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Child Support Calculation Form

Name and birthdate of each child Primary Custodial Parent % of time with non-custodial parent
Mother's gross monthly income from all sources: Father's gross monthly income from all sources:
Taxable Taxable
Non-Taxable Non-Taxable
Mother's monthly payroll deductions for: Father's monthly payroll deductions for:
Health Insurance Health Insurance
Union Dues Union Dues
Mandatory Retirement Mandatory Retirement
County that Custodial Parent Resides in
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THIS FORM IS DESIGNED TO PROVIDE US WITH THE INFORMATION REQUIRED TO RENDER A GENERAL CHILD SUPPORT CALCULATION. SOME CASES REQUIRE FURTHER EXAMINATION DUE TO HARDSHIP DEDUCTIONS AND OTHER UNIQUE SITUATIONS. IF YOU BELIEVE YOUR SITUATION REQUIRES MORE SPECIALIZED CONSIDERATION, SEND US AN E-MAIL SEPARATELY FROM THIS FORM, AND WE WILL DISCUSS YOUR NEEDS ON AN INDIVIDUAL BASIS BY APPOINTMENT, AT NO ADDITIONAL CHARGE.

THE LAW OFFICE OF BRIAN DON LEVY
908 S. VILLAGE OAKS DRIVE, SUITE 200
COVINA, CALIFORNIA 91724-3676
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(626) 332-1304
(800) 330-8216
FAX (626) 332-3362
Lawyer@CalAttorney.com

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