Opinion
04-02-2020
IN RE IMPLEMENTATION OF THE REVISED ADMINISTRATIVE ORDER NO. 10
The court hereby adopts and implements the revised Administrative Order No. 10. Effective immediately, the new guidelines may be used as an alternative to the previous version of Administrative Order No. 10. The new guidelines shall be used for all support orders entered after June 30, 2020.
The Court extends its sincere gratitude to the following members of the Child Support Committee for their work to implement the revised Administrative Order No. 10.
Hon. Douglas Schrantz (Chairman), Circuit Judge of Bentonville, Hon. Brandon J. Harrison, Arkansas Court of Appeals, Hon. Andrew Bailey, Circuit Judge of Mountain Home, Hon. David Clark, Circuit Judge of Conway, Rep. Charlene Fite of Van Buren, Allison Allred, Esq., of North Little Rock, Johnnie A. Copeland, Esq., of Mountain Home, Traci LaCerra, Esq., of Little Rock, Mark D'Auteuil, Esq., of Russellville, Michael Shone, Esq., of the Arkansas Office of Child Support Enforcement, and Brooke F. Steen, Staff Attorney, Arkansas Administrative Office of the Courts. Section I. Authority and Scope
Pursuant to Act 948 of 1989, as amended, codified at Ark. Code Ann. § 9-12-312(a) and the Family Support Act of 1988, Pub. L. No. 100-485 (1988), the Court adopted and published Administrative Order Number 10, titled "Child Support Guidelines" ("Guidelines"). Pursuant to Act 907 of 2019, codified at Ark. Code Ann. § 9-12-312(a)(4), the attached revised monthly "Family Support Chart" ("Chart") is based on an Income Shares Model. The attached Chart therefore supersedes any prior payor-income-based family support chart. (Section II.1 discusses when this Administrative Order's incorporation of the Income Shares Model affects existing child-support orders.) This Administrative Order includes and incorporates by reference the "Forms" Addendum: Sample Calculation, Sample Language for Child-Support Orders, Family Support Chart, Child Support Worksheet ("Worksheet"), and the revised Affidavit of Financial Means.
These Guidelines are based on the Income Shares Model, developed by the Child Support Guidelines Project of the National Center for State Courts. The Income Shares Model is based on the concept that children should receive the same proportion of parental income that they would have received had the parents lived together and shared financial resources. The best available economic data on child-rearing expenditures was used to develop the model. A more detailed explanation of the Income Shares Model and the underlying economic evidence used to support it is contained in Development of Guidelines for Child Support Orders, Report to the Federal Office of Child Support Enforcement, September 1987 (National Center for State Courts, Denver, Colorado). The September 2019 Review of the Arkansas Child Support Guidelines, an Analysis of Economic Data, Development of Income Shares Charts, and Other Considerations, prepared by Jane Venohr, Ph.D., is available at www.arcourts.gov/forms-and-publications/arkansas-child-support-guidelines .
Under the revised Family Support Chart, each parent's share is that parent's prorated share of the two parents' combined income. The Chart reflects the average amount of money that families in the United States spend on their children. Differences between Arkansas prices and prices across the United States more generally have been accounted for using an index that the U.S. Bureau of Economic Analysis (BEA) developed. The Chart also considers and accounts for:
• federal and state income taxes and FICA;
• average child-rearing expenditures using current measurements developed by Professor David Betson using the Rothbarth methodology to separate the children's share of expenditures from total expenditures;
• out-of-pocket medical expenses of $250.00 per child per year.
The Chart excludes parental expenditures for work-related childcare, the child's share of health insurance premiums, and out-of-pocket medical expenses over $250.00 per child per year.
These Guidelines and the accompanying Worksheet assume that the parent to whom support is owed (payee parent) is spending his or her calculated share directly on the child. For the parent with the obligation to pay support (payor parent), the pro-rata charted amount establishes the base level of child support to be given to the payee parent. The base amount may, however, be adjusted to account for work-related childcare expenditures, the child's share of the health insurance premium, out-of-pocket medical expenses exceeding $250.00 per child per year, the self-support reserve, or other factors a court determines to be in the best interest of a child or children. Section II. Use of the Guidelines
There is a rebuttable presumption that the amount of child support calculated pursuant to the most recent revision of the Family Support Chart and these Guidelines is the amount to be awarded in any judicial proceeding for divorce, separation, paternity, guardianship, or child support.
In addition to an initial award for child support or the modification of an existing obligation, these Guidelines should be used to assess the adequacy of agreements for child support and to encourage parties to settle support-related disputes in a comprehensive manner.
These Guidelines provide calculated amounts of child support for a combined parental gross income of up to $30,000.00 per month, or $360,000.00 per year. The child-support obligation for incomes above $30,000.00 per month shall be determined by using the highest amount in these Guidelines. The court may then use its discretion in setting an amount above that to meets the needs of the child and the parent's ability to provide support.
These Guidelines assume that the payor parent has the minor child(ren) overnight in his or her residence less than 141 overnights per calendar year.
This Administrative Order presumes that a traditional visitation schedule will be less than 141 nights while a liberal visitation schedule is usually more than 141 nights.
1. Modification of Existing Child-Support Obligation:
Pursuant to Act 904 of 2019, codified at Arkansas Code Annotated § 9-14-107(c)(2), "an inconsistency between the existing child-support award and the amount of child support that results from application of the Family Support Chart shall constitute a material change of circumstances sufficient to petition the court for modification of child support according to the Family Support Chart after appropriate deductions unless:
a. The inconsistency does not meet a reasonable quantitative standard established by the State of Arkansas in accordance with subsection (a) of this section;
b. The inconsistency is due to the fact that the amount of the current child support award resulted from a rebuttal of the guideline amount and there has not been a change of circumstances that resulted in the rebuttal of the guidelines amount; or
c. The inconsistency is due solely to a promulgation to a revision of the Family Support Chart."
The Section titled "Modification of Existing Child-Support Order" recites verbatim Arkansas Code Annotated 9-14-107(c)(2).
2. Deviation from the Chart:
All orders granting or modifying child support shall contain the court's determination of the payor's income, payee's income, recite the amount of support required under these Guidelines, and state whether the court deviated from the presumptive child-support calculation set by the Worksheet and these Guidelines. If an order deviates from the Guidelines amount, then the order must explain the reason(s) for the deviation. When deciding whether the Worksheet-based amount is unjust or inappropriate, the court must consider all the relevant factors, including what is in the child's or children's best interest. A deviation from these Guidelines should be the exception rather than the rule. If a court chooses to deviate from the Guidelines amount, then it must make written findings and explain the deviation. It shall be sufficient in a particular case to rebut the presumption that the amount of child support calculated pursuant to the Worksheet is correct if the court provides in the order a specific written finding that the Worksheet-based amount is unjust or inappropriate. When determining whether to deviate from the Guidelines' amount, a court should consider the following:
a. Educational expenses for the child(ren) (i.e., those incurred for private or parochial schools, or other schools where there are tuition or related costs) and/or the provision or payment of special education needs or expenses for the child(ren);
b. The procurement and/or maintenance of life insurance, dental insurance, and/or other insurance for the children's benefit (for health insurance premiums, see Section II.2 infra);
c. Extraordinary travel expenses for court-ordered visitation;
d. Significant available income of the child(ren);
e. The creation or maintenance of a trust fund for the children;
f. The support given by a parent for minor children in the absence of a court order;
g. Extraordinary time spent with the payor parent;
h. Additional expenses incurred because of natural or adopted children living in the home, including stepchildren if the court finds there is a court-ordered responsibility to a stepchild;
i. The provision for payment of work-related childcare, extraordinary medical expenses for the child in excess of $250.00 per year per child, and/or health insurance premiums. Ordinarily, these expenses will be divided pro rata between the parents and added to the base child support of the payor parent on the Worksheet. In that scenario, it shall not support a deviation. However, if the court chooses not to add them in the total child-support obligation, they could support a deviation; and
j. Any other factors that warrant a deviation.
3. Self-Support Reserve, Minimum Order, and Deviation from the Minimum Order:
In cases where the payor parent's monthly gross income is less than $900.00, the Chart applies a self-support reserve (SSR). The SSR considers the basic subsistence needs of the payor parent and is based on the Federal Poverty Guidelines multiplied by Arkansas's price parity. Arkansas's price parity is the index used to adjust the Chart to reflect Arkansas prices. If the payor parent's child-support amount pursuant to the chart is based solely on the payor parent's gross income and corresponding number of children falls within the shaded area of the Chart, then the basic child-support obligation and the payor parent's total child-support obligation are computed using only the payor parent's income. In these cases, health insurance premiums, extraordinary medical expenses, and childcare expenses shall not be used to calculate the total child-support obligation. However, payment of these costs by either parent may be used as a reason to deviate from these Guidelines.
When the payor parent's monthly gross income is less than $900.00, a presumptive minimum award of $125.00 per month must issue unless a party can rebut the presumptive amount by a preponderance of the evidence. Some factors that a court may consider when deciding whether a party has rebutted the minimum order amount include but are not limited to the following:
a. There is a large adjustment due to parenting time;
b. The payor is incarcerated (see Section II.4 below);
c. The payor is institutionalized due to a mental illness or other impairment;
d. The payor has a verified physical disability that precludes work;
e. The payor's only income is Supplemental Security Income (SSI);
f. The payor's ability or inability to work; or
g. Any other deviation factor listed above in Subsection II.2 or any income imputation factor listed below in Section III.7.
4. Incarcerated Individuals
Pursuant to Act 904 of 2019, codified at Arkansas Code Annotated § 9-12-312(a), § 9-14-106(a), and § 9-14-107(a), the incarceration of a parent shall be treated as involuntary unemployment for the purpose of establishing or modifying an award of child support. "Incarceration" means a conviction that results in a sentence of confinement to a local jail, state or federal correctional facility, or state psychiatric hospital for at least 180 days and excludes credit for time served before sentencing. Section III. Gross Income
1. Definitions:
"Income" means the actual gross income of the parent, if employed to full capacity, or potential income if unemployed or underemployed as allowed under Section III.7. Gross income is used to avoid disputes over issues of deductibility that would arise if a net income was used.
These Guidelines presume that the parent with the legal obligation to pay support will file federal taxes as a single individual and have only one state exemption. Adjustments have been made in the Chart for federal and state income taxes, FICA, and average child-rearing expenditures (for example, out-of-pocket medical expenses of $250.00 per child per year).
The monthly child-support amount shall be converted to coincide with the payor's receipt of salary, wages, or other income. For purposes of computing gross monthly income, a month is 4.334 weeks. Bi-weekly means a party is paid once every two weeks, or 26 times during a calendar year. Semi-monthly means a person is paid twice a month, or 24 times per calendar year.
"Child Support Gross Income" means gross income—minus amounts for preexisting child-support obligations paid to another who is not a party to the proceedings and on behalf of a child who is not the subject of the action of the court. Child support arrearage payments shall not be considered in determining a payor's gross income.
"Combined Gross Income" means the combined gross income of both parties.
2. Gross Income Inclusions:
"Income" is "intentionally broad and designed to encompass the widest range of sources consistent with the State's policy to interpret 'income' broadly for the benefit of the child." Evans v. Tillery, 361 Ark. 63, 204 S.W.3d 547 (2005); Ford v. Ford, 347 Ark. 485, 65 S.W.3d 432 (2002); McWhorter v. McWhorter, 346 Ark. 475, 58 S.W.3d 840 (2001); Davis v. Office of Child Support Enforcement, 341 Ark. 349, 20 S.W. 3d 273 (2000).
Gross income includes, but is not limited to, the following:
i. Wages, overtime pay, commissions, regularly-received bonuses, or other monies from all employers or as a result of any employment (as usually reported in the Medicare, wages, and tips section of the parent's W-2).
ii. Earnings generated from a business, partnership, contract, self-employment or other similar arrangement, or from rentals.
(a) Income (or losses) from a corporation should be carefully examined to determine the extent to which they were historically passed on to the parent or used merely as a tax strategy.
iii. Distributed profits or payments from profit-sharing, a pension or retirement, an insurance contract, an annuity, trust fund, deferred compensation, retirement account, social security disability payments, social security retirement payments, unemployment compensation, supplemental unemployment benefits, disability insurance or benefits, or worker's compensation.
(a) Consider insurance or other similar payments received as compensation for lost earnings, but do not include payments that compensate for actual medical bills or for property loss or damage.
(b) If a parent receives payments from an IRA, defined contribution, or deferred compensation plan, income does not include contributions to that account that were previously considered as the parent's income used to calculate an earlier child-support obligation for a child in this case. To the extent that the funds received are equivalent to the amount of the funds contributed by the parent while paying child support, that amount should be excluded from the computation of gross income.
iv. Military specialty pay, allowance for quarters and rations, housing, veterans' administration benefits, G.I. benefits (other than education allotment), or drill pay.
