Birth Birth Birth Children Date Children Date Children Date

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Birth Birth Birth Children Date Children Date Children Date

Transcript Of Birth Birth Birth Children Date Children Date Children Date

Full Name of Party Filing Document

Mailing Address (Street or Post Office Box)

City, State and Zip Code

Telephone

Email Address (if any)

IN THE DISTRICT COURT FOR THE

JUDICIAL DISTRICT

FOR THE STATE OF IDAHO, IN AND FOR THE COUNTY OF

Petitioner, vs.
Respondent.

,

Case No.

SHARED, SPLIT, OR MIXED CUSTODY WORKSHEET
,

CHILDREN 1. 4.

BIRTH DATE
2.
5.

CHILDREN

1. MONTHLY I.C.S.G. INCOME (from Affidavit) 2. SHARE OF INCOME FOR EACH PARENT
(line 1 for each parent divided by Combined Income)
3. BASIC COMBINED CHILD SUPPORT OBLIGATION
(apply line 1 Combined to Child Support Schedule)
4. EACH PARENT’S CHILD SUPPORT OBLIGATION
(line 2 multiplied by line 3 for each parent)
5. OBLIGATION ALLOCATION
(line 4 divided by the number of children)

BIRTH DATE

CHILDREN

3.

YOUR NAME:
$

OTHER PARENT:

COMBINED

$

$

BIRTH DATE

$

$

$

$

$

SHARED, SPLIT, MIXED CUSTODY CHILD SUPPORT WORKSHEET
CAO FL 1-12 07/01/2017

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6. ALLOCATION TO CHILD
For each standard-custody child enter the amount from line 5. For each shared or split-custody child Multiply line 5 by 1.5 and enter in the appropriate box.

CHILD 1 You Other
Parent

CHILD 2 You Other
Parent

CHILD 3

CHILD 4

CHILD 5

You Other You Other You Other

Parent

Parent

Parent

$

$

$

$

7. PROPORTIONAL OBLIGATION

Number of overnights with other parent

Divided by 365. If ≥ .75, enter 1.

If ≤ .25, enter 0. (For example, if child 1

lives with You 40% of the time, “.40”

goes under “Other Parent” for child 1.)

“≥” means “greater than or equal to.”

8. PARENTS’ OBLIGATION

Line 6 times line 7 for each child.

$

$

$

$

9. EACH PARENT’S TOTAL SUPPORT
(total from all boxes)

10. RECOMMENDED BASE SUPPORT
(subtract the lesser amount from the greater in 9 and enter the difference under parent with greater obligation)
OTHER COSTS TO BE CONSIDERED BY THE COURT:

$

$

$

$

You $

$

$

$

$

$

$

$

$

$

Other Parent $

$

A. Work-related childcare expenses (+/-)

$

B. Health insurance premiums (+/-)

$

C. Total TAX BENEFIT for all exemptions divided by 12

Multiply benefit by % for each parent

(+/- to off-set any excess benefit)

$

Total AMOUNT TO BE ORDERED

$

COMMENTS, CALCULATIONS AND/OR REBUTTALS:

. Date:

Typed/printed

Signature

SHARED, SPLIT, MIXED CUSTODY CHILD SUPPORT WORKSHEET
CAO FL 1-12 07/01/2017

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ParentSplitIncomeChildBenefit