Title: In Re: Amendments To The Florida Family Law Rules of Procedure
Citation: N/A
Docket Number: SC10-1468
State: Florida
Issuer: Florida Supreme Court
Date: September 23, 2010

Supreme Court of Florida 
 
 
____________ 
 
No. SC10-1468 
____________ 
 
 
IN RE:  AMENDMENTS TO THE FLORIDA FAMILY LAW RULES OF 
PROCEDURE. 
 
[September 23, 2010] 
CORRECTED OPINION 
 
PER CURIAM. 
 
The Florida Bar’s Family Law Rules Committee (Committee) has filed a 
“fast-track” report proposing amendments to the Florida Family Law Rules of 
Procedure Forms in order to implement the 2010 legislative amendments adopted 
in chapter 2010-199, sections 3 and 5, Laws of Florida.  We have jurisdiction.  See 
art. V, § 2(a), Fla. Const.; Fla. R. Jud. Admin. 2.140(e). 
 
Under the Committee’s “fast-track” procedure for considering new 
legislation, the Committee proposes amendments to Florida Family Law Rules of 
Procedure Forms 12.902(e) (Child Support Guidelines Worksheet) and 12.996(a) 
(Income Deduction Order (Non-Title IV Case)).1  The Florida Bar Board of 
                                          
 
 
1.  Form 12.996(a), as amended, is titled Income Deduction Order (Non-
Title IV-D Case). 
 
- 2 - 
Governors unanimously approved the Committee’s proposals.  The proposed 
amendments are in response to chapter 2010-199, sections 3 and 5, Laws of 
Florida, which amend numerous provisions within chapter 61, Florida Statutes, 
pertaining to alimony and child support.2  With regard to forms 12.902(e) and 
12.996(a), the amendments require: removal of the first three combined net income 
amounts in the guidelines schedule; the elimination of the twenty-five percent 
reduction in calculating monthly child care costs to be added to the basic child 
support obligation; a decrease from forty percent to twenty percent of the 
overnights in a year that a parent must have with a child to qualify as a “substantial 
amount of time” for time-sharing (formerly visitation) purposes; and the addition 
of a “Child Support Reduction/Termination Schedule” to income deduction orders 
issued after October 1, 2010.   
After considering the Committee’s proposals and reviewing the relevant 
legislation, we amend forms 12.902(e) and 12.996(a) as reflected in the appendix 
to this opinion.  The forms are fully engrossed and ready for use.  The amendments 
to form 12.902(e) shall take effect on January 1, 2011, at 12:01 a.m.; the 
amendments to form 12.996(a) shall take effect on October 1, 2010, at 12:01 a.m.  
Because the amendments were not published for comment prior to their adoption, 
                                          
 
 
2.  Chapter 2010-199, section 3, Laws of Florida, is effective October 1, 
2010.  See Ch. 2010-199, § 3, Laws of Fla.  Chapter 2010-199, section 5, Laws of 
Florida is effective January 1, 2011.  See Ch. 2010-199, § 6, Laws of Fla. 
 
- 3 - 
interested persons shall have sixty days from the date of this opinion in which to 
file comments with the Court.3 
It is so ordered. 
CANADY, C.J., and PARIENTE, LEWIS, QUINCE, POLSTON, LABARGA, 
and PERRY, JJ., concur. 
 
THE FILING OF A MOTION FOR REHEARING SHALL NOT ALTER THE 
EFFECTIVE DATE OF THESE AMENDMENTS. 
 
