
| Who Will Be Awarded Custody? |
Mother |
Father |
Combined |
| Enter the number of natural and adopted children whose custody will be awarded to each parent. | . | . | |
| Enter the father's and mother's gross monthly income. | . | ||
| Enter previously ordered child support or alimony. (Do not enter obligations ordered in this case). | . | ||
| Enter the actual monthly amount paid for medical insurance coverage for the minor children in this case. | . | ||
| Enter any mandatory (not discretionary) monthly retirement contributions paid. | . | ||
| Enter the monthly amount of any actual state income taxes paid. | . | ||
| If there are work-related child care expenditures for the children in this case, enter the monthly net amount actually paid. | . |