(a) If the servicemember receives housing pay and supports another home (i.e. second residence), housing pay is not considered income to the individual.
v. Tips, gratuities, royalties, interest, dividends, fees, or gambling or lottery winnings.
vi. Capital gains to the extent that they result from recurring transactions.
vii. The standard (basic needs) portion of adoption subsidies for children in the case under consideration (do not consider the medical needs and intensive rate portion of the subsidy, nor the family support subsidy as income).
viii. Any money or income due or owed by another individual, source of income, government, or other legal entity.
ix. Income also includes the market value of perquisites (perks) received as goods,
services, or other noncash benefit for which the parent did not pay, if they reduce personal expenses, and have significant value or are received regularly.
(a) Common forms of perquisites (perks) or goods and services received in-kind include, but are not limited to, the following: housing, meals, or room and board, personal use of a company business vehicle or mileage reimbursement, including use between home and primary worksite, and other goods or services.
(b) Perquisites (perks) do not include money paid by an employer for benefits like tuition reimbursement, educational cost reimbursement, uniforms, and health savings account (HSA) contributions.
x. The court may consider assets available to generate income for child support. For example, the court may determine the reasonable earning potential of any asset at its market value and assess against it the current Treasury bill interest rate or some other similar appropriate method of computing income.
To further this State's policy of interpreting "income" broadly for the benefit of children, a support order may include as its basis a percentage of a bonus to be paid in the future. The child support attributable to a bonus amount (or another one-time source of money) shall be in addition to the periodic child-support obligation. This child-support obligation shall terminate when the underlying child-support obligation terminates. Variable income such as commissions, bonuses, overtime pay, military bonuses, and dividends shall be averaged by the court over a reasonable period of time consistent with the circumstances of the case and added to a parent's fixed salary or wages to determine gross income. When income is received on an irregular, nonrecurring, or onetime basis, the court may, but is not required to, average or prorate the income over a reasonable specified period of time or require the parent to pay as a one-time support amount a percentage of his or her nonrecurring income.
One-time sources of money like an inheritance, gambling or lottery winning, or liquidating a Certificate of Deposit, for example, is income for these Guidelines purposes (as detailed in the previous paragraph). If the receipt of an asset is not sold or otherwise disposed of, however, then it has not "realized a gain" and therefore is not income under these Guidelines.
3. Income from Self-employment, Business Owners, Executives, and Others
a. Difficulty in determining income for self-employed individuals, business owners, and others occurs for several reasons including:
i. These individuals often have types of income and expenses not frequently encountered when determining income for most people.
ii. Taxation rules, business records, and forms associated with business ownership and self-employment differ from those that apply to individuals employed by others. Common business documents reflect policies unrelated to an obligation to support one's child.
iii. Due to the control that business owners or executives exercise over the form and manner of their compensation, a parent, or a parent with the cooperation of a business owner or executive, may arrange compensation to reduce the amount visible to others looking for common forms of income.
b. To determine monies that a parent has available for support, it may be necessary to examine business tax returns, balance sheets, accounting or banking records, and other business documents to identify additional monies a parent has available for support that were not included as personal income. At a minimum, a self-employed parent shall provide their two most recent years of state and federal tax returns. The parent should provide three years of tax returns when there is a reduced, deferred, or elective income situation. Unless otherwise prohibited by law, the court may award expert witness fees when necessary to determine self-employed parent's income.
c. For income from self-employment, proprietorship of a business, or ownership or a partnership or closely held corporation, gross income is defined as gross receipts minus ordinary and necessary expenses required for self-employment or business operation, including an employer's share of FICA. However, the court should exclude from those expenses amounts allowed by the Internal Revenue Service for accelerated depreciation of investment tax credits for purposes of these Guidelines and add those amounts back in to determine gross income. In general, the court should carefully review income and expenses from a parent's self-employment or operation of a business to determine actual levels of gross income available to the parent. The court's duty is to accurately determine a child-support obligation in every case. This amount may differ from the determination of business income for tax purposes.
d. Whether organized informally, or as a corporation, a partnership, a sole proprietorship, or other arrangement or entity, these considerations apply to all forms of self-employment and business ownership, as well as to business executives and others who may receive similar forms of compensation.
e. For purposes of this subsection, income includes amounts that were not otherwise included as income elsewhere in this chapter. Special attention shall be given to the following forms of compensation:
i. Distributed profits, profit sharing, officers' fees and other compensation, management or consulting fees, commissions, and bonuses.
ii. In-kind income or perquisites (perks), gifts, free admission to entertainment, or personal use of business property. The value of these items must be based on a fair-market price, that is, the price a person not affiliated with the business would pay. In-kind payments received by a parent from self-employment or the operation of a business is income if the payments are significant and reduce personal living expenses.
f. Redirected income, or amounts treated by the business or company as if the redirected amounts were something other than the parent's income. Amounts include, but are not limited to, the following:
i. Personal loans. Presume personal loans from a business are in fact redirected income, unless all the following are true: (1) the parent signed a contract or promissory note outlining the terms of the loan, (2) the business maintains records showing the loan owed as a receivable, (3) the parent makes installment payments and the present loan is paid current, and (4) the interest earned and repayment rate appear to be a reasonable business practice. Unless the presumption is overcome by a preponderance of the evidence, then a parent's income includes the difference between the amount the parent repays and a repayment amount for a similar commercially available unsecured personal loan.
ii. Payments made to friends or relatives of the parent. If the business cannot demonstrate that the payments are equivalent to a fair market value payment for the work or services the friend or relative performs, then include any amount that exceeds the fair-market value as the parent's income.
g. Reduced or deferred income. Because a parent's compensation can be rearranged to hide income, determine whether unnecessary reductions in salaries, fees, or distributed profits have occurred by comparing amounts and rates to historical patterns.
i. Unless the business can demonstrate legitimate reasons for a substantial reduction in the percentage of distributed profits, use a three-year average to determine the amount to include as a parent's income.
ii. Unless a business can demonstrate legitimate reasons for reductions (as a percentage of gross business income) in salaries, bonuses, management fees, or other amounts paid to a parent, use a three-year average to determine the amount to include as a parent's income.
h. Business income subject to elective treatment. Income that is subject to elective status (for example, retained income) may be considered as income after the court considers the circumstances and history of the elective treatment, which includes but is not limited to the status prior to the implementation of the support order. If a change in the status was made after the original election, then a court can either choose to include the income in child-support calculations or not include it in the calculations.
i. Deductions for Tax Purposes. For a variety of historical and policy reasons, the government allows considerable deductions for business-related expenses before taxes are calculated. Those same considerations are not always relevant to monies a parent should have available for child support. Therefore, some deductions should be added back into a parent's income for purposes of determining child support. The deductions include, but are not limited to, the following:
i. Rent paid by the business to the parent, if it is not counted as income on that parent's personal tax return.
ii. Real estate depreciation shall always be added back into a parent's income when calculating support.
iii. Depreciation figured at a straight-line (not accelerated) rate on a parent's (not a corporation's or partnership's) tangible personal property, other than for personal vehicles or home offices, shall be deducted from income. Any parent who uses accelerated depreciation for tangible personal property may deduct the value of the straight-line depreciation amount for property other than personal vehicles or home offices, if the parent proves what the straight-line amounts would have been.
iv. Home office expenses, including rent, hazard insurance, utilities, repairs, and maintenance.
v. Entertainment expenses spent by the parent. Legitimate expenses for customers' entertainment may be treated as deductions.
vi. Travel expense reimbursements, except where such expenses are inherent in the nature of the business or occupation (for example, a traveling salesperson), and do not exceed the standard rates allowed by the State of Arkansas for employee travel.
vii. Personal automobile repair and maintenance expenses.
4. Gross Income Exclusions:
Gross income does not include benefits received from means-tested public assistance programs, such as Temporary Assistance to Needy Families (TANF), Supplemental Security Income (SSI) received for self or any child; Food Stamps and General Assistance; income derived by other household members; child support, adoption subsidy payments, and foster care board payments received for other children not involved in the case.
5. Spousal Support:
If a parent paying spousal support also pays child support to the same person, then the amount of alimony a former payee spouse may be receiving shall be reduced from the payor's gross income and added to the payee's gross income for purposes of determining income under the child-support calculation.
6. Other Child Support Paid:
Any previous or existing court orders requiring the payment of current child support shall receive priority over any subsequent child-support obligation. A subsequent support obligation shall not constitute the sole basis for a material change of circumstances sufficient to support a petition to the court for modification of a prior child-support order.
Current child support paid for the benefit of children other than those considered in this computation, to the extent such payment or payments are required by a previous court order, shall be deducted from gross income. Child support arrearage payments shall not be considered in determining a payor's gross income.
7. Income Verification:
The Affidavit of Financial Means and Worksheet shall be used in all family-support matters. Each party shall exchange the Affidavit of Financial Means and Worksheet at least three days before a hearing to establish or modify a support order. The Worksheet shall be filed in the court file and attached to the order that includes the child-support award. The Affidavit of Financial Means shall not be filed in the court file.
A court may rely on suitable documentation of current earnings, preferably for at least one month. Suitable documentation includes, but is not limited to, pay stubs, employer statements or verifications, and receipts and expenses if the parent is self-employed.
Verification of current earnings, whether they are reflected on the Affidavit of Financial Means or not, can be supported with copies of the most recent federal and state tax returns that a parent has filed.
Income can also be verified through the Department of Workforce Services or through the Department of Finance and Administration.
8. Income Imputation Considerations:
If imputation of income is ordered, the court must take into consideration the specific circumstances of both parents, to the extent known, including such factors as the parents' assets, residence, employment and earnings history, job skills, educational attainment, literacy, age, health, criminal record and other employment barriers, and record of seeking work, as well as the local job market, the availability of employers willing to hire the parent, prevailing earnings level in the local community, and other relevant background factors in the case.
There is a rebuttable presumption that the payor and the payee can work full-time or earn full-time income, and the court may calculate child support based on a determination of potential income that would otherwise ordinarily be available to the parties.
The court may consider a disability or the presence of young children or disabled children who must be cared for by the parent as being a reason why a parent is unable to work.
Although Temporary Assistance to Needy Families (TANF) and other means-tested public assistance benefits are not included in gross income, income may be imputed to these recipients.
In addition to determining potential earnings, the court may impute income to any non-income producing assets of either parent, if significant, other than a primary residence or personal property. Examples of such assets are vacation homes (if not maintained as rental property) and idle land. The current rate determined by the court is the rate at which income may be imputed to such nonperforming assets. Section IV. Health Insurance , Extraordinary Medical Expenses, and Childcare Costs
Three additional child-rearing expenses—health insurance premiums, extraordinary medical expenses, and childcare expenses—shall be added to the Worksheet and must be considered by the court when determining the total child-support obligation. If either or both parents carry health insurance for the child(ren), incur extraordinary medical expenses for the child(ren), or pay for childcare expenses for one or more children who receive support, the cost of these expenses shall be added to the Worksheet. The court may in turn add one or more of these expenses to the basic child-support obligation as detailed below.
1. Health insurance:
The court shall consider provisions for the children's health care needs through health insurance coverage. Health insurance coverage is considered reasonable if the cost of dependent coverage does not exceed 5% of the gross income of the parent who is to provide coverage. The court may require coverage by one or both parents who can obtain the most comprehensive coverage through an employer or otherwise, and at the most reasonable cost.
If the employer provides some coverage, then only the amount the employee pays shall be used in the calculation of support. This amount may be determined by the difference between self-only coverage and family coverage, or the cost of medical insurance for the child. If the amounts for self-only and family coverage cannot be verified, then the total cost of the premium may be divided by the total number of persons covered by the policy and then multiplied by the number of children in the support order. If the party providing coverage does not incur an additional cost to add the child(ren), then no amount shall be added to the child-support obligation for insurance.
2. Extraordinary Medical Expenses:
Extraordinary medical expenses may be added to the basic child-support obligation and may include uninsured expenses for a single illness or condition. It may include but is not limited to reasonable and necessary costs for orthodontia, dental treatment, asthma treatment, physical therapy, uninsured chronic health problems, and professional counseling or psychiatric therapy for diagnosed mental disorders (including any reasonable treatment or diagnostic testing needed to diagnose whether there is a recognized mental disorder or disability in the first place).
3. Childcare Costs:
The childcare costs that a parent incurs due to employment or the search for employment is the third add-on to the Worksheet, and they may be considered in the total child-support obligation. Childcare costs must be reasonable, not to exceed the level required to provide quality care for child(ren) from a licensed provider. Section V. Computation of Child Support
1. Calculation and Use of Worksheet:
Except as provided in Section II, paragraph 3, Self-Support Reserve, the gross income of both parents shall first be determined and combined. Each parent's share of the combined total gross income is then determined based on their percentage of the combined income. Next, the basic child-support obligation is determined by looking at the Chart for the parties' combined income and the number of children they have. A presumptive child-support obligation is then determined by adding the allowed additional monthly child-rearing expenses (including health insurance premiums, extraordinary medical expenses, and childcare expenses). Each parent's share of additional child-rearing expenses is determined by multiplying the percentage of income they have available for support, which was determined in step 1. The total child-support obligation for each parent is determined by adding each parent's share of the child-support obligation with their share of allowed additional child-rearing expenses. Lastly, the payor receives a credit for the additional child-rearing expenses that the payor is paying out of pocket, resulting in their presumed child-support order. See the "Forms" Addendum for a sample child-support calculation.