 
Original Proceedings – The Florida Family Law Rules Committee 
 
 
Steven P. Combs, Chair, Family Law Rules Committee, Jacksonville, Florida, and 
John F. Harkness, Jr., Executive Director, The Florida Bar, Tallahassee, Florida, 
 
 
for Petitioner 
 
 
                                          
 
 
3.  An original and nine paper copies of all comments must be filed with the 
Court on or before November 22, 2010, with a certificate of service verifying that a 
copy has been served on the committee chair, Steven Patrick Combs, 3217 Atlantic 
Boulevard, Jacksonville, Florida, 32207-8901, as well as a separate request for oral 
argument if the person filing the comment wishes to participate in oral argument, 
which may be scheduled in this case.  The committee chair has until December 13, 
2010, to file a response to any comments filed with the Court.  Electronic copies of 
all comments and responses also must be filed in accordance with the Court's 
administrative order In re Mandatory Submission of Electronic Copies of 
Documents, Fla. Admin. Order No. AOSC04-84 (Sept. 13, 2004). 
 
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet 
(01/11) 
 
- 4 - 
APPENDIX 
 
INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE 
FORM 12.902(e), CHILD SUPPORT GUIDELINES WORKSHEET (01/11) 
 
When should this form be used? 
 
You should complete this worksheet if child support is being requested in your case.  If you know 
the income of the other party, this worksheet should accompany your financial affidavit.  If you do 
not know the other party’s income, this form must be completed after the other party files his or 
her financial affidavit, and serves a copy on you. 
 
This form should be typed or printed in black ink.  You should file the original with the clerk of the 
circuit court in the county where your case is filed and keep a copy for your records. 
 
What should I do next? 
 
A copy of this form must be mailed or hand delivered to the other party in your case, if it is not 
served on him or her with your initial papers. 
 
 
Where can I look for more information? 
 
Before proceeding, you should read “General Information for Self-Represented Litigants” found at 
the beginning of these forms.  The words that are in “bold underline” in these instructions are 
defined there.  For further information, see section 61.30, Florida Statutes. 
 
Special notes... 
 
If this is a domestic violence case and you want to keep your address confidential for safety reasons, 
do not enter the address, telephone, and fax information at the bottom of this form.  Instead, file 
Petitioner’s Request for Confidential Filing of Address, Florida Supreme Court Approved Family Law 
Form 12.980(h). 
 
The chart below contains the guideline amounts that you should use when calculating child support.  
This amount is based on the number of children and the combined income of the parents, and it is 
 
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet 
(01/11) 
 
- 5 - 
divided between the parents in direct proportion to their income or earning capacity.  From time to 
time, some of the amounts in the child support guidelines chart will change.  Be sure you have the 
most recent version of the chart before using it. 
Because the guidelines are based on monthly amounts, it may be necessary to convert some income 
and expense figures from other frequencies to monthly.  You should do this as follows: 
 
If payment is twice per month 
Payment amount x 
2 
= 
Monthly amount 
 
If payment is every two weeks 
Payment amount x 
26 = 
Yearly amount due 
Yearly amount 
÷ 
12 = 
Monthly amount 
 
If payment is weekly 
Weekly amount 
x 
52 = 
Yearly amount due 
Yearly amount 
÷ 
12 = 
Monthly amount 
 
If you or the other parent request that the court award an amount that is different than the 
guideline amount, you must also complete and attach a Motion to Deviate from Child Support 
Guidelines, Florida Supreme Court Approved Family Law Form 12.943. 
 
Remember, a person who is NOT an attorney is called a nonlawyer.  If a nonlawyer helps you fill out 
these forms, that person must give you a copy of a Disclosure from Nonlawyer, Florida Family Law 
Rules of Procedure Form 12.900(a), before he or she helps you.  A nonlawyer helping you fill out 
these forms also must put his or her name, address, and telephone number on the bottom of the 
last page of every form he or she helps you complete. 
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (01/11) 
 
