DHS ORS CSS GWJT
10/94 Rev. 6/00 IN
THE _________________ DISTRICT COURT
__________________________, )
) CHILD SUPPORT OBLIGATION WORKSHEET
vs. ) (JOINT PHYSICAL CUSTODY)
)
___________________________ ) Civil No. _________________

MOTHER 
FATHER 
COMBINED 
1. Enter the # of natural
and adopted children of this mother and father for whom support is to be
awarded. 



2a. Enter the father’s and
mother’s gross monthly income. Refer to Instructions for definition of
income. 
$ 
$ 

2b. Enter previously
ordered alimony that is actually paid. (Do not enter alimony ordered for this
case). 
 
 

2c. Enter previously
ordered child support. (Do no enter obligations ordered for the children in
Line 1). 
 
 

2d. OPTIONAL: Enter the
amount from Line 12 of the Children in Present Home Worksheet for either
parent. 
 
 

3. Subtract Lines 2b, 2c,
and 2d from 2a. This is the Adjusted Gross Income for child support purposes. 
$ 
$ 
$ 
4. Take the COMBINED figure
in Line 3 and the number of children in Line 1 to the Support Table. Enter
the Combined Support Obligation here. 


$ 
5. Divide each parent’s
adjusted monthly gross in Line 3 by the COMBINED adjusted monthly gross in
Line 3. 
% 
% 

6. Multiply Line 4 by Line
5 for each parent to obtain each parent’s share of the Base Support
Obligation. 
$ 
$ 

7. Enter the number of
overnights the children will spend with each parent. (They must total
365).Each parent must have at least 111 overnights to qualify for Joint
Physical Custody (UCA 78457.9). 


365 
7b. Identify the parent who
has the child the lesser number of overnights, and continue the rest of the
calculation for them. You will be making adjustments to the net amount owed
by this parent. 
(Name of parent with lesser
number of overnights) 
8a. For the parent who has the child the lesser number of
overnights multiply the number of overnights that are greater than 110 but
less than 131 by .0027 to obtain a resulting figure and enter in the space to
the right.


8b. Multiply the result on
line 8a. by the Combined Support Obligation on line
4 for this parent and enter the number
in the space to the right. 
$ 
8c. Subtract the respective
dollar amount on line 8b. from this parent’s share of the Base Support
Obligation found in the column for this parent on line 6 to determine the amount as indicated by UCA
78457.9 (3)(a) and enter the amount in the space to the right. 
$ 
9a. Additional calculation necessary if both parents have the child for
more than 131 overnights (Otherwise go to line 10): For the parent who
has the child the lesser number of overnights multiply
the number of overnights that exceed 130 (131 overnights or more) by .0084 to
obtain a resulting figure and enter it in the space to the right. 

