CHILD SUPPORT GUIDELINES WORKSHEET Case No.:
Commonwealth of Virginia Va. Code Section 20-108.2
v. Date:
Monthly Gross Income $ $
Adjustment for spousal support payments
Between parties (show amt. as negative for person paying) $ $
To/from other spouses (show amt. as negative for person paying) $ $
Adjustment for support of child(ren)
Deductions from Monthly Gross Income allowable by law
a. Available Gross Income $ $
b. Combined monthly available income - add both amts in line 5a $
Number of children for whom support is sought
a. Monthly basic child support obligation (from schedule) $
b. Monthly amount allowable for health care coverage $ $ $
c. Monthly amount allowable for employment-related child care expenses $
Total monthly child support obligation (add lines 7.a, 7.b, and 7.c) $
Percent obligation of each party (divide line 5.a by line 5.b)
Monthly child support obligation of each party (line 8 x line 9) $ $
Deduction by non-custodial parent for health care coverage when
paid directly by non-custodial parent or his/her spouse.
a. Credit for benefits received by or for child derived from parent's
entitlement to disab. insurance benefits to the extent that such
derivative benefits are included in parent's gross income
use +/- $ $
use +/- $ $
Total Adj: $ $
Each party's adjusted share $ $
Presumptive Child Support Amount Payable to: $ $
VA FORM DC-637 (09/06/2017) © Resolution Point LLC (www.resolutionpoint.com)
Monthly Gross Income $ $
monthly $ $
Adjustment for spousal support payments
Between parties (show amt. as negative for person paying) $ $
monthly $ $
To/from other spouses (show amt. as negative for person paying) $ $
monthly $ $
Adjustment for support of child(ren)
monthly
Deductions from Monthly Gross Income allowable by law
monthly
a. Available Gross Income $ $
b. Combined monthly available income - add both amts in line 5a $
Number of children for whom support is sought
a. Monthly basic child support obligation (from schedule) $
b. Monthly amount allowable for health care coverage $ $
monthly $ $ $
c. Monthly amount allowable for employment-related child care expenses $
monthly $
Total monthly child support obligation (add lines 7.a, 7.b, and 7.c) $
Percent obligation of each party (divide line 5.a by line 5.b)
Monthly child support obligation of each party (line 8 x line 9) $ $
Deduction by non-custodial parent for health care coverage when
paid directly by non-custodial parent or his/her spouse.
a. Credit for benefits received by or for a child derived from the parent's
entitlement to disability insurance benefits to the extent that such
derivative benefits are included in parent's gross income
monthly
use +/- $ $
monthly $ $
use +/- $ $
monthly $ $
Total Adj: $ $
Each party's adjusted share $ $
Presumptive Child Support Amount Payable to: $ $