- 6 - 
 
CHILD SUPPORT GUIDELINES CHART 
Combined 
Monthly 
Available 
Income 
 
One 
Child 
 
Two 
Children 
 
Three 
Children 
 
Four 
Children 
 
Five 
Children 
 
Six 
Children 
 
800.00 
190 
211 
213 
216 
218 
220 
850.00 
202 
257 
259 
262 
265 
268 
900.00 
213 
302 
305 
309 
312 
315 
950.00 
224 
347 
351 
355 
359 
363 
1000.00 
235 
365 
397 
402 
406 
410 
1050.00 
246 
382 
443 
448 
453 
458 
1100.00 
258 
400 
489 
495 
500 
505 
1150.00 
269 
417 
522 
541 
547 
553 
1200.00 
280 
435 
544 
588 
594 
600 
1250.00 
290 
451 
565 
634 
641 
648 
1300.00 
300 
467 
584 
659 
688 
695 
1350.00 
310 
482 
603 
681 
735 
743 
1400.00 
320 
498 
623 
702 
765 
790 
1450.00 
330 
513 
642 
724 
789 
838 
1500.00 
340 
529 
662 
746 
813 
869 
1550.00 
350 
544 
681 
768 
836 
895 
1600.00 
360 
560 
701 
790 
860 
920 
1650.00 
370 
575 
720 
812 
884 
945 
1700.00 
380 
591 
740 
833 
907 
971 
1750.00 
390 
606 
759 
855 
931 
996 
1800.00 
400 
622 
779 
877 
955 
1022 
1850.00 
410 
638 
798 
900 
979 
1048 
1900.00 
421 
654 
818 
923 
1004 
1074 
1950.00 
431 
670 
839 
946 
1029 
1101 
2000.00 
442 
686 
859 
968 
1054 
1128 
2050.00 
452 
702 
879 
991 
1079 
1154 
2100.00 
463 
718 
899 
1014 
1104 
1181 
2150.00 
473 
734 
919 
1037 
1129 
1207 
2200.00 
484 
751 
940 
1060 
1154 
1234 
2250.00 
494 
767 
960 
1082 
1179 
1261 
2300.00 
505 
783 
980 
1105 
1204 
1287 
2350.00 
515 
799 
1000 
1128 
1229 
1314 
2400.00 
526 
815 
1020 
1151 
1254 
1340 
2450.00 
536 
831 
1041 
1174 
1279 
1367 
2500.00 
547 
847 
1061 
1196 
1304 
1394 
2550.00 
557 
864 
1081 
1219 
1329 
1420 
2850.00 
616 
956 
1197 
1349 
1471 
1573 
2900.00 
626 
971 
1215 
1370 
1494 
1598 
2950.00 
635 
986 
1234 
1391 
1517 
1622 
3000.00 
644 
1001 
1252 
1412 
1540 
1647 
 
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (01/11) 
 
