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CHILD SUPPORT GUIDELINES Case No.:
WORKSHEET - SHARED CUSTODY                                      
Commonwealth of Virginia Va. Code � 20-108.2                                          
v.  
I. GUIDELINE CALCULATION                                           Date  
A. INCOME                   Mother         Father       Combined
  Monthly Gross Income (see instructions) (1) $     (2) $                  
  Adjustment for spousal support payments                                          
      Deduct from payor's income (see instructions) (3) -$     (4) -$                  
      Add to recipient's income   $       $                  
  Adjustments for support of child(ren) (see instructions) (5) -$     (6) -$                  
  Deductions from Monthly Gross Income (7) -$     (8) -$                  
      allowable by law (see instructions)                                          
  Available Gross Income (9) $     (10) $     = (11) $
  Percentage of Combined Gross Income (12)   %   (13)   %   =     100%
B. CHILD SUPPORT NEEDS                                          
  Number of children for whom support is sought                         (14)  
  Child support from guideline table - apply lines (11) and (14) to table             (15) $
  Total shared support - line (15) x 1.40     (16) $
                    Mother         Father                  
  Total days in year each parent has custody (17)       (18)       =     365
  Each parent's custody share (19)   %   (20)   %   =     100%
C. EACH PARENT'S SUPPORT OBLIGATION TO OTHER PARENT                
  1. Father's obligation to Mother             Mother         Father                  
      Basic support to Mother - lines (19) x (16)               (21) $                  
      Health care coverage PAID by Mother (if any)               (22) $                  
      Work-related child care of Mother (if any)               (23) $                  
      Monthly tax savings from child-care deductions or credits     (23a) $
      Total - lines (21) + (22) + (23)               (24) $                  
      Father's obligation - lines (24) x (13) =               (25) $                  
  2. Mother's obligation to Father                                                  
      Basic support to Father - lines (20) x (16) (26) $                                
      Health care coverage PAID by Father (if any) (27) $                                
      Work-related child care of Father (if any) (28) $                                
      Monthly tax savings from child-care deductions or credits(28a) $
      Total - lines (26) + (27) + (28) (29) $                                
      Mother's obligation - lines (29) x (12) = (30) $                                
D. NET MONTHLY CHILD SUPPORT PAYABLE FROM ONE PARENT TO THE OTHER PARENT
  Shared custody child support guideline amount - difference between lines (25) and (30) =       (31) $
  (32) Payable to Mother Father (see instructions)                          
II. ADJUSTMENTS (IF ANY) TO SHARED CUSTODY CHILD SUPPORT GUIDELINE AMOUNT      
A. ADJUSTMENT ITEMS     Mother         Father                  
  1.   Credit for benefits received by or for the child derived from the parent's entitlement to disability insurance benefits to the extent that such derivative benefits are included in a parent's gross income    
         
      (33) -$     (34) - $                  
  2.   use +/- $       $                  
  3.   use +/- $       $                  
      Total adjustments             (35) $     (36) $        
  Net adjustment - difference between lines (35) and (36)     (37) $                  
  (38)   Owed to Mother Father (see instructions)                                    
B. TOTAL ADJUSTED SUPPORT (see instructions) $       $       (39) $
  (40)   Payable to Mother Father                                      
VA FORM DC-640 v. 2003-2004