New Hampshire Child Support Guidelines Worksheet Form - Free Download
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New Hampshire Child Support Guidelines Worksheet Form
New Hampshire Child Support Guidelines Worksheet Form
NHJB-2101-FS (04/01/2014) Page 1 of 3
THE STATE OF NEW HAMPSHIRE
JUDICIAL BRANCH
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://www.courts.state.nh.us
Court Name:
Case Name:
Case Number:
(if known)
CHILD SUPPORT GUIDELINES WORKSHEET
Child's name DOB Child's name DOB
1. Total number of children
2. Obligor’s reasonable medical support
obligation
(4% monthly gross income)
3. Obligee’s reasonable medical support
obligation (4% monthly gross income)
PAYMENT CALCULATIONS
Note: All income and expenses must be converted to monthly amounts
(multiply weekly amounts by 4.33: bi-weekly amounts by 2.17).
OBLIGOR
(Column 1)
OBLIGEE
(Column 2)
COMBINED
(Column 3)
4. Monthly gross income
$ $
5A. Court/Admin. ordered support for other children
$ $
5B. 50% of actual self-employment taxes paid
$
$
5C. Mandatory retirement
$ $
5D. Actual state income taxes paid
$ $
5E. Allowable child care expenses (obligor) (See LINE 5E instructions)
$
5F. Medical support for children (obligor)
$
5G. Total deductions (Add lines 5A through 5F)
$
$
6. Adjusted monthly gross income (Subtract line 5G from line 4)
$
$ $
7A. Child support guideline amount (From Guideline Calculation Table)
$
7B. Guideline percentage (From Guideline Calculation Table)
%
8A. Allowable child care expenses (obligee)
(See LINE 8A instructions)
$
8B. Medical support for children (obligee)
$
8C. Total allowable obligee expenses (Add line 8A and 8B)
$
9. Total adjusted monthly gross income
$ $ $
10. Proportional share of income
11. Parental support obligation (Line 10 times line 7A)
$ $
ABILITY TO PAY CALCULATION
12. Self-support reserve (From Guideline Calculation Table)
$
13. Income available for support (Subtract line 12 from line 9, column 1)
$
14. Monthly support payable
(Enter the smaller of line 11, column 1 or line 13, column 1. If line 13,
column 1 is less than $50.00, then a minimum order of $50.00 is entered.)
$
15. Presumptive child support obligation
(If weekly, divide line 14 by 4.33; if bi-weekly, divide line 14 by 2.17;
if monthly, enter same amount as in line 14.)
** ROUND THE RESULT TO THE NEAREST WHOLE DOLLAR **
$
Frequency (check one):
Weekly Bi-Weekly
Monthly
Prepared by: Title: Date:
Clear Form
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00%
100.00%
0.00
0.00
0.00
50.00
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