9b. Multiply the result on line 9a. by the Combined Support Obligation on line 4 for this
parent and enter each in the space to the right. 
$ 
9c. Subtract this parent’s
dollar amount on line 9b. from their respective
amount as identified on line 8c. to determine the
amount as indicated by UCA 78457.9(3)(b) and enter the amount in the space
to the right. Go to line 10. 
$ 
10. BASE CHILD SUPPORT AWARD:
If the result in line 9c. is > 0, then this
parent is the obligor (and the other parent is the obligee). Enter the amount
in line 9c. here. This is the amount owed by this
parent to the obligee all 12 months of the year. If the result in line 9c. is < 0, then this parent is the obligee (and the other
parent is the obligor). Enter the absolute value of the result in line 9C. here. This is the amount owed to this parent by the
obligor all 12 months of the year. 
$ 
11. Which parent is the obligor? ( )
Mother ( ) Father
12. Is the support award the same as the
guideline amount in line10? ( ) Yes
( ) No
If NO, enter the amount ordered:
$_________, and answer number 13.
13. What were the reasons stated by the Court for the deviation?
( ) property settlement
( ) excessive debts of the marriage
( ) absence of need of the custodial parent
( ) other:
______________________________________________________________________________
Attorney Bar
No. __________________ ( ) Electronic filing ( ) Manual filing
Line 1. Enter the
number of natural and adopted children of the mother and father for whom
support is to be determined. Do not
include any children of either parent by another partner on this line. If a child for whom support is to be
determined is an unemancipated minor who does not live with his parents, use
the total number of children, including the unemancipated minor, by that set of
parents for Line 1.
Line 2a. Enter the
mother's and father's gross monthly income. Definition of gross monthly income 
prospective income from any source, salaries, wages, commissions, royalties,
bonuses, rents, gifts, prizes, dividends, severance pay, pensions, interest,
trust income, alimony from previous marriages, annuities, capital gains, social
security benefits, workers' compensation benefits, unemployment compensation,
disability insurance benefits and payments for "nonmeanstested"
government programs. Income from earned
sources is limited to the equivalent of one full time job. For selfemployed parents, see UCA
78457.5(4)(a) and (b).
Excluded from gross income are: cash assistance
provided under Title 35A, Chapter 3, Part 3, Family Employment Program,
benefits from: the housing subsidy program, the Job Training Partnership Act,
S.S.I., S.S.D.I., Medicaid, Food Stamps, General Assistance, and other
"meanstested" benefits received by a parent; earnings or benefits of
a child who is subject to this award.
All income must be verified. Verification includes: year to date pay
stubs, employer statements or records, the last year's tax return and
documentation of nonearned income appropriate to the source.
Line 2b. Enter the
amount of spousal support either parent is court ordered to pay and actually
pays to another parent. Do not include
alimony payments for this case. Alimony
payments must be verified. Cancelled
checks or a statement from the recipient of the alimony may be accepted as
verification.
Line 2c. Enter the amount of support either parent is court
ordered to pay for children by another partner.
Previously ordered support may include specifically ordered payments toward
a child's medical expenses, child care, or child support. A copy of the order is required for
verification.
Line 2d. Natural or
adoptive children of either parent who live in the home of that parent and are
not children in common to both parties, may at the option of either party be
taken into account under the guidelines in setting or adjusting a child support
award. Use the WORKSHEET TO DETERMINE
FATHER'S OBLIGATION TO CHILDREN IN HIS PRESENT HOME and/or the WORKSHEET TO
DETERMINE MOTHER'S OBLIGATION TO CHILDREN IN HER PRESENT HOME to compute the
obligations of the respective parents for the additional children.
Consideration of natural or adoptive child(ren) other
than those in common to both parties may be applied to lessen an increase in
the award, but may not be applied to justify a decrease in the award. The party requesting the credit must provide
verification of the residence of the children and the present spouse’s income.
Line 3. Complete the
calculation as directed.
Line 4. The amount on
the "Combined Child Support Obligation Table" shows the amount BOTH
parents combined should contribute for the support of their child(ren).
Line 5. Each parent's share of the combined support obligation as a
percentage figure.
Line 6. Each parent’s share of the base
support obligation as a dollar figure.
Line 7. This is the total number of overnights the children
will have with each parent. Each parent must have atleast 111 overnights to
qualify for Joint Physical Custody (UCA 78457.9).
Line 7b. The rest of the calculation will be made for the
parent who has the child(ren) the lesser number of
overnights. So identify this parent here and continue the calculation for only
this parent.
Line 8a. Complete the calculation as directed. This is the mathematical
figure that will be used to reduce the base support obligation for overnights
totaling between 110 to 130.
Line 8b. Complete the calculation as directed. This is the
combined support obligation as a dollar figure for this parent.
Line 8c. Complete the calculation as directed. This is this
parent’s share of the base support obligation as a dollar figure.
Line 9a. If both parents have the child for more than 131
overnights, then continue the calculation as directed. This is the mathematical
figure that will be used to reduce the base support obligation for any
overnights greater than 130 that the child(ren) have with the parent who has
the child(ren) the lesser number of overnights. Otherwise go to line 10.
Line 9b. Complete the calculation as directed. This is the
combined support obligation as a dollar figure for this parent.
Line 9c. Complete the calculation as directed. This is this
parent’s share of the base support obligation as a dollar figure.
Line 10. Designate
which parent must pay support and the support amount. The Base Child Support
Award is the amount the obligor pays to the obligee all 12 months of the year.
See the Insurance Premium and Child Care Adjustment Worksheet to
determine how the insurance premiums and child care expenses may change the
amount the obligor pays to the obligee.
Line 11. Designate which parent must pay support.
Line 12. Complete line 12 to show if the amount ordered deviates from the guideline amount in line 10. Complete line 13 if you deviated from the guideline amount.