
                       CHILD SUPPORT GUIDELINES WORKSHEET

       I. NET MONTHLY INCOME OF PETITIONER, 

       A. Source and Amount of Annual Income:

          Gross income:                                              $0.00

       B. Federal Tax Deduction:
          Gross Annual Income:                          $0.00
             less 1/2 self-employment (FICA) tax:       <0.00>
             less personal exemptions
              (self plus  1 dependents):            <5,600.00>
             less standard deduction
               filing as: Head of Household         <6,450.00>
          Net taxable income - federal:                 $0.00
          Beginning Federal Tax Liability:              $0.00
             less tax credits                         <500.00>
          Final federal tax liability:                               <0.00>

       C. State Tax Deduction:
          Gross Annual Income:                          $0.00
             less 1/2 self employment (FICA) tax:       <0.00>
             less federal tax liability:                <0.00>
             less state standard deduction
               filing as: Head of Household         <3,630.00>
          Net taxable income - state:                   $0.00
          State tax liability (tables):      $0.00
             less pers/dep. credits:       <120.00>
             less earned income credit:      <0.00>
          Final state tax liability:                                 <0.00>

       D. Social Security and Medicare Tax Ded.:
          Annual earned income:                         $0.00
          Income not subject to FICA: $0.00
          Annual liability:                                          <0.00>

       E. Other Deductions (annual basis):
          1. Union dues:                                             <0.00>
          2. Mandatory Pension:                                      <0.00>
          3. Medical insurance premiums:                             <0.00>
          4. Affiant's medical insurance/expenses (up to $300):      <0.00>
          5. Prior child support obligations:                        <0.00>
          6. Spousal / Medical support obligations:                  <0.00>
          7. Deductions for additional qualified dependents          <0.00>
          8. Child care expenses: (present action)      $0.00
                less federal tax credits:               <0.00>
                less state tax credits:                 <0.00>
                less state tax refund:                  <0.00>
             Net child care expenses:                                <0.00>

       Federal Earned Income Credit:                                  0.00
       Net Annual Income:                                            $0.00
       Net Monthly Income: (Petitioner)                              $0.00


                    CHILD SUPPORT GUIDELINES WORKSHEET

       II. NET MONTHLY INCOME OF RESPONDENT, 

       A. Source and Amount of Annual Income:
          Gross income:                                              $0.00

       B. Federal Tax Deduction:
          Gross Annual Income:                          $0.00
             less 1/2 self-employment (FICA) tax:       <0.00>
             less personal exemptions
              (self plus  0 dependents):            <2,800.00>
             less standard deduction
               filing as: Single                    <4,400.00>
          Net taxable income - federal:                 $0.00
          Final federal tax liability:                               <0.00>

       C. State Tax Deduction:
          Gross Annual Income:                          $0.00
             less 1/2 self employment (FICA) tax:       <0.00>
             less federal tax liability:                <0.00>
             less state standard deduction
               filing as: Single                    <1,470.00>
          Net taxable income - state:                   $0.00
          State tax liability (tables):      $0.00
             less pers/dep. credits:        <40.00>
             less earned income credit:      <0.00>
          Final state tax liability:                                 <0.00>

       D. Social Security and Medicare Tax Ded.:
          Annual earned income:                         $0.00
          Income not subject to FICA: $0.00
          Annual liability:                                          <0.00>

       E. Other Deductions (annual basis):
          1. Union dues:                                             <0.00>
          2. Mandatory Pension:                                      <0.00>
          3. Medical insurance premiums:                             <0.00>
          4. Affiant's medical insurance/expenses (up to $300):      <0.00>
          5. Prior child support obligations:                        <0.00>
          6. Spousal / Medical support obligations:                  <0.00>
          7. Deductions for additional qualified dependents          <0.00>
          8. Child care expenses: (present action)      $0.00
                less federal tax credits:               <0.00>
                less state tax credits:                 <0.00>
                less state tax refund:                  <0.00>
             Net child care expenses:                                <0.00>

       Federal Earned Income Credit:                                 $0.00
       Net Annual Income:                                            $0.00
       Net Monthly Income: (Respondent)                              $0.00


     III. CALCULATION OF THE GUIDELINE AMOUNT OF SUPPORT

     A.  Custodial parent's net monthly income:        $0.00
         Noncustodial parent's net monthly income                 $0.00

     B.  Number of children for whom support is sought:  1

         Guideline percentage                                 X   0%

     C.  Guideline amount of support                             $50.00

     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 MARSHALL:   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: __________________         _____________________________________
                                                      (Petitioner)


          The undersigned attorney for the Petitioner 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: __________________         _____________________________________
                                      Michael Wilson Alft, Esq., PIN# 12345
                                                  (Attorney for Petitioner)
                                                           Alft Law Offices





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