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FEB/27/2012/MON 02:56 AM <br />�,. - , <br />District Judge <br />FAX �o , 308 385 566y <br />20�202403 <br />B,A�TC NET INCOME AAIb SUPPORT C.AI.CC.Tr,ATiON <br />Case: R4ose v. Roose CI 11-647 Date; 0�/27/2012 <br />Three ChiIdren Custody:Mother <br />1. To1�1 mpntlz]�y mcome from aII sourees <br />To'Cal Monthly Yncome (Npn Taxable)� <br />2. Deduations <br />a. Federal Income Tax <br />�. Statt Tncome Tax <br />b. FICA Tax <br />c. Retirement <br />d. Child support previqusly <br />ordered �'or other chiIdren <br />e. ChiId regular s�,tpp�rt for other aluIdren <br />f. TotaI Deducfians <br />Child Tax Credit <br />3. Monthly net Income <br />4. Combined mant}ily rtet ineome <br />5. Combined annual net incorne <br />6. Percent oontribution of each parent <br />7. MonTlzly support from table 1 <br />8, Heaith instuance premium or aesh medic�] support as ordered <br />9. Tota1 oblig�tinn <br />10. Each puent's monthly share <br />I 1. Each parent's crediz far heal4h <br />premlum a�t.ua,lly paid <br />12. �ach parent's final share a�the obligation <br />Patagraph § 42.18 Adjusted 1Vlanthly 5hare(�°) <br />� See Paragraph § 4-218 undar'Nebreska �hiId �Support GuideIines' <br />� 2a. Each pazen�'s fmal share of the obliga,tion(rounded) <br />Psragraph § 4218 Adjusted Monthly Share(*) <br />`� Sae Paragraph § 4.23$ under'NebFaska Child $r�pport Guidelines' <br />r, UU��UU4 <br />Page 1 af 2 <br />W4Tksheet � <br />Moth.er Pather <br />�Cornbined <br />$ I,5b4.67 $2,284.50 <br />$0.00 $0.(JO <br />3 ExEmptions <br />$o.ao <br />$O.Op <br />$119.'74 <br />$0.00 <br />$0.00 <br />$�,00 <br />$114.70 <br />$Q.40 <br />2 <br />� 137.OS <br />$4�.46 <br />�17�.76 <br />�0.00 <br />$0.00 <br />,�0.0� <br />$358,27 <br />$0.00 <br />$1,4�44.97 $1,926.z3 <br />$3,371.20 <br />$40,454.44 <br />42.86% 57. I4% <br />$ I,334.U0 <br />�a.00 so.00 <br />$I,334.00 <br />$571:7$ <br />$0.00 <br />57$ 1.78* <br />$513.97'" <br />572.00� <br />$513.97�` <br />$762.22 <br />$0.00 <br />7'62.22 <br />$"162.22* <br />762.00 <br />�762.U0* <br />Page � of____�_ <br />