State of Tennessee - Child Support Worksheet
Part I.  Identification
PRP ARP SPLIT
Indicate the status Name of Mother:
of each parent or Name of Father:
caretaker by placing Name of non-parent Caretaker:
an "X" in the TCSES case #:
appropriate column Docket #:
Court name:
Days
with Mother		 Days
with Father		 Days
with Caretaker
Name(s) of Child(ren) Date of Birth
 
 
 
 
 
 
 
 
 
 
Part II.  Adjusted Gross Income
Mother /    Column A Father /     Column B Nonparent Caretaker \ Column C
1 Monthly Gross Income $ $
    1a Social Security Benefit for child + +
1b Self-employment tax paid - -
Use Credit Worksheet 1c Subtotal $ $
to calculate line items 1d Credit for in-home children - -
1d - 1e 1e Credit for not-in-home children - -
2 Adjusted Gross Income (AGI) $ $
2a Combined Adjusted Gross Income $
3 Percentage Share of Income (PI) % %
Part III.  Parents' Share of BCSO
4 BCSO allotted to primary parent's household $ $ $
4a Share of BCSO owed to primary parent $ $
5 Each parent's average parenting time
5a Equal parenting time
6 Parenting time adjustment $ $
7 Adjusted BCSO $ $
    
    
    
    
    
Part IV.  Additional Expenses Mother /    Column A Father /     Column B Nonparent Caretaker / Column C
8a Children’s portion of health insurance premium  $ $ $
8b Recurring uninsured medical expenses $ $ $
8c Work-related childcare - Payroll Deducted $ $ $
8d Work-related childcare - Non-Payroll Deducted $ $ $
9 Total additional expenses $ $ $
10 Share of additional expenses owed $ $
11 Adjusted Support Obligation (ASO) $ $
Reminder - Line 8d expenses are to be paid by the child's PRP or either parent in a 50-50 situation
Part V.  Presumptive Child Support Order

OBLIGATION
12 Presumptive Child Support Order (PCSO) $ $
  * Enter the difference between the greater and smaller numbers from Line 11.
  Low Income? (N=15% Y=7.5%)
    Current Order Flat %? (N/Y)  
Modification of Current 13a Current child support order amount for the payor parent $ $
Child Support Order 13b Amount required for significant variance to exist $ $
13c Actual variance between current and presumptive child support orders $ $
Part VI.  Deviations and FCSO
Deviations must be  14 Deviations (Specify): $ $
substantiated by
written findings in the
Child Support Order
 
15 Final Child Support Order (FCSO) $ $
  16 FCSO adjusted for SS benefit, Line 1a, Obligor's column $ $

 

 

 

 

 

 

 

 

 

 

State of Tennessee - Credit Worksheet
Part I.  Identification
PRP ARP SPLIT
Indicate the status Name of Mother:  
of each parent or Name of Father:  
caretaker by placing Name of non-parent Caretaker:  
an "X" in the TCSES case #:  
appropriate column Docket #:  
Court name:  
Part II.  Additional Children Mother

Father
ü If a parent is claiming more than five children on line 3 or line 7, use the Additional Credit sheet to list information for each child.
Parent Income
Information
1 Applicable gross income for credit worksheet $ $
In-Home Children 2 Below, list qualified children living in the parent's home (if none, skip to line 7):
Name(s) of Child(ren) for Mother Date of Birth Name(s) of Child(ren) for Father Date of Birth