Client Intake Form – Marriage

Form Part II Child Custody and Child Support

Security


Today's Date:

Email of person completing this form (required)



Children


NoneOneTwoThreeFourFive































































Shared Residential Arangement




Enter the annual income of the Husband's, Wife's and then the combined Income of both.  Use the income from the last tax return, most recent paystub deducting of 7.65% for (FICA) but not less than the 2017 self-support reserve of $16,281, unless a party is disabled. Also see: CSSA Guidelines Chart



Annual Combined Support Obligation

Weekly Combined Support Obligation

Husband's Percentage of Comdined CSSA Support Obligation and uninsured medical expenses

Husband's Weekly Child Support Obligation

Wife's Percentage of Comdined CSSA Support Obligation and uninsured medical expenses

Wifes's Weekly Child Support Obligation

The parties have agreed to OPT-INOPT-OUT