment for minor children born to or adopted by either parent and another parent who are living with this parent; adjustment does not apply to stepchildren (number of children times federal income tax exemption less child support received, not to exceed the federal tax
exemption) ..................................................$ .............. $ ..............
9. Annual court-ordered support paid for other children .............................................................$ .............. $ ..............
10. Annual court-ordered spousal support paid to any spouse or
former spouse ...............................................$ .............. $ ..............
11. Amount of local income taxes actually paid or estimated to
be paid .....................................................$ .............. $ ..............
12. Mandatory work-related deductions such as union dues,
uniform fees, etc. (not including taxes, social security, or retirement) .............................................................$ .............. $ ..............
13. Total gross income adjustments (add lines 8 through 12) .............................................................$ .............. $ ..............
14. Adjusted annual gross income (subtract line 13 from line
7) ..........................................................$ .............. $ ..............
15. Combined annual income that is basis for child support
order (add line 14, Col. I and Col. II) ...................................... $ ..............
16. Percentage of parent's income to total income
a. Father (divide line 14, Col. I, by line 15, Col. III) ..%
b. Mother (divide line 14, Col. II, by line 15, Col. III) .%
17. Basic combined child support obligation (refer to schedule, first column, locate the amount nearest to the amount on line 15, Col. III, then refer to column for number of children with this parent. If the income of the parents is more than one sum but less than another, you may calculate the difference)
For children For children
for whom the for whom the
mother is the father is the
residential residential
parent and parent and
legal legal
custodian custodian
$ .................... $ ....................
18. Annual support obligation per parent
a. Of father for children for whom mother is the residential
parent and legal custodian (multiply line 17, Col. I, by line 16a) .............................................................$ ..............
b. Of mother for children for whom the father is the residential parent and legal custodian (multiply line 17, Col. II, by line
16b) ......................................................................... $ ..............
19. Annual child care expenses for children who are the subject of this order that are work-, employment training-, or education-related, as approved by the court or agency (deduct tax credit from
annual cost whether or not claimed) ..................................Paid by Paid by
father mother
$ .............. $ ..............
20. Marginal, out-of-pocket costs, necessary to provide for
health insurance for the children who are the subject of this order ..Paid by Paid by
father mother
$ .............. $ ..............
21. ADJUSTMENTS TO CHILD SUPPORT
Father (only if obligor or
shared
parenting) Mother (only if obligor or
shared
parenting)
a. Additions: line 16a times sum of
amounts shown on line 19, Col. II
and line 20, Col. II
$
............... b. Additions: line 16b times sum of
amounts shown on line 19, Col. I
and
line 20, Col. I
$ ...............
c. Subtractions: line 16b times sum
of amounts shown on line 19,
Col. I
and line 20, Col. I
$
............... d. Subtractions: line 16a times sum
of amounts shown on line 19,
Col. II
and line 20, Col. II
$
...............
22. ACTUAL ANNUAL OBLIGATION:
a. Father: line 18a plus line 21a minus line 21c (if the amount on line 21c is greater than or equal to the amount on line 21a - enter
the number on line 18a in Col. I) ...........................$ ..............
b. Any non-means-tested benefits, including social security and veterans' benefits, paid to and received by children for whom the mother is the residential parent and legal custodian or a person on behalf of those
children due to death, disability, or retirement of the father .............................................................$ ..............
c. Actual annual obligation of father (subtract line 22b
from line 22a) ..............................................$ ..............
d. Mother: line 18b plus line 21b minus line 21d (if the amount on line 21d is greater than or equal to the amount on line 21b - enter
the number on line 18b in Col. II) ........................................... $ ..............
e. Any non-means-tested benefits, including social security and veterans' benefits, paid to and received by children for whom the father is the residential parent and legal custodian or a person on behalf of those
children due to death, disability, or retirement of the mother ............... $ ..............
f. Actual annual obligation of mother (subtract line 22e
from line 22d) ............................................................... $ ..............
g. Actual annual obligation payable (subtract lesser actual annual obligation from greater actual annual obligation using amounts in
lines 22c and 22f to determine net child support payable) ...$ .............. $ ..............
23. Deviation from split residential parent guideline amount shown on line 22c or 22f if amount would be unjust or inappropriate: (see
section 3119.23 of the Revised Code.) (Specific facts and monetary value must be stated.)
..............................................................................
..............................................................................
..............................................................................
..............................................................................
24. FINAL FIGURE (this amount reflects final annual child support obligation; line 22g plus or minus any amounts indicated in line 23.)
.............................................................................. $ .............. Father/Mother,
OBLIGOR
Prepared by:
Counsel: .................... Pro se: ....................
(For mother/father)
CSEA: .................... Other: ....................
Worksheet Has Been Reviewed and Agreed To:
........................................................... .............
Mother Date
........................................................... .............
Father Date
HISTORY: 148 v S 180. Eff 3-22-2001.
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