- 7 - 
Combined 
Monthly 
Available 
Income 
 
One 
Child 
 
Two 
Children 
 
Three 
Children 
 
Four 
Children 
 
Five 
Children 
 
Six 
Children 
 
3050.00 
654 
1016 
1271 
1433 
1563 
1671 
3100.00 
663 
1031 
1289 
1453 
1586 
1695 
3150.00 
673 
1045 
1308 
1474 
1608 
1720 
3200.00 
682 
1060 
1327 
1495 
1631 
1744 
3250.00 
691 
1075 
1345 
1516 
1654 
1769 
3300.00 
701 
1090 
1364 
1537 
1677 
1793 
3350.00 
710 
1105 
1382 
1558 
1700 
1818 
3400.00 
720 
1120 
1401 
1579 
1723 
1842 
3450.00 
729 
1135 
1419 
1599 
1745 
1867 
3500.00 
738 
1149 
1438 
1620 
1768 
1891 
3550.00 
748 
1164 
1456 
1641 
1791 
1915 
3600.00 
757 
1179 
1475 
1662 
1814 
1940 
3650.00 
767 
1194 
1493 
1683 
1837 
1964 
3700.00 
776 
1208 
1503 
1702 
1857 
1987 
3750.00 
784 
1221 
1520 
1721 
1878 
2009 
3800.00 
793 
1234 
1536 
1740 
1899 
2031 
3850.00 
802 
1248 
1553 
1759 
1920 
2053 
3900.00 
811 
1261 
1570 
1778 
1940 
2075 
3950.00 
819 
1275 
1587 
1797 
1961 
2097 
4000.00 
828 
1288 
1603 
1816 
1982 
2119 
4050.00 
837 
1302 
1620 
1835 
2002 
2141 
4100.00 
846 
1315 
1637 
1854 
2023 
2163 
4150.00 
854 
1329 
1654 
1873 
2044 
2185 
4200.00 
863 
1342 
1670 
1892 
2064 
2207 
4250.00 
872 
1355 
1687 
1911 
2085 
2229 
4300.00 
881 
1369 
1704 
1930 
2106 
2251 
4350.00 
889 
1382 
1721 
1949 
2127 
2273 
4400.00 
898 
1396 
1737 
1968 
2147 
2295 
4450.00 
907 
1409 
1754 
1987 
2168 
2317 
4500.00 
916 
1423 
1771 
2006 
2189 
2339 
4550.00 
924 
1436 
1788 
2024 
2209 
2361 
4600.00 
933 
1450 
1804 
2043 
2230 
2384 
4650.00 
942 
1463 
1821 
2062 
2251 
2406 
4700.00 
951 
1477 
1838 
2081 
2271 
2428 
4750.00 
959 
1490 
1855 
2100 
2292 
2450 
4800.00 
968 
1503 
1871 
2119 
2313 
2472 
4850.00 
977 
1517 
1888 
2138 
2334 
2494 
4900.00 
986 
1530 
1905 
2157 
2354 
2516 
4950.00 
993 
1542 
1927 
2174 
2372 
2535 
5000.00 
1000 
1551 
1939 
2188 
2387 
2551 
5050.00 
1006 
1561 
1952 
2202 
2402 
2567 
5100.00 
1013 
1571 
1964 
2215 
2417 
2583 
5150.00 
1019 
1580 
1976 
2229 
2432 
2599 
 
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (01/11) 
 
- 8 - 
Combined 
Monthly 
Available 
Income 
 
One 
Child 
 
Two 
Children 
 
Three 
Children 
 
Four 
Children 
 
Five 
Children 
 
Six 
Children 
 
5200.00 
1025 
1590 
1988 
2243 
2447 
2615 
5250.00 
1032 
1599 
2000 
2256 
2462 
2631 
5300.00 
1038 
1609 
2012 
2270 
2477 
2647 
5350.00 
1045 
1619 
2024 
2283 
2492 
2663 
5400.00 
1051 
1628 
2037 
2297 
2507 
2679 
5450.00 
1057 
1638 
2049 
2311 
2522 
2695 
5500.00 
1064 
1647 
2061 
2324 
2537 
2711 
5550.00 
1070 
1657 
2073 
2338 
2552 
2727 
5600.00 
1077 
1667 
2085 
2352 
2567 
2743 
5650.00 
1083 
1676 
2097 
2365 
2582 
2759 
5700.00 
1089 
1686 
2109 
2379 
2597 
2775 
5750.00 
1096 
1695 
2122 
2393 
2612 
2791 
5800.00 
1102 
1705 
2134 
2406 
2627 
2807 
5850.00 
1107 
1713 
2144 
2418 
2639 
2820 
5900.00 
1111 
1721 
2155 
2429 
2651 
2833 
5950.00 
1116 
1729 
2165 
2440 
2663 
2847 
6000.00 
1121 
1737 
2175 
2451 
2676 
2860 
6050.00 
1126 
1746 
2185 
2462 
2688 
2874 
6100.00 
1131 
1754 
2196 
2473 
2700 
2887 
6150.00 
1136 
1762 
2206 
2484 
2712 
2900 
6200.00 
1141 
1770 
2216 
2495 
2724 
2914 
6250.00 
1145 
1778 
2227 
2506 
2737 
2927 
6300.00 
1150 
1786 
2237 
2517 
2749 
2941 
6350.00 
1155 
1795 
2247 
2529 
2761 
2954 
6400.00 
1160 
1803 
2258 
2540 
2773 
2967 
6450.00 
1165 
1811 
2268 
2551 
2785 
2981 
6500.00 
1170 
1819 
2278 
2562 
2798 
2994 
6550.00 
1175 
1827 
2288 
2573 
2810 
3008 
6600.00 
1179 
1835 
2299 
2584 
2822 
3021 
6650.00 
1184 
1843 
2309 
2595 
2834 
3034 
6700.00 
1189 
1850 
2317 
2604 
2845 
3045 
6750.00 
1193 
1856 
2325 
2613 
2854 
3055 
6800.00 
1196 
1862 
2332 
2621 
2863 
3064 
6850.00 
1200 
1868 
2340 
2630 
2872 
3074 
6900.00 
1204 
1873 
2347 
2639 
2882 
3084 
6950.00 
1208 
1879 
2355 
2647 
2891 
3094 
7000.00 
1212 
1885 
2362 
2656 
2900 
3103 
7050.00 
1216 
1891 
2370 
2664 
2909 
3113 
7100.00 
1220 
1897 
2378 
2673 
2919 
3123 
7150.00 
1224 
1903 
2385 
2681 
2928 
3133 
7200.00 
1228 
1909 
2393 
2690 
2937 
3142 
7250.00 
1232 
1915 
2400 
2698 
2946 
3152 
7300.00 
1235 
1921 
2408 
2707 
2956 
3162 
 