The payor parent shall owe his or her presumed child-support obligation as a money judgment of child support to payee parent.
All orders granting or modifying child support shall contain the court's determination of both parents' gross income and shall specify who is the payor parent and who is the payee parent. Any order shall also state the amount of health insurance premiums, extraordinary medical expenses, and childcare expenses allowed in determining the total child-support obligation. See the "Forms" Addendum for sample language that may be used.
2. Shared Custody Adjustment:
In cases of joint or shared custody, where both parents have responsibility of the child(ren) for at least 141 overnights per calendar year, the parties shall complete the Worksheet and Affidavit of Financial Means as they would in any other support case. The court may then consider the time spent by the child(ren) with the payor parent as a basis for adjusting the child-support amount from the amount determined on the Worksheet. In particular, in deciding whether to apply an additional credit, the court should consider the presence and amount of disparity between the income of the parties, giving more weight to those disparities in the parties' income of less than 20% and considering which parent is responsible for the majority of the non-duplicated fixed expenditures, such as routine clothing costs, costs for extracurricular activities, school supplies, and any other similar non-duplicated fixed expenditures.
The Guidelines intend for the court to deviate (in an amount to be determined) on a case-by-case basis when the payor parent has more than 141 nights with a child(ren). This discretionary deviation shall also apply when the parents each have the child(ren) for approximately 50% of the time.
This discretionary adjustment is based on the number of overnights, or overnight equivalents, that a parent spends with a child pursuant to a court order. For purposes of this section, overnight equivalents are calculated using a method other than overnights if the parent has significant time periods on separate days when the child is in the parent's physical custody, under the direct care of the parent, but does not stay overnight.
3. Split Custody:
When each of the parents have sole custody of one or more of the children, a theoretical support obligation for each parent shall be determined based on the number of children in the other household and offsetting the smaller obligation against the larger one. The parent with the larger obligation pays the difference. To accomplish this calculation, a Worksheet must be completed for each custody arrangement. There must be separate worksheets for the child(ren) who do not live primarily with the other(s).
4. Third-party Custody:
When one computing the obligation of each parent by multiplying each parent's share of income by the total child-support obligation shall owe his or her total child-support obligation as a money judgment of child support to the third-party caretaker or guardian. If only one parent is available, that parent's sole income shall be used to determine the total gross income and one hundred percent of the basic child-support obligation shall be given to that parent. If the third-party caretaker or guardian incurs costs for health insurance premiums, extraordinary medical expenses, and childcare expenses, those expenses may be apportioned pro rata between the parents, or apportioned by the court if only one parent is available, as a deviation from these Guidelines. SECTION VI. Miscellaneous Provisions
1. Allocation of Dependents for Tax Purposes:
Allocation of dependents for tax purposes belongs to the payee parent pursuant to the Internal Revenue Code. However, if allowed by state or federal law, the court shall have the discretion to grant dependency allocation, or any part of it, to the payor parent if the benefit of the allocation to the payor parent substantially outweighs the benefit to the payee parent.
2. Administrative Costs:
The amount paid to the Clerk of the Court or to the Arkansas Clearinghouse for administrative costs pursuant to Ark. Code Ann. § 9-12-312(e)(1)(A), § 9-10-109(b)(1)(A) and § 9-14-804(b) shall not be included as support.
3. Provisions for payment
All child-support orders shall fix the beginning date of the child-support obligation and the interval (weekly, bi-weekly, semimonthly, or monthly) on which payments shall be made.
Child-support obligations shall be rounded down to the nearest whole dollar. All other computations relating to the determination of a payor's child-support obligation shall use mathematical rules for rounding. If the number you are rounding is followed by 5, 6, 7, 8, or 9, round the number up. For example: 37.5 will be rounded to 38. If the number you are rounding is followed by 0, 1, 2, 3, or 4, round the number down. For example, 37.4 will be rounded to 37. Each parent's share of the basic child-support obligation on Line 5 of the Worksheet should be rounded to two decimal places.
All child-support orders shall include a provision for immediate implementation of income withholding or withholding from a financial institution, absent a finding of good cause not to require immediate income withholding or withholding from a financial institution. All withholding forms shall be filed in the court file and have a security level where it can only be viewed by the parties and attorneys of record. Circuit clerks shall only release the withholding order to parties, their employers, and attorneys of record.
Payment shall be made through the Arkansas Clearinghouse pursuant to Ark. Code Ann. § 9-14-805.
4. Sharing of income information
Parents shall provide proof of income for a previous calendar year whenever requested in writing by certified mail by the other parent, but not more than one (1) time a year.
FORMS ADDENDUM
Sample Calculation
Step 1: The gross income of both parents is determined and combined. Payor parent earns $2,000 and (payee parent earns $1,000, for a $3,000 combined gross income. Each parents' share of income is then determined based on their percentage of the combined income. Payor earns 66.66% of the income, and payee earns 33.33% of the income.
Step 2: The basic child-support obligation is determined by looking at the Chart for the $3,000 combined income and is $469 for the parties' one child. Each parent's share of the basic child-support obligation is then determined: 66.66% of $469 is $312.67 (payor parent), and 33.33% of $469 is $156.33 (payee parent).
Step 3: A presumptive child-support obligation is then determined by adding the allowed additional monthly child-rearing expenses including health insurance premiums, extraordinary medical expenses, and childcare expenses. In this case, the court allows $100 that payor parent is paying for the child's health insurance premium and $200 that payee parent is paying for childcare expenses, for a total of $300 for additional child-rearing expenses. Each parent's share of additional child-rearing expenses is determining by multiplying the percentage of income they have available for support (see step 1) by the total expenses: 66.66% of $300 is $200 (payor parent), and 33.33% of $300 is $100 (payee parent).
Step 4: The total child-support obligation for each parent is determined by adding each parent's share of the child-support obligation with their share of allowed additional child-rearing expenses. Payor parent ($312.67 plus $200) has a total child-support obligation of $512.67, and payee parent ($156.33 plus $100) has a total child-support obligation of $256.33.
Step 5: The payor receives a credit for the additional child-rearing expenses that he is paying out of pocket. In this example, payor is paying $100 for the child's health insurance premium, so we deduct $100 from payor's total child-support obligation of $512.67. Payor has a presumed child-support order of $412.67, which shall be rounded down to $412.
Sample language for a court order based on the calculation provided above:
The court has determined that Plaintiff (payor) earns a gross income of $2,000 per month and Defendant (payee) earns a gross income of $1,000 per month. Therefore, the parents' combined gross income is $3,000 with a basic child-support obligation of $469 for their one child per the Chart. The court also finds that Plaintiff (payor) is paying for the child's health insurance premium in the amount of $100 per month and that Defendant (payee) is paying $200 for childcare expenses, for a total of $300 for additional child-rearing expenses. Plaintiff (payor) is responsible for 66% of the total obligation ($312.67 share of basic obligation plus $200 for expenses) and has a total child-support obligation of $512.67. Defendant (payee) is responsible for 33% of the total obligation ($156.33 share of basic obligation plus $100 for expenses) and has a total child-support obligation of $256.33. Plaintiff, as the payor, shall receive a $100 credit for the additional child-rearing expenses that he is paying out of pocket. Plaintiff shall pay $412 per month to Defendant beginning on March 1, 2020, and he shall continue to cover the child's health insurance premium.
