Worksheet
               __________ County Domestic Relations Court (or)
             __________ County Child Support Enforcement Agency
                          Child Support Computation
                 Split Parental Rights and Responsibilities
Name of parties _____________________________________
Case No. _____
Number of minor children _____. The following parent was designated
residential parent and legal custodian:
__________ mother; __________ father.

Father has _____ pay periods annually; mother has _____ pay periods annually.


                                          Column I   Column II   Column III
                                          Father      Mother      Combined
1a. Annual gross income from employment
or, when determined to be appropriate by
the court or agency, average annual
gross income from employment over a
reasonable period of years (exclude
overtime and bonuses)...................  $_____     $_____
b. Amount of overtime and bonuses         Father     Mother
      Yr. 3
      (Three years ago)                   $_____     $_____
      Yr. 2
      (Two years ago)                     $_____     $_____
      Yr. 1
      (Last calendar year)                $_____     $_____
      Average:                            $_____     $_____
(Include in Column I and/or Column 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 three years
or the year 1 amount, include only the
amount reasonably expected to be
earned this year.)......................  $_____       $_____
2. Annual income from interest and
dividends (whether or not taxable)......  $_____       $_____
3. Annual income from unemployment
compensation............................  $_____       $_____
4. Annual income from workers'
compensation or disability insurance
benefits................................  $_____       $_____
5. Other annual income (identify).......  $_____       $_____
6. Total annual gross income (add
lines 1-5)..............................  $_____       $_____
7. Annual court-ordered support paid for
other children..........................  $_____       $_____
8. Adjustment for minor children born to
either parent and another parent, which
children are living with this parent
(number of children times federal income
tax exemption less child support
received for the year, not to exceed the
federal tax exemption)..................  $_____       $_____
9. Annual court-ordered spousal support
paid to a former spouse.................  $_____       $_____
10. Amount of local income taxes
actually paid or estimated to be
paid....................................  $_____       $_____
11. For self-employed individuals,
deduct 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...........................  $_____       $_____
12. For self-employed individuals,
deduct ordinary and necessary business
expenses................................  $_____       $_____
13. Total gross income adjustments (add
lines 7-12).............................  $_____       $_____
14. Adjusted annual gross income
(subtract line 13 from line 6)..........  $_____       $_____
15. Combined annual income that is basis
for child support order (add line 14,
Col. I and Col. II).....................                           $_____
16. Percentage 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)......................               + __________% = 100%
17. Basic combined child support
obligation/household
a. For children for whom the father is
the residential parent and legal
custodian (Refer to basic child support
schedule in division (D) of section
3113.215 of the Revised Code; in the
first column of the schedule, locate the
sum that is nearest to the combined
annual income listed in line 15, Col.
III of this worksheet, then refer to the
column of the schedule that corresponds
to the number of children for whom the
father is the residential parent and
legal custodian. If the income of the
parents is more than one sum, and less
than another sum, in the first column of
the schedule, you may calculate the
basic combined child support obligation
based upon the obligation for those two
sums.)..............................................               $_____
b. For children for whom the mother is
the residential parent and the legal
custodian. (Refer to basic child support
schedule in division (D) of section
3113.215 of the Revised Code; in the
first column of the schedule, locate the
sum that is nearest to the combined
annual income listed in line 15, Col.
III of this worksheet, then refer to the
column of the schedule that corresponds
to the number of children for whom the
mother is the residential parent and the
legal custodian. If the income of the
parents is more than one sum, and less
than another sum, in the first column of
the schedule, you may calculate the
basic combined child support obligation
based upon the obligation for those two
sums.)..............................................               $_____
18. Annual child care expenses for the
children who are the subject of this
order that are work, employment
training, or education related, as
approved by the court or agency (deduct
the tax credit from annual cost, whether
or not claimed)
a. Expenses paid by the father..........  $_____
b. Expenses paid by the mother..........               $_____
19. Marginal, out-of-pocket costs,
necessary to provide for health
insurance for the children who are the
subject of this order
a. Costs paid by the father.............  $_____
b. Costs paid by the mother.............               $_____
20. Total annual child care and medical
expenses
a. Of father (add lines 18a and 19a)....  $_____
b. Of mother (add lines 18b and 19b)....               $_____
21. Total annual child support
obligation
a. Of father for child(ren) for whom the
mother is the residential parent and
legal custodian (add lines 20a and 17b
and multiply by line 16a)...............  $_____
b. Of mother for child(ren) for whom the
father is the residential parent and
legal custodian (add lines 20b and 17a
and multiply by line 16b)...............               $_____
22. Adjustment for actual expenses paid
for annual child care expenses, and
marginal, out-of-pocket costs, necessary
to provide for health insurance
a. For father (enter number from line
20a)....................................  $_____
b. For mother (enter number from line
20b)....................................               $_____
23. Actual annual obligation (subtract
line 22a from line 21a and insert in
Column I; subtract line 22b from line
21b and insert in Column II)............  $_____       $_____
24. Net annual support obligation
(greater amount on line 23 Column I or
line 23 Column II minus lesser amount on
line 23 Column I or line 23 Column
II).....................................  $_____       $_____
25. Gross household income per party
after exchange of child support.........  $_____       $_____
      (add line 14 and line 24 for the
parent receiving a child support
payment; subtract line 24 from line 14
for the parent making a child support
payment)
26. Comments, rebuttal, or adjustments
to correct figures in lines 24, Column I
and 24, Column II if they would be
unjust or inappropriate and would not be
in best interest of the children
(specific facts to support adjustments
must be included).......................  $_____       $_____
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
(Addendum sheet may be attached)
27. Final figure (this amount reflects
final annual child support
obligation).............................  $_____       father/mother obligor
28. For decree: child support per child
per week or per month (divide obligor's
annual share, line 27, by 12 or 52 and
by the number of children)..............  $_____
29. For deduction order: child support
per day (calculate support per pay
period from figure on line 28) and add
appropriate poundage....................                $_____
Calculations have been reviewed.
Signatures            __________________________________
				   Father
			   I do/do not consent.
      Sworn to before me and subscribed in my presence, this _____ day of
__________, 19___.
		      __________________________________
				Notary Public
 		      __________________________________
				   Mother
			   I do/do not consent.
      Sworn to before me and subscribed in my presence, this _____ day of
__________, 19___.
		      __________________________________
				Notary Public
__________________________________        __________________________________
Attorney for father                              Attorney for mother

-- The Law Offices of Dennis P. Levin

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