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (01/11) 
 
- 9 - 
Combined 
Monthly 
Available 
Income 
 
One 
Child 
 
Two 
Children 
 
Three 
Children 
 
Four 
Children 
 
Five 
Children 
 
Six 
Children 
 
7350.00 
1239 
1927 
2415 
2716 
2965 
3172 
7400.00 
1243 
1933 
2423 
2724 
2974 
3181 
7450.00 
1247 
1939 
2430 
2733 
2983 
3191 
7500.00 
1251 
1945 
2438 
2741 
2993 
3201 
7550.00 
1255 
1951 
2446 
2750 
3002 
3211 
7600.00 
1259 
1957 
2453 
2758 
3011 
3220 
7650.00 
1263 
1963 
2461 
2767 
3020 
3230 
7700.00 
1267 
1969 
2468 
2775 
3030 
3240 
7750.00 
1271 
1975 
2476 
2784 
3039 
3250 
7800.00 
1274 
1981 
2483 
2792 
3048 
3259 
7850.00 
1278 
1987 
2491 
2801 
3057 
3269 
7900.00 
1282 
1992 
2498 
2810 
3067 
3279 
7950.00 
1286 
1998 
2506 
2818 
3076 
3289 
8000.00 
1290 
2004 
2513 
2827 
3085 
3298 
8050.00 
1294 
2010 
2521 
2835 
3094 
3308 
8100.00 
1298 
2016 
2529 
2844 
3104 
3318 
8150.00 
1302 
2022 
2536 
2852 
3113 
3328 
8200.00 
1306 
2028 
2544 
2861 
3122 
3337 
8250.00 
1310 
2034 
2551 
2869 
3131 
3347 
8300.00 
1313 
2040 
2559 
2878 
3141 
3357 
8350.00 
1317 
2046 
2566 
2887 
3150 
3367 
8400.00 
1321 
2052 
2574 
2895 
3159 
3376 
8450.00 
1325 
2058 
2581 
2904 
3168 
3386 
8500.00 
1329 
2064 
2589 
2912 
3178 
3396 
8550.00 
1333 
2070 
2597 
2921 
3187 
3406 
8600.00 
1337 
2076 
2604 
2929 
3196 
3415 
8650.00 
1341 
2082 
2612 
2938 
3205 
3425 
8700.00 
1345 
2088 
2619 
2946 
3215 
3435 
8750.00 
1349 
2094 
2627 
2955 
3224 
3445 
8800.00 
1352 
2100 
2634 
2963 
3233 
3454 
8850.00 
1356 
2106 
2642 
2972 
3242 
3464 
8900.00 
1360 
2111 
2649 
2981 
3252 
3474 
8950.00 
1364 
2117 
2657 
2989 
3261 
3484 
9000.00 
1368 
2123 
2664 
2998 
3270 
3493 
9050.00 
1372 
2129 
2672 
3006 
3279 
3503 
9100.00 
1376 
2135 
2680 
3015 
3289 
3513 
9150.00 
1380 
2141 
2687 
3023 
3298 
3523 
9200.00 
1384 
2147 
2695 
3032 
3307 
3532 
9250.00 
1388 
2153 
2702 
3040 
3316 
3542 
9300.00 
1391 
2159 
2710 
3049 
3326 
3552 
9350.00 
1395 
2165 
2717 
3058 
3335 
3562 
9400.00 
1399 
2171 
2725 
3066 
3344 
3571 
9450.00 
1403 
2177 
2732 
3075 
3353 
3581 
 