| Child Support Worksheet | |||
|---|---|---|---|
| Number of children for whom support is sought___Plaintiff is payee/payor (circle one) and Defendant is payee/payor (circle one) | |||
| Payee | Payor | Combined | |
| PART I: Monthly Income | |||
| Line 1: Child support guidelines income | |||
| Line 1a: Permissible deduction from income | |||
| Line 1b: Another Permissible deduction from income | |||
| Line 2: Income available for support (Line 1 minus Line 1a minus Line 1b) | |||
| Line 3: Each parent's share of income available for support(Each parent's line 2 divided by combined line 2) | |||
| PART II: Basic Obligation | |||
| Line 4: Basic child-support obligation from monthly chart. | |||
| Line 5: Each parent's share of the basic child-support obligation(each parent's line 3 multiplied by combined Line 4) | |||
| PART III: Additional Monthly Child-Rearing Expenses | |||
| Line 6: Cost of the child's health insurance | |||
| Line 7: Cost of the child's extraordinary medical expenses | |||
| Line 8: Cost of work-related child care expenses | |||
| Line 9: Total additional child-rearing expenses (sum of line 6, 7 & 8) | |||
| Line 10: Each parent's share of additional child-rearing expenses(each parent's line 3 multiplied by combined Line 9) | |||
| PART IV: Monthly Child-Support Order | |||
| Line 11: Total child-support obligation(each parent's line 5 plus line 10) | |||
| Line 12: Credit for additional child-rearing expenses (obligor's line 9 only) | |||
| Line 13: Presumed child-support order (Line 11 minus line 12 for obligoronly) |
| Family Support Chart of Basic Child Support Obligations(Self-Support Reserve = $900/month, Minimum Order = $125 per month) | |||||||
|---|---|---|---|---|---|---|---|
| [Redacted] | OneChild | TwoChildren | ThreeChildren | FourChildren | FiveChildren | SixChildren | |
| [Redacted] | [Redacted] | [Redacted] | [Redacted] | [Redacted] | [Redacted] | [Redacted] | [Redacted] |
| 1-1050 | [Redacted] | 125 | 125 | 125 | 125 | 125 | 125 |
| 1100 | [Redacted] | 140 | 142 | 144 | 146 | 148 | 150 |
| 1150 | [Redacted] | 175 | 178 | 180 | 183 | 185 | 188 |
| 1200 | [Redacted] | 203 | 213 | 216 | 219 | 222 | 225 |
| 1250 | [Redacted] | 211 | 249 | 252 | 256 | 259 | 263 |
| 1300 | [Redacted] | 218 | 284 | 288 | 292 | 296 | 300 |
| 1350 | [Redacted] | 226 | 320 | 324 | 329 | 333 | 338 |
| 1400 | [Redacted] | 234 | 343 | 360 | 365 | 370 | 375 |
| 1450 | [Redacted] | 241 | 354 | 396 | 402 | 407 | 413 |
| 1500 | [Redacted] | 249 | 365 | 432 | 438 | 444 | 450 |
| 1550 | [Redacted] | 256 | 376 | 454 | 475 | 481 | 488 |
| 1600 | [Redacted] | 264 | 387 | 468 | 511 | 518 | 525 |
| 1650 | [Redacted] | 271 | 398 | 481 | 537 | 555 | 563 |
| 1700 | [Redacted] | 279 | 409 | 494 | 552 | 592 | 600 |
| 1750 | [Redacted] | 286 | 420 | 507 | 567 | 623 | 638 |
| 1800 | [Redacted] | 293 | 431 | 520 | 581 | 639 | 675 |
| 1850 | [Redacted] | 301 | 442 | 534 | 596 | 656 | 713 |
| 1900 | [Redacted] | 308 | 453 | 547 | 611 | 672 | 730 |
| 1950 | [Redacted] | 316 | 463 | 560 | 626 | 688 | 748 |
| 2000 | [Redacted] | 323 | 474 | 573 | 640 | 704 | 765 |
| 2050 | [Redacted] | 330 | 485 | 586 | 654 | 720 | 783 |
| 2100 | [Redacted] | 338 | 496 | 599 | 669 | 736 | 800 |
| 2150 | [Redacted] | 345 | 506 | 612 | 683 | 752 | 817 |
| 2200 | [Redacted] | 352 | 517 | 625 | 698 | 768 | 834 |
| 2250 | [Redacted] | 360 | 528 | 638 | 712 | 784 | 852 |
| 2300 | [Redacted] | 367 | 538 | 651 | 727 | 799 | 869 |
| 2350 | [Redacted] | 374 | 549 | 664 | 741 | 815 | 886 |
| 2400 | [Redacted] | 381 | 560 | 677 | 756 | 831 | 904 |
| 2450 | [Redacted] | 389 | 571 | 689 | 770 | 847 | 921 |
| 2500 | [Redacted] | 396 | 581 | 702 | 785 | 863 | 938 |
| 2550 | [Redacted] | 403 | 592 | 715 | 799 | 879 | 955 |
| 2600 | [Redacted] | 411 | 603 | 728 | 814 | 895 | 973 |
| 2650 | [Redacted] | 418 | 613 | 741 | 828 | 911 | 990 |
| 2700 | [Redacted] | 425 | 624 | 754 | 842 | 927 | 1007 |
| 2750 | [Redacted] | 433 | 635 | 767 | 857 | 943 | 1025 |
| 2800 | [Redacted] | 440 | 646 | 780 | 871 | 958 | 1042 |
| 2850 | [Redacted] | 447 | 656 | 793 | 886 | 974 | 1059 |
| 2900 | [Redacted] | 454 | 667 | 806 | 900 | 990 | 1076 |
| 2950 | [Redacted] | 462 | 678 | 819 | 915 | 1006 | 1094 |
| 3000 | [Redacted] | 469 | 688 | 832 | 929 | 1022 | 1111 |
| 3050 | [Redacted] | 476 | 699 | 845 | 944 | 1038 | 1128 |
| 3100 | [Redacted] | 484 | 710 | 858 | 958 | 1054 | 1146 |
| 3150 | [Redacted] | 491 | 720 | 871 | 972 | 1070 | 1163 |
| 3200 | [Redacted] | 498 | 731 | 883 | 987 | 1085 | 1180 |
| 3250 | [Redacted] | 505 | 742 | 896 | 1001 | 1101 | 1197 |
| 3300 | [Redacted] | 512 | 752 | 909 | 1015 | 1117 | 1214 |
| 3350 | [Redacted] | 520 | 763 | 922 | 1029 | 1132 | 1231 |
| 3400 | [Redacted] | 527 | 773 | 934 | 1044 | 1148 | 1248 |
| 3450 | [Redacted] | 534 | 784 | 947 | 1058 | 1164 | 1265 |
| 3500 | [Redacted] | 541 | 794 | 960 | 1072 | 1180 | 1282 |
| 3550 | [Redacted] | 548 | 805 | 973 | 1087 | 1195 | 1299 |
| 3600 | [Redacted] | 556 | 816 | 986 | 1101 | 1211 | 1316 |
| 3650 | [Redacted] | 563 | 826 | 998 | 1115 | 1227 | 1333 |
| 3700 | [Redacted] | 570 | 837 | 1011 | 1129 | 1242 | 1350 |
| 3750 | [Redacted] | 577 | 847 | 1024 | 1144 | 1258 | 1367 |
| 3800 | [Redacted] | 584 | 858 | 1037 | 1158 | 1274 | 1385 |
| 3850 | [Redacted] | 592 | 868 | 1049 | 1172 | 1289 | 1402 |
| 3900 | [Redacted] | 599 | 879 | 1062 | 1186 | 1305 | 1419 |
| 3950 | [Redacted] | 606 | 890 | 1075 | 1201 | 1321 | 1436 |
| 4000 | [Redacted] | 612 | 899 | 1086 | 1213 | 1335 | 1451 |
| 4050 | [Redacted] | 619 | 908 | 1097 | 1226 | 1348 | 1465 |
| 4100 | [Redacted] | 625 | 917 | 1108 | 1238 | 1362 | 1480 |
| 4150 | [Redacted] | 631 | 926 | 1119 | 1250 | 1375 | 1495 |
| 4200 | [Redacted] | 637 | 935 | 1130 | 1263 | 1389 | 1510 |
| 4250 | [Redacted] | 644 | 945 | 1141 | 1275 | 1402 | 1524 |
| 4300 | [Redacted] | 650 | 954 | 1152 | 1287 | 1416 | 1539 |
| 4350 | [Redacted] | 656 | 963 | 1163 | 1300 | 1429 | 1554 |
| 4400 | [Redacted] | 662 | 972 | 1174 | 1312 | 1443 | 1569 |
| 4450 | [Redacted] | 668 | 981 | 1185 | 1324 | 1457 | 1583 |
| 4500 | [Redacted] | 675 | 990 | 1197 | 1337 | 1470 | 1598 |
| 4550 | [Redacted] | 681 | 999 | 1208 | 1349 | 1484 | 1613 |
| 4600 | [Redacted] | 687 | 1008 | 1219 | 1361 | 1497 | 1628 |
| 4650 | [Redacted] | 693 | 1018 | 1230 | 1373 | 1511 | 1642 |
| 4700 | [Redacted] | 699 | 1027 | 1241 | 1386 | 1524 | 1657 |
| 4750 | [Redacted] | 706 | 1036 | 1252 | 1398 | 1538 | 1672 |
| 4800 | [Redacted] | 712 | 1045 | 1263 | 1410 | 1552 | 1686 |
| 4850 | [Redacted] | 718 | 1054 | 1274 | 1423 | 1565 | 1701 |
| 4900 | [Redacted] | 724 | 1063 | 1285 | 1435 | 1579 | 1716 |
| 4950 | [Redacted] | 731 | 1072 | 1296 | 1447 | 1592 | 1731 |
| 5000 | [Redacted] | 737 | 1081 | 1307 | 1460 | 1606 | 1745 |
| 5050 | [Redacted] | 743 | 1091 | 1318 | 1472 | 1619 | 1760 |
| 5100 | [Redacted] | 749 | 1100 | 1329 | 1484 | 1633 | 1775 |
| 5150 | [Redacted] | 755 | 1109 | 1340 | 1497 | 1646 | 1790 |
| 5200 | [Redacted] | 762 | 1118 | 1351 | 1509 | 1660 | 1804 |
| 5250 | [Redacted] | 768 | 1127 | 1362 | 1521 | 1674 | 1819 |
| 5300 | [Redacted] | 774 | 1136 | 1373 | 1534 | 1687 | 1834 |
| 5350 | [Redacted] | 780 | 1145 | 1384 | 1546 | 1701 | 1849 |
| 5400 | [Redacted] | 785 | 1152 | 1392 | 1555 | 1710 | 1859 |
| 5450 | [Redacted] | 788 | 1154 | 1394 | 1557 | 1712 | 1861 |
| 5500 | [Redacted] | 790 | 1156 | 1395 | 1559 | 1715 | 1864 |
| 5550 | [Redacted] | 793 | 1159 | 1397 | 1561 | 1717 | 1866 |
| 5600 | [Redacted] | 795 | 1161 | 1399 | 1563 | 1719 | 1869 |
| 5650 | [Redacted] | 798 | 1163 | 1401 | 1565 | 1721 | 1871 |
| 5700 | [Redacted] | 800 | 1165 | 1403 | 1567 | 1724 | 1873 |
| 5750 | [Redacted] | 802 | 1167 | 1405 | 1569 | 1726 | 1876 |
| 5800 | [Redacted] | 805 | 1170 | 1406 | 1571 | 1728 | 1878 |
| 5850 | [Redacted] | 807 | 1172 | 1408 | 1573 | 1730 | 1881 |
| 5900 | [Redacted] | 810 | 1174 | 1410 | 1575 | 1733 | 1883 |
| 5950 | [Redacted] | 812 | 1176 | 1412 | 1577 | 1735 | 1886 |
| 6000 | [Redacted] | 815 | 1178 | 1414 | 1579 | 1737 | 1888 |
| 6050 | [Redacted] | 817 | 1181 | 1416 | 1582 | 1740 | 1891 |
| 6100 | [Redacted] | 821 | 1185 | 1421 | 1587 | 1746 | 1897 |
| 6150 | [Redacted] | 824 | 1189 | 1425 | 1592 | 1751 | 1904 |
| 6200 | [Redacted] | 827 | 1193 | 1430 | 1598 | 1757 | 1910 |
| 6250 | [Redacted] | 830 | 1197 | 1435 | 1603 | 1763 | 1916 |
| 6300 | [Redacted] | 834 | 1201 | 1440 | 1608 | 1769 | 1923 |
| 6350 | [Redacted] | 837 | 1205 | 1444 | 1613 | 1775 | 1929 |
| 6400 | [Redacted] | 840 | 1209 | 1449 | 1619 | 1781 | 1936 |
| 6450 | [Redacted] | 843 | 1214 | 1454 | 1624 | 1787 | 1942 |
| 6500 | [Redacted] | 847 | 1218 | 1459 | 1629 | 1792 | 1948 |
| 6550 | [Redacted] | 850 | 1222 | 1464 | 1635 | 1798 | 1955 |
| 6600 | [Redacted] | 853 | 1226 | 1468 | 1640 | 1804 | 1961 |
