                    CHILD SUPPORT GUIDELINES WORKSHEET

       I. NET MONTHLY INCOME OF PETITIONER,

       A. Source and Amount of Annual Income:


          Gross income:                                         

       B. Federal Tax Deduction:
          Gross Annual Income:                     
             less 1/2 self-employment (FICA) tax:  
             less federal adjustments to income:   
             less personal exemptions
              (self plus    dependents):           
             less standard deduction
               filing as: 
          Net taxable income - federal:             
          Final federal tax liability:              

       C. State Tax Deduction:
          Gross Annual Income:                     
             less 1/2 self employment (FICA) tax:  
             less federal tax liability:           
             less state standard deduction
               filing as: Head of Household        
          Net taxable income - state:              
          State tax liability (tables):    
             less pers/dep. credits:       
             less earned income credit:    
          Final state tax liability:       

       D. Social Security and Medicare Tax Ded.:
          Annual earned income:            
          Income not subject to FICA:
          Annual liability:                           

       E. Other Deductions (annual basis):
          1. Union dues:                                         
          2. Mandatory Pension:                                  
          3. Medical insurance premiums:                         
          4. Affiant's medical insurance/expenses (up to $300):  
          5. Prior child support obligations:                    
          6. Spousal support obligations:                        
          7. Deductions for additional qualified dependents      
          8. Child care expenses: (present action) 
                less federal tax credits:          
                less state tax credits:            
                less state tax refund:             
             Net child care expenses:                            

       Federal Earned Income Credit:                             

       Net Annual Income:                                        

       Net Monthly Income: (Petitioner)                          
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                    CHILD SUPPORT GUIDELINES WORKSHEET

       I. NET MONTHLY INCOME OF RESPONDENT, 

       A. Source and Amount of Annual Income:


          Gross income:                                     

       B. Federal Tax Deduction:
          Gross Annual Income:                    
             less 1/2 self-employment (FICA) tax: 
             less federal adjustments to income:  
             less personal exemptions
              (self plus    dependents):          
             less standard deduction
               filing as: 
          Net taxable income - federal:         
          Final federal tax liability:          

       C. State Tax Deduction:
          Gross Annual Income:                  
             less 1/2 self employment (FICA) tax:
             less federal tax liability:         
             less state standard deduction
               filing as: Head of Household      
          Net taxable income - state:            
          State tax liability (tables):   
             less pers/dep. credits:      
             less earned income credit:   
          Final state tax liability:      

       D. Social Security and Medicare Tax Ded.:
          Annual earned income:           
          Income not subject to FICA:
          Annual liability:             

       E. Other Deductions (annual basis):
          1. Union dues:                                        
          2. Mandatory Pension:                                 
          3. Medical insurance premiums:                        
          4. Affiant's medical insurance/expenses (up to $300): 
          5. Prior child support obligations:                   
          6. Spousal support obligations:                       
          7. Deductions for additional qualified dependents     
          8. Child care expenses: (present action)
                less federal tax credits:         
                less state tax credits:           
                less state tax refund:            
             Net child care expenses:             

       Federal Earned Income Credit:               

       Net Annual Income:                          

       Net Monthly Income: (Respondent)            
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     III. CALCULATION OF THE GUIDELINE AMOUNT OF SUPPORT

     A.  Custodial parent's net monthly income:    
         Noncustodial parent's net monthly income  

     B.  Number of children for whom support is sought:
         Guideline percentage                                 X      %

     C.  Guideline amount of support                     

     IV. SPECIAL FINDINGS

     A.  Income imputed to Respondent:
           
         Income imputed to Petitioner:
           
     B.  Estimated income of Respondent:
           
         Estimated income of Petitioner:
           

     C.  Deviations made from Child Support Guidelines:


     D.  Requested amount of child support:

     STATE OF IOWA, COUNTY OF                 ss:

        I,                 , do hereby swear or affirm that the foregoing
     statement is true, complete and correct as I verily believe from all
     information available to me at this time.


     Date: __________________         _____________________________________
                           


          The undersigned attorney for the            hereby certifies that
     the foregoing Child Support Guidelines Worksheets were prepared by me
     or at my direction in good faith reliance upon information available
     to me at this time.


     Date: __________________         _____________________________________
