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717i)r.f/3 yr 3 2.01506904 Page 1 of 2 <br /> Worksheet 1 <br /> BASIC NET INCOME AND SUPPORT CALCULATION <br /> Case:HC CI 09 460 Molina v Molina Date: 02/03/2010 <br /> Two Children Custody:Mother <br /> Mother Father <br /> Combined <br /> 1.Total monthly income from all sources $2,166.00 $0.00 <br /> 2.Deductions 3 Exemptions 1 <br /> a.Federal Income Tax $55.77 $0.00 <br /> a. State Income Tax $19.20 $0.00 <br /> b.FICA Tax $165.70 $0.00 <br /> c.Retirement $0.00 $0.00 <br /> d. Child support previously $0.00 $0.00 <br /> ordered for other children <br /> e. Child regular support for other children $0.00 $0.00 <br /> f. Total Deductions $240.66 $0.00 <br /> Child Tax Credit $0.00 $0.00 <br /> 3.Monthly net Income $1,925.34 $0.00 <br /> 4.Combined monthly net income $1,925.34 <br /> 5.Combined annual net income $23,104.04 <br /> 6.Percent contribution of each parent 100.00% 0.00% <br /> 7.Monthly support from table 1 $689.00 <br /> 8.Health insurance premium $0.00 $0.00 <br /> 9.Total obligation $689.00 <br /> 10.Each parent's monthly share $689.00 $0.00 <br /> 11.Each parent's credit for health $0.00 $0.00 <br /> premium actually paid <br /> 12.Each parent's final share of the obligation $689.00* $0.00* <br /> Paragraph §4-209 suggested Monthly Share(*) $689.00* $50.00* <br /> Paragraph §4-218 Adjusted Monthly Share(*) $689.00* $0.00* <br /> * See Paragraph§4-218 under'Nebraska Child Support Guidelines' <br /> Page ( S of �� <br />