| 6650 | [Redacted] | 856 | 1230 | 1473 | 1645 | 1810 | 1967 |
| 6700 | [Redacted] | 860 | 1234 | 1478 | 1651 | 1816 | 1974 |
| 6750 | [Redacted] | 865 | 1240 | 1485 | 1659 | 1825 | 1984 |
| 6800 | [Redacted] | 870 | 1247 | 1494 | 1669 | 1835 | 1995 |
| 6850 | [Redacted] | 875 | 1254 | 1502 | 1678 | 1846 | 2006 |
| 6900 | [Redacted] | 880 | 1261 | 1510 | 1687 | 1856 | 2017 |
| 6950 | [Redacted] | 886 | 1268 | 1519 | 1696 | 1866 | 2028 |
| 7000 | [Redacted] | 891 | 1274 | 1527 | 1705 | 1876 | 2039 |
| 7050 | [Redacted] | 896 | 1281 | 1535 | 1715 | 1886 | 2050 |
| 7100 | [Redacted] | 901 | 1288 | 1543 | 1724 | 1896 | 2061 |
| 7150 | [Redacted] | 907 | 1295 | 1552 | 1733 | 1907 | 2072 |
| 7200 | [Redacted] | 912 | 1302 | 1560 | 1742 | 1917 | 2083 |
| 7250 | [Redacted] | 917 | 1308 | 1568 | 1752 | 1927 | 2095 |
| 7300 | [Redacted] | 923 | 1315 | 1576 | 1761 | 1937 | 2106 |
| 7350 | [Redacted] | 928 | 1322 | 1585 | 1770 | 1947 | 2117 |
| 7400 | [Redacted] | 932 | 1328 | 1592 | 1778 | 1956 | 2126 |
| 7450 | [Redacted] | 936 | 1334 | 1598 | 1785 | 1964 | 2135 |
| 7500 | [Redacted] | 939 | 1340 | 1605 | 1793 | 1972 | 2143 |
| 7550 | [Redacted] | 943 | 1345 | 1611 | 1800 | 1980 | 2152 |
| 7600 | [Redacted] | 947 | 1351 | 1618 | 1807 | 1988 | 2161 |
| 7650 | [Redacted] | 950 | 1357 | 1624 | 1814 | 1996 | 2169 |
| 7700 | [Redacted] | 954 | 1362 | 1631 | 1821 | 2004 | 2178 |
| 7750 | [Redacted] | 957 | 1368 | 1637 | 1828 | 2011 | 2186 |
| 7800 | [Redacted] | 961 | 1373 | 1643 | 1835 | 2019 | 2195 |
| 7850 | [Redacted] | 964 | 1379 | 1649 | 1842 | 2027 | 2203 |
| 7900 | [Redacted] | 968 | 1384 | 1656 | 1849 | 2034 | 2211 |
| 7950 | [Redacted] | 971 | 1390 | 1662 | 1856 | 2042 | 2220 |
| 8000 | [Redacted] | 975 | 1395 | 1668 | 1863 | 2050 | 2228 |
| 8050 | [Redacted] | 978 | 1401 | 1674 | 1870 | 2057 | 2236 |
| 8100 | [Redacted] | 980 | 1402 | 1676 | 1872 | 2060 | 2239 |
| 8150 | [Redacted] | 982 | 1404 | 1678 | 1875 | 2062 | 2242 |
| 8200 | [Redacted] | 984 | 1406 | 1681 | 1877 | 2065 | 2245 |
| 8250 | [Redacted] | 986 | 1408 | 1683 | 1880 | 2068 | 2248 |
| 8300 | [Redacted] | 988 | 1410 | 1685 | 1882 | 2070 | 2250 |
| 8350 | [Redacted] | 989 | 1411 | 1687 | 1885 | 2073 | 2253 |
| 8400 | [Redacted] | 991 | 1413 | 1689 | 1887 | 2076 | 2256 |
| 8450 | [Redacted] | 993 | 1415 | 1691 | 1889 | 2078 | 2259 |
| 8500 | [Redacted] | 995 | 1417 | 1694 | 1892 | 2081 | 2262 |
| 8550 | [Redacted] | 997 | 1419 | 1696 | 1894 | 2084 | 2265 |
| 8600 | [Redacted] | 999 | 1420 | 1698 | 1897 | 2086 | 2268 |
| 8650 | [Redacted] | 1001 | 1422 | 1700 | 1899 | 2089 | 2271 |
| 8700 | [Redacted] | 1002 | 1424 | 1702 | 1902 | 2092 | 2274 |
| 8750 | [Redacted] | 1005 | 1427 | 1705 | 1905 | 2095 | 2278 |
| 8800 | [Redacted] | 1008 | 1430 | 1709 | 1909 | 2100 | 2283 |
| 8850 | [Redacted] | 1011 | 1434 | 1714 | 1914 | 2106 | 2289 |
| 8900 | [Redacted] | 1014 | 1438 | 1718 | 1919 | 2111 | 2294 |
| 8950 | [Redacted] | 1017 | 1442 | 1722 | 1923 | 2116 | 2300 |
| 9000 | [Redacted] | 1020 | 1445 | 1726 | 1928 | 2121 | 2305 |
| 9050 | [Redacted] | 1023 | 1449 | 1730 | 1933 | 2126 | 2311 |
| 9100 | [Redacted] | 1027 | 1453 | 1735 | 1937 | 2131 | 2317 |
| 9150 | [Redacted] | 1030 | 1457 | 1739 | 1942 | 2136 | 2322 |
| 9200 | [Redacted] | 1033 | 1461 | 1743 | 1947 | 2141 | 2328 |
| 9250 | [Redacted] | 1036 | 1464 | 1747 | 1951 | 2147 | 2333 |
| 9300 | [Redacted] | 1039 | 1468 | 1751 | 1956 | 2152 | 2339 |
| 9350 | [Redacted] | 1042 | 1472 | 1755 | 1961 | 2157 | 2344 |
| 9400 | [Redacted] | 1045 | 1476 | 1760 | 1965 | 2162 | 2350 |
| 9450 | [Redacted] | 1048 | 1478 | 1763 | 1970 | 2167 | 2355 |
| 9500 | [Redacted] | 1050 | 1480 | 1767 | 1974 | 2171 | 2360 |
| 9550 | [Redacted] | 1053 | 1483 | 1770 | 1977 | 2175 | 2364 |
| 9600 | [Redacted] | 1055 | 1485 | 1774 | 1981 | 2180 | 2369 |
| 9650 | [Redacted] | 1057 | 1487 | 1777 | 1985 | 2184 | 2374 |
| 9700 | [Redacted] | 1060 | 1489 | 1781 | 1989 | 2188 | 2379 |
| 9750 | [Redacted] | 1062 | 1491 | 1784 | 1993 | 2193 | 2383 |
| 9800 | [Redacted] | 1064 | 1493 | 1788 | 1997 | 2197 | 2388 |
| 9850 | [Redacted] | 1067 | 1495 | 1791 | 2001 | 2201 | 2393 |
| 9900 | [Redacted] | 1069 | 1497 | 1795 | 2005 | 2206 | 2397 |
| 9950 | [Redacted] | 1071 | 1499 | 1799 | 2009 | 2210 | 2402 |
| 10000 | [Redacted] | 1074 | 1501 | 1802 | 2013 | 2214 | 2407 |
| 10050 | [Redacted] | 1076 | 1504 | 1806 | 2017 | 2219 | 2412 |
| 10100 | [Redacted] | 1078 | 1506 | 1809 | 2021 | 2223 | 2416 |
| 10150 | [Redacted] | 1081 | 1508 | 1813 | 2025 | 2227 | 2421 |
| 10200 | [Redacted] | 1083 | 1510 | 1816 | 2029 | 2232 | 2426 |
| 10250 | [Redacted] | 1085 | 1512 | 1820 | 2033 | 2236 | 2430 |
| 10300 | [Redacted] | 1088 | 1514 | 1823 | 2037 | 2240 | 2435 |
| 10350 | [Redacted] | 1090 | 1516 | 1827 | 2040 | 2245 | 2440 |
| 10400 | [Redacted] | 1092 | 1518 | 1830 | 2044 | 2249 | 2444 |
| 10450 | [Redacted] | 1095 | 1521 | 1834 | 2049 | 2253 | 2449 |
| 10500 | [Redacted] | 1098 | 1526 | 1839 | 2054 | 2260 | 2456 |
| 10550 | [Redacted] | 1102 | 1531 | 1844 | 2060 | 2266 | 2463 |
| 10600 | [Redacted] | 1106 | 1536 | 1850 | 2066 | 2273 | 2471 |
| 10650 | [Redacted] | 1109 | 1542 | 1855 | 2072 | 2279 | 2478 |
| 10700 | [Redacted] | 1113 | 1547 | 1860 | 2078 | 2286 | 2485 |
| 10750 | [Redacted] | 1116 | 1552 | 1866 | 2084 | 2292 | 2492 |
| 10800 | [Redacted] | 1120 | 1557 | 1871 | 2090 | 2299 | 2499 |
| 10850 | [Redacted] | 1123 | 1562 | 1876 | 2096 | 2305 | 2506 |
| 10900 | [Redacted] | 1127 | 1568 | 1881 | 2101 | 2312 | 2513 |
| 10950 | [Redacted] | 1130 | 1573 | 1887 | 2107 | 2318 | 2520 |
| 11000 | [Redacted] | 1134 | 1578 | 1892 | 2113 | 2324 | 2527 |
| 11050 | [Redacted] | 1137 | 1583 | 1897 | 2119 | 2331 | 2534 |
| 11100 | [Redacted] | 1141 | 1589 | 1903 | 2125 | 2338 | 2541 |
| 11150 | [Redacted] | 1145 | 1595 | 1908 | 2132 | 2345 | 2549 |
| 11200 | [Redacted] | 1149 | 1600 | 1914 | 2138 | 2352 | 2557 |
| 11250 | [Redacted] | 1153 | 1606 | 1920 | 2145 | 2359 | 2564 |
| 11300 | [Redacted] | 1156 | 1612 | 1926 | 2151 | 2366 | 2572 |
| 11350 | [Redacted] | 1160 | 1618 | 1931 | 2157 | 2373 | 2580 |
| 11400 | [Redacted] | 1164 | 1623 | 1937 | 2164 | 2380 | 2587 |
| 11450 | [Redacted] | 1168 | 1629 | 1943 | 2170 | 2387 | 2595 |
| 11500 | [Redacted] | 1172 | 1635 | 1949 | 2177 | 2395 | 2603 |
| 11550 | [Redacted] | 1176 | 1641 | 1955 | 2183 | 2402 | 2611 |
| 11600 | [Redacted] | 1180 | 1646 | 1960 | 2190 | 2409 | 2618 |
| 11650 | [Redacted] | 1184 | 1652 | 1966 | 2196 | 2416 | 2626 |
| 11700 | [Redacted] | 1187 | 1658 | 1972 | 2203 | 2423 | 2634 |
| 11750 | [Redacted] | 1191 | 1664 | 1978 | 2209 | 2430 | 2642 |
| 11800 | [Redacted] | 1195 | 1668 | 1984 | 2216 | 2437 | 2649 |
| 11850 | [Redacted] | 1198 | 1672 | 1990 | 2222 | 2445 | 2657 |
| 11900 | [Redacted] | 1202 | 1677 | 1996 | 2229 | 2452 | 2665 |
| 11950 | [Redacted] | 1206 | 1681 | 2002 | 2236 | 2459 | 2673 |
| 12000 | [Redacted] | 1209 | 1686 | 2008 | 2242 | 2467 | 2681 |
| 12050 | [Redacted] | 1213 | 1690 | 2013 | 2249 | 2474 | 2689 |
| 12100 | [Redacted] | 1216 | 1695 | 2019 | 2256 | 2481 | 2697 |
| 12150 | [Redacted] | 1220 | 1699 | 2025 | 2262 | 2489 | 2705 |
| 12200 | [Redacted] | 1223 | 1703 | 2031 | 2269 | 2496 | 2713 |
| 12250 | [Redacted] | 1227 | 1708 | 2037 | 2276 | 2503 | 2721 |
| 12300 | [Redacted] | 1231 | 1712 | 2043 | 2282 | 2511 | 2729 |
| 12350 | [Redacted] | 1234 | 1717 | 2049 | 2289 | 2518 | 2737 |
| 12400 | [Redacted] | 1238 | 1721 | 2055 | 2296 | 2525 | 2745 |
| 12450 | [Redacted] | 1241 | 1725 | 2061 | 2302 | 2532 | 2753 |
| 12500 | [Redacted] | 1245 | 1730 | 2067 | 2309 | 2540 | 2761 |
| 12550 | [Redacted] | 1248 | 1734 | 2073 | 2316 | 2547 | 2769 |
| 12600 | [Redacted] | 1252 | 1739 | 2079 | 2322 | 2554 | 2777 |
| 12650 | [Redacted] | 1256 | 1743 | 2085 | 2329 | 2562 | 2785 |
| 12700 | [Redacted] | 1259 | 1748 | 2091 | 2335 | 2569 | 2792 |
| 12750 | [Redacted] | 1263 | 1752 | 2097 | 2342 | 2576 | 2800 |
| 12800 | [Redacted] | 1266 | 1756 | 2103 | 2349 | 2584 | 2808 |
| 12850 | [Redacted] | 1270 | 1761 | 2109 | 2355 | 2591 | 2816 |
| 12900 | [Redacted] | 1273 | 1765 | 2115 | 2362 | 2598 | 2824 |
| 12950 | [Redacted] | 1277 | 1770 | 2121 | 2369 | 2606 | 2832 |
| 13000 | [Redacted] | 1280 | 1774 | 2127 | 2375 | 2613 | 2840 |
| 13050 | [Redacted] | 1284 | 1779 | 2132 | 2382 | 2620 | 2848 |
| 13100 | [Redacted] | 1288 | 1783 | 2138 | 2389 | 2627 | 2856 |
| 13150 | [Redacted] | 1291 | 1787 | 2144 | 2395 | 2635 | 2864 |
| 13200 | [Redacted] | 1295 | 1792 | 2150 | 2402 | 2642 | 2872 |
| 13250 | [Redacted] | 1298 | 1796 | 2156 | 2409 | 2649 | 2880 |
| 13300 | [Redacted] | 1302 | 1801 | 2162 | 2415 | 2657 | 2888 |
| 13350 | [Redacted] | 1305 | 1805 | 2168 | 2422 | 2664 | 2896 |
| 13400 | [Redacted] | 1309 | 1809 | 2174 | 2428 | 2671 | 2904 |
| 13450 | [Redacted] | 1313 | 1814 | 2180 | 2435 | 2679 | 2912 |
| 13500 | [Redacted] | 1316 | 1818 | 2186 | 2442 | 2686 | 2920 |
| 13550 | [Redacted] | 1320 | 1823 | 2192 | 2448 | 2693 | 2928 |
| 13600 | [Redacted] | 1323 | 1827 | 2198 | 2455 | 2701 | 2936 |
| 13650 | [Redacted] | 1326 | 1831 | 2202 | 2460 | 2706 | 2942 |
