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* IN THE COURT OF COUNTY
 
STATE OF GEORGIA
* Civil Action Case Number:   IV-D Case Number:
Initial Action   Modification
Modification Information
Date of initial child support order
mm / dd / yyyy
* Requesting on behalf of: Mother Father Nonparent
* Plaintiff: Mother Father Nonparent
* Defendant: Mother Father Both
* Non-Custodial Parent: Mother Father Both
  Name
* Mother:
* Father:
Nonparent Custodian:
Children for Whom Support is Being Determined in This Case
 
Total Number of Children:
* Submitted By:
Calculation Submission Date:
mm / dd / yyyy

Judge Last Saved Date:
Mother Father Total
1. Monthly Gross Income (from Schedule A, Line 23)
2. Monthly Adjusted Income
If either parent pays self-employment tax or pays child support under a Preexisting Order or is entitled to a credit for other qualified children living in the home, complete Schedule B and enter amount from Schedule B, Line 9 or Line 14 here.
Otherwise, enter amount form Line 1 here.
3. Pro Rata Shares of Combined Income:
On Line 2 above (Divide each parent's income by the combined income to find %) 		% % %
4. Basic Child Support Obligation (from Table)    
5. Pro rata shares of Basic Child Support Obligation
Multiply Line 4 by percentages on Line 3) 		 
6. Adjustment for Work Related Child Care and Health Insurance Expenses
Complete Schedule D and enter amount from Schedule D, Line 5 here. If none, skip Schedule D and enter zero here. 		 
7. Add Line 5 & 6 and enter results here.  
8. Adjustment for Additional Expenses Paid
Insert amounts PAID by each parent for child care & children's insurance from Schedule D, Line 3, Columns (a) and (b). 		 
9a. Subtotal excluding Parenting Time Deviation
>If Line 8 is zero, carry down amount from Line 7.
>Otherwise, subtract Line 8 from Line 7. Identify the amount of the Parenting Time Deviation entered on Line 13, Schedule E for the Noncustodial Parent, and add back in that amount on this line. 		 
9b. Subtotal including Parenting Time Deviation
>If a Parenting Time Deviation was claimed on Line 13, Schedule E, and, if Line 8 is zero, carry down the amount from Line 7.
>Otherwise, subtract Line 8 from Line 7. 		 
The amount on Line 9(a) is the Presumptive Child Support Amount.
10. Deviations from Presumptive Child Support Amount
Enter amount from Schedule E, Line 14 here.
11. Subtotal
If Line 10 is zero, then enter amount on Line 9b here.
If Line 10 is positive (+), then add Line 10 to Line 9b and enter result here.
If Line 10 is negative (-), then subtract Line 10 from Line 9b and enter result here. 		 
12. Social Security Payments
If children receive Title II benefits as dependents on a parent's account, enter the monthly amount in that parent's column here.
If none, enter zero. 		 
13. If the amount on Line 12 is equal to or greater than Line 11, the child support responsibility is met and no further obligation is owed. Enter zero here.
Otherwise, subtract Line 12 from Line 11 and enter result here. 		 
The amount on Line 13 is the Final Child Support Amount.
Uninsured Health Expenses
14. Uninsured Health Expenses
Carry down the percentage from Line 3 or enter the percentage otherwise ordered by the Court. 		% %  
Frequency Calculator Tool

The Frequency Calculator tool will convert income or payments to weekly, bi-weekly, semi-monthly, monthly and yearly amounts.

Click the link below to use the Frequency Calculator tool.

Frequency Calculator Tool

Schedules Attached Not Applicable
A Gross Income
B Adjusted Income
Schedule C is not in use and is intentionally left blank
D Additional Expenses
E Deviations from Presumptive Amount
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