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (01/11) 
 
- 10 - 
Combined 
Monthly 
Available 
Income 
 
One 
Child 
 
Two 
Children 
 
Three 
Children 
 
Four 
Children 
 
Five 
Children 
 
Six 
Children 
 
9500.00 
1407 
2183 
2740 
3083 
3363 
3591 
9550.00 
1411 
2189 
2748 
3092 
3372 
3601 
9600.00 
1415 
2195 
2755 
3100 
3381 
3610 
9650.00 
1419 
2201 
2763 
3109 
3390 
3620 
9700.00 
1422 
2206 
2767 
3115 
3396 
3628 
9750.00 
1425 
2210 
2772 
3121 
3402 
3634 
9800.00 
1427 
2213 
2776 
3126 
3408 
3641 
9850.00 
1430 
2217 
2781 
3132 
3414 
3647 
9900.00 
1432 
2221 
2786 
3137 
3420 
3653 
9950.00 
1435 
2225 
2791 
3143 
3426 
3659 
10000.00 
1437 
2228 
2795 
3148 
3432 
3666 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (01/11) 
 
- 11 - 
IN THE CIRCUIT COURT OF THE                                               JUDICIAL CIRCUIT, 
IN AND FOR                                                  COUNTY, FLORIDA 
 
Case No.:  
 
Division:  
 
 
 
 
 
, 
                        Petitioner, 
                               and 
 
 
 
 
 
, 
 
 
                     Respondent. 
 
NOTICE OF FILING CHILD SUPPORT GUIDELINES WORKSHEET 
 
 
PLEASE TAKE NOTICE, that {name}                                                           , is filing his/her Child 
Support Guidelines Worksheet attached and labeled Exhibit 1. 
CERTIFICATE OF SERVICE 
I certify that a copy of this Notice of Filing with the Child Support Guidelines Worksheet was 
[check one only] (    ) mailed (    ) faxed and mailed (    ) hand delivered to the person(s) listed below on 
{date}   
. 
 
Other party or his/her attorney: 
Name:   
 
 
 
 
Address:  
 
 
 
 
City, State, Zip:   
 
 
 
Fax Number:  
 
 
 
 
Date:   
 
 
 
 
 
 
 
 
Signature of Party 
Printed Name:  
 
Address:  
 
City, State, Zip:  
 
Telephone Number:  
 
Fax Number:  
Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (01/11) 
 
- 12 - 
CHILD SUPPORT GUIDELINES WORKSHEET 
 
A. FATHER 
B. MOTHER 
TOTAL 
1. Present Net Monthly Income 
Enter the amount from line number 
27, Section I of Florida Family Law 
Rules of Procedure Form 12.902(b) 
or (c), Financial Affidavit. 
 
 
 
2.  Basic Monthly Obligation  
There is (are) {number} ____  minor 
child(ren) common to the parties.  
Using the total amount from line 1, 
enter the appropriate amount from 
the child support  guidelines chart. 
 