| 13700 | [Redacted] | 1329 | 1834 | 2206 | 2465 | 2711 | 2947 |
| 13750 | [Redacted] | 1331 | 1838 | 2211 | 2469 | 2716 | 2952 |
| 13800 | [Redacted] | 1334 | 1841 | 2215 | 2474 | 2721 | 2958 |
| 13850 | [Redacted] | 1337 | 1844 | 2219 | 2478 | 2726 | 2963 |
| 13900 | [Redacted] | 1339 | 1848 | 2223 | 2483 | 2731 | 2969 |
| 13950 | [Redacted] | 1342 | 1851 | 2227 | 2487 | 2736 | 2974 |
| 14000 | [Redacted] | 1345 | 1854 | 2231 | 2492 | 2741 | 2979 |
| 14050 | [Redacted] | 1347 | 1858 | 2235 | 2496 | 2746 | 2985 |
| 14100 | [Redacted] | 1350 | 1861 | 2238 | 2500 | 2750 | 2990 |
| 14150 | [Redacted] | 1352 | 1864 | 2242 | 2504 | 2755 | 2994 |
| 14200 | [Redacted] | 1354 | 1867 | 2245 | 2508 | 2759 | 2999 |
| 14250 | [Redacted] | 1357 | 1870 | 2249 | 2512 | 2763 | 3004 |
| 14300 | [Redacted] | 1359 | 1873 | 2253 | 2516 | 2768 | 3008 |
| 14350 | [Redacted] | 1361 | 1876 | 2256 | 2520 | 2772 | 3013 |
| 14400 | [Redacted] | 1363 | 1879 | 2260 | 2524 | 2776 | 3018 |
| 14450 | [Redacted] | 1366 | 1882 | 2263 | 2528 | 2781 | 3023 |
| 14500 | [Redacted] | 1368 | 1885 | 2267 | 2532 | 2785 | 3027 |
| 14550 | [Redacted] | 1370 | 1888 | 2270 | 2536 | 2790 | 3032 |
| 14600 | [Redacted] | 1373 | 1891 | 2274 | 2540 | 2794 | 3037 |
| 14650 | [Redacted] | 1375 | 1894 | 2277 | 2544 | 2798 | 3042 |
| 14700 | [Redacted] | 1377 | 1897 | 2281 | 2548 | 2803 | 3046 |
| 14750 | [Redacted] | 1380 | 1900 | 2284 | 2552 | 2807 | 3051 |
| 14800 | [Redacted] | 1382 | 1903 | 2288 | 2556 | 2811 | 3056 |
| 14850 | [Redacted] | 1384 | 1906 | 2292 | 2560 | 2816 | 3061 |
| 14900 | [Redacted] | 1387 | 1909 | 2295 | 2564 | 2820 | 3065 |
| 14950 | [Redacted] | 1389 | 1911 | 2299 | 2568 | 2824 | 3070 |
| 15000 | [Redacted] | 1391 | 1914 | 2302 | 2572 | 2829 | 3075 |
| 15050 | [Redacted] | 1394 | 1917 | 2306 | 2576 | 2833 | 3080 |
| 15100 | [Redacted] | 1396 | 1920 | 2309 | 2580 | 2838 | 3084 |
| 15150 | [Redacted] | 1398 | 1923 | 2313 | 2584 | 2842 | 3089 |
| 15200 | [Redacted] | 1401 | 1926 | 2316 | 2587 | 2846 | 3094 |
| 15250 | [Redacted] | 1403 | 1929 | 2320 | 2591 | 2851 | 3099 |
| 15300 | [Redacted] | 1405 | 1932 | 2324 | 2595 | 2855 | 3103 |
| 15350 | [Redacted] | 1408 | 1935 | 2327 | 2599 | 2859 | 3108 |
| 15400 | [Redacted] | 1410 | 1938 | 2331 | 2603 | 2864 | 3113 |
| 15450 | [Redacted] | 1412 | 1941 | 2334 | 2607 | 2868 | 3118 |
| 15500 | [Redacted] | 1414 | 1944 | 2338 | 2611 | 2872 | 3122 |
| 15550 | [Redacted] | 1417 | 1947 | 2341 | 2615 | 2877 | 3127 |
| 15600 | [Redacted] | 1419 | 1950 | 2345 | 2619 | 2881 | 3132 |
| 15650 | [Redacted] | 1421 | 1953 | 2348 | 2623 | 2886 | 3137 |
| 15700 | [Redacted] | 1424 | 1956 | 2352 | 2627 | 2890 | 3141 |
| 15750 | [Redacted] | 1426 | 1959 | 2356 | 2631 | 2894 | 3146 |
| 15800 | [Redacted] | 1428 | 1962 | 2359 | 2635 | 2899 | 3151 |
| 15850 | [Redacted] | 1431 | 1965 | 2363 | 2639 | 2903 | 3156 |
| 15900 | [Redacted] | 1433 | 1968 | 2366 | 2643 | 2907 | 3160 |
| 15950 | [Redacted] | 1435 | 1971 | 2370 | 2647 | 2912 | 3165 |
| 16000 | [Redacted] | 1438 | 1974 | 2373 | 2651 | 2916 | 3170 |
| 16050 | [Redacted] | 1440 | 1977 | 2377 | 2655 | 2920 | 3174 |
| 16100 | [Redacted] | 1442 | 1980 | 2380 | 2659 | 2925 | 3179 |
| 16150 | [Redacted] | 1445 | 1983 | 2384 | 2663 | 2929 | 3184 |
| 16200 | [Redacted] | 1447 | 1986 | 2387 | 2667 | 2934 | 3189 |
| 16250 | [Redacted] | 1449 | 1989 | 2391 | 2671 | 2938 | 3193 |
| 16300 | [Redacted] | 1452 | 1992 | 2395 | 2675 | 2942 | 3198 |
| 16350 | [Redacted] | 1454 | 1995 | 2398 | 2679 | 2947 | 3203 |
| 16400 | [Redacted] | 1456 | 1998 | 2402 | 2683 | 2951 | 3208 |
| 16450 | [Redacted] | 1459 | 2001 | 2405 | 2686 | 2955 | 3212 |
| 16500 | [Redacted] | 1462 | 2004 | 2408 | 2690 | 2959 | 3216 |
| 16550 | [Redacted] | 1464 | 2007 | 2412 | 2694 | 2963 | 3221 |
| 16600 | [Redacted] | 1467 | 2009 | 2415 | 2697 | 2967 | 3225 |
| 16650 | [Redacted] | 1470 | 2012 | 2418 | 2701 | 2971 | 3230 |
| 16700 | [Redacted] | 1472 | 2015 | 2421 | 2705 | 2975 | 3234 |
| 16750 | [Redacted] | 1475 | 2018 | 2425 | 2708 | 2979 | 3239 |
| 16800 | [Redacted] | 1478 | 2021 | 2428 | 2712 | 2983 | 3243 |
| 16850 | [Redacted] | 1480 | 2024 | 2431 | 2716 | 2987 | 3247 |
| 16900 | [Redacted] | 1483 | 2027 | 2435 | 2720 | 2992 | 3252 |
| 16950 | [Redacted] | 1486 | 2030 | 2438 | 2723 | 2996 | 3256 |
| 17000 | [Redacted] | 1488 | 2033 | 2441 | 2727 | 3000 | 3261 |
| 17050 | [Redacted] | 1491 | 2036 | 2445 | 2731 | 3004 | 3265 |
| 17100 | [Redacted] | 1494 | 2038 | 2448 | 2734 | 3008 | 3269 |
| 17150 | [Redacted] | 1496 | 2041 | 2451 | 2738 | 3012 | 3274 |
| 17200 | [Redacted] | 1499 | 2044 | 2455 | 2742 | 3016 | 3278 |
| 17250 | [Redacted] | 1501 | 2047 | 2457 | 2745 | 3019 | 3282 |
| 17300 | [Redacted] | 1504 | 2050 | 2461 | 2748 | 3023 | 3286 |
| 17350 | [Redacted] | 1506 | 2052 | 2464 | 2752 | 3027 | 3291 |
| 17400 | [Redacted] | 1509 | 2055 | 2467 | 2756 | 3031 | 3295 |
| 17450 | [Redacted] | 1512 | 2058 | 2470 | 2759 | 3035 | 3299 |
| 17500 | [Redacted] | 1514 | 2061 | 2474 | 2763 | 3039 | 3304 |
| 17550 | [Redacted] | 1517 | 2064 | 2477 | 2767 | 3043 | 3308 |
| 17600 | [Redacted] | 1520 | 2067 | 2480 | 2770 | 3047 | 3312 |
| 17650 | [Redacted] | 1522 | 2070 | 2483 | 2774 | 3051 | 3317 |
| 17700 | [Redacted] | 1525 | 2072 | 2487 | 2778 | 3055 | 3321 |
| 17750 | [Redacted] | 1527 | 2075 | 2490 | 2781 | 3059 | 3325 |
| 17800 | [Redacted] | 1530 | 2078 | 2493 | 2784 | 3063 | 3329 |
| 17850 | [Redacted] | 1532 | 2081 | 2496 | 2788 | 3067 | 3333 |
| 17900 | [Redacted] | 1535 | 2083 | 2499 | 2791 | 3070 | 3338 |
| 17950 | [Redacted] | 1537 | 2086 | 2502 | 2795 | 3074 | 3342 |
| 18000 | [Redacted] | 1540 | 2089 | 2505 | 2798 | 3078 | 3346 |
| 18050 | [Redacted] | 1542 | 2091 | 2508 | 2802 | 3082 | 3350 |
| 18100 | [Redacted] | 1545 | 2094 | 2511 | 2805 | 3086 | 3354 |
| 18150 | [Redacted] | 1547 | 2097 | 2514 | 2809 | 3090 | 3358 |
| 18200 | [Redacted] | 1550 | 2100 | 2518 | 2812 | 3093 | 3362 |
| 18250 | [Redacted] | 1552 | 2102 | 2521 | 2816 | 3097 | 3367 |
| 18300 | [Redacted] | 1555 | 2105 | 2524 | 2819 | 3101 | 3371 |
| 18350 | [Redacted] | 1557 | 2108 | 2527 | 2822 | 3105 | 3375 |
| 18400 | [Redacted] | 1560 | 2110 | 2530 | 2826 | 3109 | 3379 |
| 18450 | [Redacted] | 1562 | 2113 | 2533 | 2829 | 3112 | 3383 |
| 18500 | [Redacted] | 1565 | 2116 | 2536 | 2833 | 3116 | 3387 |
| 18550 | [Redacted] | 1567 | 2119 | 2539 | 2836 | 3120 | 3391 |
| 18600 | [Redacted] | 1570 | 2121 | 2542 | 2840 | 3124 | 3396 |
| 18650 | [Redacted] | 1572 | 2124 | 2545 | 2843 | 3128 | 3400 |
| 18700 | [Redacted] | 1575 | 2127 | 2549 | 2847 | 3131 | 3404 |
| 18750 | [Redacted] | 1577 | 2129 | 2552 | 2850 | 3135 | 3408 |
| 18800 | [Redacted] | 1580 | 2132 | 2555 | 2854 | 3139 | 3412 |
| 18850 | [Redacted] | 1582 | 2135 | 2558 | 2857 | 3143 | 3416 |
| 18900 | [Redacted] | 1585 | 2138 | 2561 | 2861 | 3147 | 3420 |
| 18950 | [Redacted] | 1587 | 2140 | 2564 | 2864 | 3150 | 3424 |
| 19000 | [Redacted] | 1590 | 2143 | 2567 | 2867 | 3154 | 3429 |
| 19050 | [Redacted] | 1592 | 2146 | 2570 | 2871 | 3158 | 3433 |
| 19100 | [Redacted] | 1595 | 2148 | 2573 | 2874 | 3162 | 3437 |
| 19150 | [Redacted] | 1597 | 2151 | 2576 | 2878 | 3166 | 3441 |
| 19200 | [Redacted] | 1599 | 2154 | 2579 | 2881 | 3169 | 3445 |
| 19250 | [Redacted] | 1602 | 2157 | 2583 | 2885 | 3173 | 3449 |
| 19300 | [Redacted] | 1604 | 2159 | 2586 | 2888 | 3177 | 3453 |
| 19350 | [Redacted] | 1607 | 2162 | 2589 | 2892 | 3181 | 3458 |
| 19400 | [Redacted] | 1609 | 2165 | 2592 | 2895 | 3185 | 3462 |
| 19450 | [Redacted] | 1612 | 2167 | 2595 | 2899 | 3188 | 3466 |
| 19500 | [Redacted] | 1614 | 2170 | 2598 | 2902 | 3192 | 3470 |
| 19550 | [Redacted] | 1617 | 2173 | 2601 | 2905 | 3196 | 3474 |
| 19600 | [Redacted] | 1619 | 2176 | 2604 | 2909 | 3200 | 3478 |
| 19650 | [Redacted] | 1622 | 2178 | 2607 | 2912 | 3204 | 3482 |
| 19700 | [Redacted] | 1624 | 2181 | 2610 | 2916 | 3207 | 3486 |
| 19750 | [Redacted] | 1627 | 2184 | 2614 | 2919 | 3211 | 3491 |
| 19800 | [Redacted] | 1629 | 2186 | 2617 | 2923 | 3215 | 3495 |
| 19850 | [Redacted] | 1632 | 2189 | 2620 | 2926 | 3219 | 3499 |
| 19900 | [Redacted] | 1634 | 2192 | 2623 | 2930 | 3223 | 3503 |
| 19950 | [Redacted] | 1637 | 2195 | 2626 | 2933 | 3226 | 3507 |
| 20000 | [Redacted] | 1639 | 2197 | 2629 | 2937 | 3230 | 3511 |
| 20050 | [Redacted] | 1642 | 2200 | 2632 | 2940 | 3234 | 3515 |
| 20100 | [Redacted] | 1644 | 2203 | 2635 | 2944 | 3238 | 3520 |
| 20150 | [Redacted] | 1647 | 2206 | 2638 | 2947 | 3242 | 3524 |
| 20200 | [Redacted] | 1649 | 2208 | 2641 | 2950 | 3245 | 3528 |
| 20250 | [Redacted] | 1652 | 2211 | 2644 | 2954 | 3249 | 3532 |
| 20300 | [Redacted] | 1654 | 2214 | 2648 | 2957 | 3253 | 3536 |
| 20350 | [Redacted] | 1657 | 2216 | 2651 | 2961 | 3257 | 3540 |
| 20400 | [Redacted] | 1659 | 2219 | 2654 | 2964 | 3261 | 3544 |
| 20450 | [Redacted] | 1662 | 2222 | 2657 | 2968 | 3264 | 3548 |
| 20500 | [Redacted] | 1664 | 2225 | 2660 | 2971 | 3268 | 3553 |
| 20550 | [Redacted] | 1667 | 2227 | 2663 | 2975 | 3272 | 3557 |
| 20600 | [Redacted] | 1669 | 2230 | 2666 | 2978 | 3276 | 3561 |
