Worksheet 3
CALCULATION FOR JOINT PHYSICAL CUSTODY Mother 1. Each parent's percent contribution (% from line 6, worksheet 1) Monthly support obligation from table 1 (from line 7, worksheet 1) Joint physical support obligation (line 2 times 1.5) Each parent's share (line 1 times line 3) Number of days annually child(ren) is in custody of each parent Percentage of year child(ren) is in custody of each parent (line 5 divided by 365) Mother's obligation to father (line 4 mother column, times % on line 6 father column) Father's obligation to mother (line 4 father column, times % on line 6 mother column) Father/mother obligation for support (difference between lines 7 and 8) Father
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2.
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3.
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4.
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5.
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6.
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7.
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8.
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9.
______________ (mother/father)
Additional Adjustment for Child(ren)'s health insurance premium Mother Combined 10. Child(ren)'s health insurance premium* (from line 8, worksheet 1) Combined health insurance premium(s) Father
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11.
12.
Each parent's share of premium (line 1 times line 11) Amount of premium paid (line 10) Amount owed to other parent for premium (line 12 minus line 13, if negative amount enter $0)
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13.
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14.
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15.a.
Which parent owes basic support on line 9?
___________ (mother/father)
15.b.
Which parent owes support for health insurance on line 14?
___________ (mother/father)
15.c.
Does the same parent owe support on lines 15a and 15b?
___________ (Yes/No)
16.
Total support to be paid by parent on line 15a (if YES on line 15c, line 9 plus line 14; if NO on line 15c, line 9 minus line 14)
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* The parent requesting an adjustment for health insurance premiums must submit proof of the cost of the premium for the child(ren).
Worksheet 3 amended effective July 1, 2007.