Tennessee > Statewide > Parenting Plan
Child Support Worksheet - Tennessee
| Child Support Worksheet Form. This is a Tennessee form and can be used in Parenting Plan Statewide . |
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State of Tennessee Child Support Worksheet Part I. Identification PRP Indicate the status of each parent or caretaker by placing an "X" in the appropriate column Name of Mother: Name of Father: Name of non-parent Caretaker: TCSES case #: Docket #: Court name: Days with Mother Days with Father Days with Caretaker ARP SPLIT Name(s) of Child(ren) Date of Birth Part II. Basic Support Obligation ü ü 1 Use Credit Worksheet to calculate line items 1b 1d 2 3 4 For clarity and consistency, use Column A for PRP information and Column B for ARP information For Split Parenting, use Column A for Mother's information and Column B for Father's information Monthly Gross Income 1a Self-employment tax paid 1b Credit for pre-existing support orders 1c Credit for In Home Children 1d Credit for Not In Home Children Adjusted Gross Income (AGI) Percentage Share of Income (PI) Basic Child Support Obligation (BCSO) $ $ % Column A Column B Column C $ $ % $ % $ Part III. Parents' Share of Support Obligation Standard Parenting Split Parenting 5 6a 6b Each parent's share of the BCSO Mother's obligation for children for whom father is the PRP Father's obligation for children for whom mother is the PRP $ $ $ $ Part IV. Parenting Time Adjustment 7a 7b 8a 8b 9 10 Number of days per calendar year with children supported by this order with whom the ARP spends 121 or more days per calendar year Parenting time adjustment percentage Number of days per calendar year with children supported by this order with whom the ARP spends 53 or fewer days per calendar year Parenting time adjustment percentage Adjustment in ARP's support obligation for parenting time Each parent's share of the adjusted BCSO % % % $ $ $ $ % 11-4-04 American LegalNet, Inc. www.USCourtForms.com State of Tennessee Child Support Worksheet Part V. Additional Expenses Column A 11a 11b 11c 12 13 14 15 Children's portion of health insurance premium Work-related childcare Total additional expenses Each parent's share of additional expenses Adjusted Support Obligation (ASO) Enter amount of payroll deduction from lines 11a and/or 11b or direct payments made from line 11a. Subtract line 14 from line 13. Enter remainder. $ $ $ $ $ $ $ $ $ $ $ $ Column B Column C $ Part VI. Presumptive Child Support Order / Modification of Current Support Obligation Column 16 Presumptive Child Support Order (PCSO) The ARP's amount from Line 15* $ * For split parenting, enter the difference between the greater and smaller numbers from Line 15 Modification of Current Child Support Order 17a 17b 17c Current child support order amount for the payor parent Amount required for significant variance to exist Actual variance between current and presumptive child support orders $ $ $ Part VII. Uninsured Medical Expenses, Deviations, Final Child Support Order 18 19 Deviations must be Substantiated by written findings in the Child Support Order 20 Uninsured Medical Expenses (recurring): Deviations (Specify): $ $ Final Child Support Order $ Comments, Calculations, or Rebuttals to Schedule Place an "X" in the appropriate blank Preparer's Use Only Name: Title: IV-D Use Only 21a 21b Child Support Obligation Medical Support Obligation $ $ Date: Has the tribunal identified a parent as a low-income provider? Yes No 11-4-04 American LegalNet, Inc. www.USCourtForms.com
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