| 20650 | [Redacted] | 1672 | 2233 | 2669 | 2982 | 3280 | 3565 |
| 20700 | [Redacted] | 1674 | 2235 | 2672 | 2985 | 3284 | 3569 |
| 20750 | [Redacted] | 1677 | 2238 | 2675 | 2988 | 3287 | 3573 |
| 20800 | [Redacted] | 1679 | 2241 | 2679 | 2992 | 3291 | 3577 |
| 20850 | [Redacted] | 1681 | 2243 | 2681 | 2995 | 3295 | 3581 |
| 20900 | [Redacted] | 1683 | 2246 | 2684 | 2998 | 3298 | 3585 |
| 20950 | [Redacted] | 1684 | 2248 | 2687 | 3001 | 3301 | 3588 |
| 21000 | [Redacted] | 1686 | 2251 | 2689 | 3004 | 3304 | 3592 |
| 21050 | [Redacted] | 1687 | 2253 | 2692 | 3007 | 3308 | 3595 |
| 21100 | [Redacted] | 1689 | 2255 | 2695 | 3010 | 3311 | 3599 |
| 21150 | [Redacted] | 1691 | 2258 | 2697 | 3013 | 3314 | 3602 |
| 21200 | [Redacted] | 1692 | 2260 | 2700 | 3016 | 3317 | 3606 |
| 21250 | [Redacted] | 1694 | 2262 | 2702 | 3019 | 3321 | 3609 |
| 21300 | [Redacted] | 1695 | 2265 | 2705 | 3022 | 3324 | 3613 |
| 21350 | [Redacted] | 1697 | 2267 | 2708 | 3025 | 3327 | 3616 |
| 21400 | [Redacted] | 1698 | 2269 | 2710 | 3027 | 3330 | 3620 |
| 21450 | [Redacted] | 1700 | 2272 | 2713 | 3030 | 3333 | 3623 |
| 21500 | [Redacted] | 1701 | 2274 | 2716 | 3033 | 3337 | 3627 |
| 21550 | [Redacted] | 1703 | 2277 | 2718 | 3036 | 3340 | 3630 |
| 21600 | [Redacted] | 1704 | 2279 | 2721 | 3039 | 3343 | 3634 |
| 21650 | [Redacted] | 1706 | 2281 | 2723 | 3042 | 3346 | 3637 |
| 21700 | [Redacted] | 1707 | 2284 | 2726 | 3045 | 3350 | 3641 |
| 21750 | [Redacted] | 1709 | 2286 | 2729 | 3048 | 3353 | 3644 |
| 21800 | [Redacted] | 1710 | 2288 | 2731 | 3051 | 3356 | 3648 |
| 21850 | [Redacted] | 1712 | 2291 | 2734 | 3054 | 3359 | 3652 |
| 21900 | [Redacted] | 1713 | 2293 | 2737 | 3057 | 3362 | 3655 |
| 21950 | [Redacted] | 1715 | 2295 | 2739 | 3060 | 3366 | 3659 |
| 22000 | [Redacted] | 1716 | 2298 | 2742 | 3063 | 3369 | 3662 |
| 22050 | [Redacted] | 1718 | 2300 | 2744 | 3066 | 3372 | 3666 |
| 22100 | [Redacted] | 1719 | 2303 | 2747 | 3069 | 3375 | 3669 |
| 22150 | [Redacted] | 1721 | 2305 | 2750 | 3071 | 3379 | 3673 |
| 22200 | [Redacted] | 1722 | 2307 | 2752 | 3074 | 3382 | 3676 |
| 22250 | [Redacted] | 1724 | 2310 | 2755 | 3077 | 3385 | 3680 |
| 22300 | [Redacted] | 1726 | 2312 | 2758 | 3080 | 3388 | 3683 |
| 22350 | [Redacted] | 1727 | 2314 | 2760 | 3083 | 3392 | 3687 |
| 22400 | [Redacted] | 1729 | 2317 | 2763 | 3086 | 3395 | 3690 |
| 22450 | [Redacted] | 1730 | 2319 | 2766 | 3089 | 3398 | 3694 |
| 22500 | [Redacted] | 1732 | 2321 | 2768 | 3092 | 3401 | 3697 |
| 22550 | [Redacted] | 1733 | 2324 | 2771 | 3095 | 3404 | 3701 |
| 22600 | [Redacted] | 1735 | 2326 | 2773 | 3098 | 3408 | 3704 |
| 22650 | [Redacted] | 1736 | 2328 | 2776 | 3101 | 3411 | 3708 |
| 22700 | [Redacted] | 1738 | 2331 | 2779 | 3104 | 3414 | 3711 |
| 22750 | [Redacted] | 1739 | 2333 | 2781 | 3107 | 3417 | 3715 |
| 22800 | [Redacted] | 1741 | 2336 | 2784 | 3110 | 3421 | 3718 |
| 22850 | [Redacted] | 1742 | 2338 | 2787 | 3113 | 3424 | 3722 |
| 22900 | [Redacted] | 1744 | 2340 | 2789 | 3115 | 3427 | 3725 |
| 22950 | [Redacted] | 1745 | 2343 | 2792 | 3118 | 3430 | 3729 |
| 23000 | [Redacted] | 1747 | 2345 | 2794 | 3121 | 3433 | 3732 |
| 23050 | [Redacted] | 1748 | 2347 | 2797 | 3124 | 3437 | 3736 |
| 23100 | [Redacted] | 1750 | 2350 | 2800 | 3127 | 3440 | 3739 |
| 23150 | [Redacted] | 1751 | 2352 | 2802 | 3130 | 3443 | 3743 |
| 23200 | [Redacted] | 1753 | 2354 | 2805 | 3133 | 3446 | 3746 |
| 23250 | [Redacted] | 1754 | 2357 | 2808 | 3136 | 3450 | 3750 |
| 23300 | [Redacted] | 1756 | 2359 | 2810 | 3139 | 3453 | 3753 |
| 23350 | [Redacted] | 1758 | 2362 | 2813 | 3142 | 3456 | 3757 |
| 23400 | [Redacted] | 1759 | 2364 | 2815 | 3145 | 3459 | 3760 |
| 23450 | [Redacted] | 1761 | 2366 | 2818 | 3148 | 3462 | 3764 |
| 23500 | [Redacted] | 1762 | 2369 | 2821 | 3151 | 3466 | 3767 |
| 23550 | [Redacted] | 1764 | 2371 | 2823 | 3154 | 3469 | 3771 |
| 23600 | [Redacted] | 1765 | 2373 | 2826 | 3157 | 3472 | 3774 |
| 23650 | [Redacted] | 1767 | 2376 | 2829 | 3159 | 3475 | 3778 |
| 23700 | [Redacted] | 1768 | 2378 | 2831 | 3162 | 3479 | 3781 |
| 23750 | [Redacted] | 1770 | 2380 | 2834 | 3165 | 3482 | 3785 |
| 23800 | [Redacted] | 1771 | 2383 | 2836 | 3168 | 3485 | 3788 |
| 23850 | [Redacted] | 1773 | 2385 | 2839 | 3171 | 3488 | 3792 |
| 23900 | [Redacted] | 1774 | 2388 | 2842 | 3174 | 3492 | 3795 |
| 23950 | [Redacted] | 1776 | 2390 | 2844 | 3177 | 3495 | 3799 |
| 24000 | [Redacted] | 1777 | 2392 | 2847 | 3180 | 3498 | 3802 |
| 24050 | [Redacted] | 1779 | 2395 | 2850 | 3183 | 3501 | 3806 |
| 24100 | [Redacted] | 1780 | 2397 | 2852 | 3186 | 3504 | 3809 |
| 24150 | [Redacted] | 1782 | 2399 | 2855 | 3189 | 3508 | 3813 |
| 24200 | [Redacted] | 1783 | 2402 | 2857 | 3192 | 3511 | 3816 |
| 24250 | [Redacted] | 1785 | 2404 | 2860 | 3195 | 3514 | 3820 |
| 24300 | [Redacted] | 1786 | 2406 | 2863 | 3198 | 3517 | 3823 |
| 24350 | [Redacted] | 1788 | 2409 | 2865 | 3201 | 3521 | 3827 |
| 24400 | [Redacted] | 1789 | 2411 | 2868 | 3203 | 3524 | 3830 |
| 24450 | [Redacted] | 1791 | 2414 | 2871 | 3206 | 3527 | 3834 |
| 24500 | [Redacted] | 1793 | 2416 | 2873 | 3209 | 3530 | 3837 |
| 24550 | [Redacted] | 1794 | 2418 | 2876 | 3212 | 3533 | 3841 |
| 24600 | [Redacted] | 1796 | 2421 | 2878 | 3215 | 3537 | 3844 |
| 24650 | [Redacted] | 1797 | 2423 | 2881 | 3218 | 3540 | 3848 |
| 24700 | [Redacted] | 1799 | 2425 | 2884 | 3221 | 3543 | 3851 |
| 24750 | [Redacted] | 1800 | 2428 | 2886 | 3224 | 3546 | 3855 |
| 24800 | [Redacted] | 1802 | 2430 | 2889 | 3227 | 3550 | 3858 |
| 24850 | [Redacted] | 1803 | 2432 | 2892 | 3230 | 3553 | 3862 |
| 24900 | [Redacted] | 1805 | 2435 | 2894 | 3233 | 3556 | 3865 |
| 24950 | [Redacted] | 1806 | 2437 | 2897 | 3236 | 3559 | 3869 |
| 25000 | [Redacted] | 1808 | 2440 | 2899 | 3239 | 3563 | 3872 |
| 25050 | [Redacted] | 1809 | 2442 | 2902 | 3242 | 3566 | 3876 |
| 25100 | [Redacted] | 1811 | 2444 | 2905 | 3245 | 3569 | 3879 |
| 25150 | [Redacted] | 1812 | 2447 | 2907 | 3247 | 3572 | 3883 |
| 25200 | [Redacted] | 1814 | 2449 | 2910 | 3250 | 3575 | 3886 |
| 25250 | [Redacted] | 1815 | 2451 | 2913 | 3253 | 3579 | 3890 |
| 25300 | [Redacted] | 1817 | 2454 | 2915 | 3256 | 3582 | 3893 |
| 25350 | [Redacted] | 1818 | 2456 | 2918 | 3259 | 3585 | 3897 |
| 25400 | [Redacted] | 1820 | 2458 | 2920 | 3262 | 3588 | 3901 |
| 25450 | [Redacted] | 1821 | 2461 | 2923 | 3265 | 3592 | 3904 |
| 25500 | [Redacted] | 1823 | 2463 | 2926 | 3268 | 3595 | 3908 |
| 25550 | [Redacted] | 1825 | 2466 | 2928 | 3271 | 3598 | 3911 |
| 25600 | [Redacted] | 1826 | 2468 | 2931 | 3274 | 3601 | 3915 |
| 25650 | [Redacted] | 1828 | 2470 | 2934 | 3277 | 3604 | 3918 |
| 25700 | [Redacted] | 1829 | 2473 | 2936 | 3280 | 3608 | 3922 |
| 25750 | [Redacted] | 1831 | 2475 | 2939 | 3283 | 3611 | 3925 |
| 25800 | [Redacted] | 1832 | 2477 | 2941 | 3286 | 3614 | 3929 |
| 25850 | [Redacted] | 1834 | 2480 | 2944 | 3289 | 3617 | 3932 |
| 25900 | [Redacted] | 1835 | 2482 | 2947 | 3291 | 3621 | 3936 |
| 25950 | [Redacted] | 1837 | 2484 | 2949 | 3294 | 3624 | 3939 |
| 26000 | [Redacted] | 1838 | 2487 | 2952 | 3297 | 3627 | 3943 |
| 26050 | [Redacted] | 1840 | 2489 | 2955 | 3300 | 3630 | 3946 |
| 26100 | [Redacted] | 1841 | 2492 | 2957 | 3303 | 3633 | 3950 |
| 26150 | [Redacted] | 1843 | 2494 | 2960 | 3306 | 3637 | 3953 |
| 26200 | [Redacted] | 1844 | 2496 | 2962 | 3309 | 3640 | 3957 |
| 26250 | [Redacted] | 1846 | 2499 | 2965 | 3312 | 3643 | 3960 |
| 26300 | [Redacted] | 1847 | 2501 | 2968 | 3315 | 3646 | 3964 |
| 26350 | [Redacted] | 1849 | 2503 | 2970 | 3318 | 3650 | 3967 |
| 26400 | [Redacted] | 1850 | 2506 | 2973 | 3321 | 3653 | 3971 |
| 26450 | [Redacted] | 1852 | 2508 | 2976 | 3324 | 3656 | 3974 |
| 26500 | [Redacted] | 1853 | 2510 | 2978 | 3327 | 3659 | 3978 |
| 26550 | [Redacted] | 1855 | 2513 | 2981 | 3330 | 3663 | 3981 |
| 26600 | [Redacted] | 1856 | 2515 | 2983 | 3333 | 3666 | 3985 |
| 26650 | [Redacted] | 1858 | 2518 | 2986 | 3335 | 3669 | 3988 |
| 26700 | [Redacted] | 1860 | 2520 | 2989 | 3338 | 3672 | 3992 |
| 26750 | [Redacted] | 1861 | 2522 | 2991 | 3341 | 3675 | 3995 |
| 26800 | [Redacted] | 1863 | 2525 | 2994 | 3344 | 3679 | 3999 |
| 26850 | [Redacted] | 1864 | 2527 | 2997 | 3347 | 3682 | 4002 |
| 26900 | [Redacted] | 1866 | 2529 | 2999 | 3350 | 3685 | 4006 |
| 26950 | [Redacted] | 1867 | 2532 | 3002 | 3353 | 3688 | 4009 |
| 27000 | [Redacted] | 1869 | 2534 | 3004 | 3356 | 3692 | 4013 |
| 27050 | [Redacted] | 1870 | 2536 | 3007 | 3359 | 3695 | 4016 |
| 27100 | [Redacted] | 1872 | 2539 | 3010 | 3362 | 3698 | 4020 |
| 27150 | [Redacted] | 1873 | 2541 | 3012 | 3365 | 3701 | 4023 |
| 27200 | [Redacted] | 1875 | 2544 | 3015 | 3368 | 3704 | 4027 |
| 27250 | [Redacted] | 1876 | 2546 | 3018 | 3371 | 3708 | 4030 |
| 27300 | [Redacted] | 1878 | 2548 | 3020 | 3374 | 3711 | 4034 |
| 27350 | [Redacted] | 1879 | 2551 | 3023 | 3377 | 3714 | 4037 |
| 27400 | [Redacted] | 1881 | 2553 | 3025 | 3379 | 3717 | 4041 |
| 27450 | [Redacted] | 1882 | 2555 | 3028 | 3382 | 3721 | 4044 |
| 27500 | [Redacted] | 1884 | 2558 | 3031 | 3385 | 3724 | 4048 |
