Today's Date:

Email of person completing this form (required)

Wife's Last Name (required)

Husband's Last Name (required)

Children

Number of Children of the Marriage including adopted children
NoneOneTwoThreeFourFive

Who will have Custody
parties shall have joint custodythe Mother shall have custodythe Father shall have custodyNot decided yet on custody
Who will be primary residential parent
MotherFatherNeither Party

Regular Access to child(ren)It is mutually agreed that each party shall have access with the parties’ child(ren) on a liberal and reasonable basis pursuant to a schedule worked out directly between the Mother and Father and anticipated to be on a weekly basis with the times being adjusted by the parties in accordance with their work schedules and the customary schedule of the child(ren). The parties have agreed to discuss and agree on how the children are transported to and from each party for the purposes of access and visitation.
Holiday Access to child(ren)The parties decline to set a holiday access schedule. Both parties agree that each shall continue to enjoy access with the minor child(ren) for the holidays as they have traditionally, giving weight and effect to past family holiday traditions. The parties agree that they each shall enjoy access to the parties child(ren) on all major Holiday and School Vacations regular School Holidays and that should they be unable to agree on a Holiday and Vacation schedule then either party may petition a court of competent jurisdiction for such schedule.
Select the number of Children of the Marriage to set CSSA guidelines support. Percentage
1 Child and is 17%2 Children and is 25%3 Children and is 29%4 Children and is 31%5 Children and is not less than 35%
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
A = Husband's Income x .9235
B = Wife's Income x .9235
A + B = C Combined Income
Annual Combined Support Obligation
C x Percentage = D Annual Support
Weekly Combined Support Obligation
C x Percentage /52 = E Weekly Support
Husband's Percentage of Comdined CSSA Support Obligation and uninsured medical expenses
A/A+B = F
Husband's Weekly Child Support Obligation
E x F =
Wife's Percentage of Comdined CSSA Support Obligation and uninsured medical expenses
B/A+B = G
Wifes's Weekly Child Support Obligation
E x G =

The parties have agreed to OPT-INOPT-OUT

Party Paying Support HusbandWifeNeither

Party Receiving Support HusbandWifeNeither

Amount and Frequency of Payment

Payment ShallShall NotNA be made by payroll deduction.