| 27550 | [Redacted] | 1885 | 2560 | 3033 | 3388 | 3727 | 4051 |
| 27600 | [Redacted] | 1887 | 2562 | 3036 | 3391 | 3730 | 4055 |
| 27650 | [Redacted] | 1888 | 2565 | 3039 | 3394 | 3734 | 4058 |
| 27700 | [Redacted] | 1890 | 2567 | 3041 | 3397 | 3737 | 4062 |
| 27750 | [Redacted] | 1892 | 2570 | 3044 | 3400 | 3740 | 4065 |
| 27800 | [Redacted] | 1893 | 2572 | 3046 | 3403 | 3743 | 4069 |
| 27850 | [Redacted] | 1895 | 2574 | 3049 | 3406 | 3746 | 4072 |
| 27900 | [Redacted] | 1896 | 2577 | 3052 | 3409 | 3750 | 4076 |
| 27950 | [Redacted] | 1898 | 2579 | 3054 | 3412 | 3753 | 4079 |
| 28000 | [Redacted] | 1899 | 2581 | 3057 | 3415 | 3756 | 4083 |
| 28050 | [Redacted] | 1901 | 2584 | 3060 | 3418 | 3759 | 4086 |
| 28100 | [Redacted] | 1902 | 2586 | 3062 | 3420 | 3763 | 4090 |
| 28150 | [Redacted] | 1904 | 2588 | 3065 | 3423 | 3766 | 4093 |
| 28200 | [Redacted] | 1905 | 2591 | 3067 | 3426 | 3769 | 4097 |
| 28250 | [Redacted] | 1907 | 2593 | 3070 | 3429 | 3772 | 4100 |
| 28300 | [Redacted] | 1908 | 2596 | 3073 | 3432 | 3775 | 4104 |
| 28350 | [Redacted] | 1910 | 2598 | 3075 | 3435 | 3779 | 4107 |
| 28400 | [Redacted] | 1911 | 2600 | 3078 | 3438 | 3782 | 4111 |
| 28450 | [Redacted] | 1913 | 2603 | 3081 | 3441 | 3785 | 4114 |
| 28500 | [Redacted] | 1914 | 2605 | 3083 | 3444 | 3788 | 4118 |
| 28550 | [Redacted] | 1916 | 2607 | 3086 | 3447 | 3792 | 4121 |
| 28600 | [Redacted] | 1917 | 2610 | 3088 | 3450 | 3795 | 4125 |
| 28650 | [Redacted] | 1919 | 2612 | 3091 | 3453 | 3798 | 4128 |
| 28700 | [Redacted] | 1920 | 2614 | 3094 | 3456 | 3801 | 4132 |
| 28750 | [Redacted] | 1922 | 2617 | 3096 | 3459 | 3804 | 4135 |
| 28800 | [Redacted] | 1924 | 2619 | 3099 | 3462 | 3808 | 4139 |
| 28850 | [Redacted] | 1925 | 2622 | 3102 | 3464 | 3811 | 4142 |
| 28900 | [Redacted] | 1927 | 2624 | 3104 | 3467 | 3814 | 4146 |
| 28950 | [Redacted] | 1928 | 2626 | 3107 | 3470 | 3817 | 4150 |
| 29000 | [Redacted] | 1930 | 2629 | 3109 | 3473 | 3821 | 4153 |
| 29050 | [Redacted] | 1931 | 2631 | 3112 | 3476 | 3824 | 4157 |
| 29100 | [Redacted] | 1933 | 2633 | 3115 | 3479 | 3827 | 4160 |
| 29150 | [Redacted] | 1934 | 2636 | 3117 | 3482 | 3830 | 4164 |
| 29200 | [Redacted] | 1936 | 2638 | 3120 | 3485 | 3834 | 4167 |
| 29250 | [Redacted] | 1937 | 2640 | 3123 | 3488 | 3837 | 4171 |
| 29300 | [Redacted] | 1939 | 2643 | 3125 | 3491 | 3840 | 4174 |
| 29350 | [Redacted] | 1940 | 2644 | 3127 | 3493 | 3842 | 4177 |
| 29400 | [Redacted] | 1941 | 2646 | 3129 | 3495 | 3844 | 4179 |
| 29450 | [Redacted] | 1942 | 2647 | 3130 | 3496 | 3846 | 4181 |
| 29500 | [Redacted] | 1943 | 2648 | 3131 | 3498 | 3848 | 4183 |
| 29550 | [Redacted] | 1943 | 2649 | 3133 | 3499 | 3850 | 4185 |
| 29600 | [Redacted] | 1944 | 2650 | 3134 | 3501 | 3851 | 4186 |
| 29650 | [Redacted] | 1945 | 2652 | 3135 | 3502 | 3853 | 4188 |
| 29700 | [Redacted] | 1946 | 2653 | 3137 | 3504 | 3855 | 4190 |
| 29750 | [Redacted] | 1947 | 2654 | 3138 | 3505 | 3857 | 4192 |
| 29800 | [Redacted] | 1948 | 2655 | 3140 | 3507 | 3859 | 4194 |
| 29850 | [Redacted] | 1949 | 2656 | 3141 | 3508 | 3860 | 4196 |
| 29900 | [Redacted] | 1950 | 2658 | 3142 | 3510 | 3862 | 4198 |
| 29950 | [Redacted] | 1951 | 2659 | 3144 | 3512 | 3864 | 4200 |
| 30000 | [Redacted] | 1952 | 2660 | 3145 | 3513 | 3866 | 4202 |
The Combined Gross Monthly Income does not apply in cases where the child support amount is in the blue shaded area. --------
IN THE CIRCUIT COURT OF __________ COUNTY, ARKANSAS
(Domestic Relations Division)
___Division
__________ Plaintiff v. __________ Defendant Case No. ___DR__________
AFFIDAVIT OF FINANCIAL MEANS
Name:__________, being duly sworn, says under penalty of perjury, that he/she has prepared or approved this financial statement, and that the following information and attachments (including income verification as required by page 6) are complete, true, and correct. __________
Date
__________
Signature Subscribed and sworn to before me on this ___ day of __________ 20___.
Notary Public My commission expires: __________.
MY INCOME
| 1. | How often are you paid?___ weekly___ bi-weekly (every two weeks—26 times a year)___ monthly___ bi-monthly (twice a month-24 times a year)___ other -Explain (attach an exhibit if necessary): |
| 2. | Gross Pay:$__________ |
|---|
INCOME
| 3 | Income: | Amount: | Source | Frequency |
| 3.1 | Gross wages from employment,contract labor, etc. | |||
| 3.2 | Bonuses or incentive pay notreflected on page 2: | |||
| 3.3 | Other court-ordered incomesuch as alimony/child supportpaid to you: | |||
| 3.4 | Payments from a settlement orannuity: | |||
| 3.5 | Regular gifts from relatives orfriends: | |||
| 3.6 | Investment income such as rentpayments to you: | |||
| 3.7 | Stock dividends or bondpayments: | |||
| 3.8 | Regular payments to you or onyour behalf from a Trust: | |||
| 3.9 | Other: | |||
| 3.10 | TOTALMONTHLY INCOME: | $ |
|---|
OTHER AVAILABLE FUNDS
| 4 | ASSET | AMOUNT | SOURCE |
| 4.1 | Cash on hand, and in bankaccounts: | ||
| 4.2 | Trust fund assets held on yourbehalf: | ||
| 4.3 | Stocks, bonds, mutual funds: | ||
| 4.4 | Other (i.e. 401-K, retirement, etc): | ||
| 4.5 | TOTAL: | $ |
|---|
MY CURRENT MONTHLY EXPENSES *
| 5. | Expense: | Amount: | Expense: | Amount: | |
| a. | Health Insurance- for childonly | $ | n. | Health Insurance-excludes amount in "a" | $ |
| b. | Extraordinary medicalexpenses for child in thiscase | $ | o. | Non-covered medical forself or child not involvedin this case | $ |
| c. | Childcare for child in thiscase | $ | p. | Childcare for child notinvolved in this case | $ |
| d. | Rent/house payment | $ | q. | Car payment | $ |
| e. | Media Services, e.g.Cable/Satellite, Internet | $ | r. | Car Insurance | $ |
| f. | Telephone | $ | s. | Car fuel andmaintenance | $ |
| g. | Gas, water, trash, &electricity | $ | t. | Lawn care | $ |
| h. | Union dues | $ | u. | Charitable giving | $ |
| i. | Pension plan | $ | v. | Household Expenses | $ |
| j. | 401(k) payments | $ | w. | Dry cleaning | $ |
| k. | Garnishments | $ | x. | Life Insurance: | $ |
| l. | Cigarettes | $ | y. | Other: | $ |
| m. | Alcohol | $ | z. | TOTAL | $ |
* Place a check mark by all expenses which you are not currently paying.
MINOR CHILDREN
| 6. | Number of children: | |
| a. | Number of minor children I have with opposing party: | # |
| b. | Number of other minor children I have: | # |
|---|---|---|
| c. | Names of minor children involved in this case: | AGE |
| 1. | ||
| 2. | ||
| 3. | ||
| 4. |
CREDITORS & DEBTS
7. Debts in the names of BOTH PARTIES are:
| Creditor: | Total amount owed: | Monthly payment: | |
|---|---|---|---|
| a. | $ | $ | |
| b. | $ | $ | |
| c. | $ | $ | |
| d. | $ | $ | |
| e. | $ | $ | |
| f. | $ | $ | |
| g. | $ | $ | |
| Totals: | $ | $ |
| Creditor: | Total amount owed: | Monthly payment: | |
|---|---|---|---|
| a. | $ | $ | |
| b. | $ | $ | |
| c. | $ | $ | |
| d. | $ | $ | |
| e. | $ | $ | |
| Totals: | $ | $ |
| Creditor: | Total amount owed: | Monthly payment: | |
|---|---|---|---|
| a. | $ | $ | |
| b. | $ | $ | |
| c. | $ | $ | |
| d. | $ | $ | |
| e. | $ | $ | |
| Totals: | $ | $ |
| Summary of Debts: | Total Owed: | Total Monthly Payments: | |
|---|---|---|---|
| a. | Joint Debts: | $ | $ |
| b. | My Debts: | $ | $ |
| c. | Other Party's Debts: | $ | $ |
ACKNOWLEDGEMENT OF
RESPONSIBILITIES AND CONSEQUENCES
I, __________, understand that I must comply with the following. I acknowledge and agree to each provision by initialing each paragraph below. ___Both parties must complete and exchange this six-page affidavit at least three days before a court hearing where financial matters are at issue. The affidavit must be provided to opposing counsel, if a party is represented, or directly to a self-represented litigant. ___Both parties must supply the original notarized affidavit to the court. ___ If I am employed, I must attach copies of my last three paystubs to this affidavit. ___ If I am self-employed, I must attach copies of my last two federal and state tax returns, including all schedules, to this affidavit. ___ Before each court hearing where financial matters are at issue, I will review this document and provide updated information to the other party and to the court. ___ I understand that the cost of dependent health insurance coverage is the difference between self-only and self with dependents or family coverage or the cost of adding the child(ren) to existing coverage. ___ I understand that failing to comply with these provisions, or deliberately attempting to mislead the court or the opposing party, may result in my being held in contempt of court, being fined, being ordered to pay attorney's fees, and/or being sentenced up to 6 months in jail, and that serious violations can result in prosecution for felony perjury—punishable by 3 to 10 years in prison. __________
Date
__________
Signature I certify that I have reviewed this affidavit with my client and advised him or her of the importance of providing true, correct, complete answers and the required exhibits. __________
Date
__________
Attorney Form Revised 10/2019