 
 
3. Percent of Financial Responsibility 
Divide the amount on line 1A by the 
total amount on line 1 to get 
Father’s percentage financial 
responsibility.  Enter answer on line 
3A.  Divide the amount on line 1B by 
the total amount on line 1 to get 
Mother’s percentage financial 
responsibility.  Enter answer on line 
3B. 
% 
% 
 
4. Share of Basic Monthly Obligation 
Multiply the number on line 2 by the 
percentage on line 3A to get Father’s 
share of basic obligation.  Enter 
answer on line 4A. 
Multiply the number on line 2 by the 
percentage on line 3B to get 
Mother’s share of basic obligation.  
Enter answer on line 4B. 
 
 
 
Additional Support — Health Insurance, Child Care & Other 
5.  
a. 100% of Monthly Child Care 
Costs 
[Child care costs should not exceed 
the level required to provide quality 
care from a licensed source.  See 
section 61.30(7), Fla. Stat. for more 
information.] 
 
 
 
 
Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (01/11) 
 
- 13 - 
CHILD SUPPORT GUIDELINES WORKSHEET 
 
A. FATHER 
B. MOTHER 
TOTAL 
b. Total Monthly Child(ren)’s 
Health Insurance Cost 
[This is only amounts actually paid 
for health insurance on the 
child(ren).] 
 
 
 
c. Total Monthly Child(ren)’s 
Noncovered Medical, Dental and 
Prescription Medication Costs 
 
 
 
d. Total Monthly Child Care & 
Health Costs [Add lines 
5a+5b+5c] 
 
 
 
6. Additional Support Payments 
Multiply the number on line 5d by 
the percentage on line 3A to 
determine the Father’s share. 
Enter answer on line 6A. 
Multiply the number on line 5d by 
the percentage on line 3B to 
determine the Mother’s share. 
Enter answer on line 6B. 
 
 
 
Statutory Adjustments/Credits 
7.  
a. Monthly child care payments 
actually made 
 
 
 
b. Monthly health insurance 
payments actually made  
 
 
 
c. Other payments/credits actually 
made for any noncovered 
medical, dental and prescription 
medication expenses of the 
child(ren) not ordered to be 
separately paid on a percentage 
basis. [See § 61.30 (8), Florida 
Statutes] 
 
 
 
8. Total Support Payments actually made 
[Add 7a through 7c] 
 
 
 
9. MINIMUM CHILD SUPPORT 
OBLIGATION FOR EACH PARENT 
[Line 4 plus line 6; minus line 8] 
 
 
 
 
 
Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (01/11) 
 
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CHILD SUPPORT GUIDELINES WORKSHEET 
 
A. FATHER 
B. MOTHER 
TOTAL 
Substantial Time-Sharing (GROSS UP METHOD) If each parent exercises time-sharing at least 20 
percent of the overnights in the year (73 overnights in the year), complete Nos. 10 through 21 
10. Basic Monthly Obligation x 150%  
[ Multiply line 2 by 1.5] 
 
 
 
11. Increased Basic Obligation for each 
parent  
Multiply the number on line 10 by 
the percentage on line 3A to 
determine the Father’s share. 
Enter answer on line 11A. 
Multiply the number on line 10 by 
the percentage on line 3B to 
determine the Mother’s share. 
Enter answer on line 11B. 
 
 
 
12. Percentage of overnight stays with 
each parent 
The child(ren) spend(s)  ______        
overnight stays with the father each 
year.  Using the number on the 
above line, multiply it by 100 and 
divide by 365.  Enter this number on 
line 12A. 
The child(ren) spend(s)   ______         
overnight stays with the mother 
each year.  Using the number on the 
above line, multiply it by 100 and 
divide by 365.  Enter this number on 
line 12B. 
% 
%  
13. Parent’s support multiplied by other 
Parent’s percentage of overnights 
[Multiply line 11A by line 12B.  Enter 
this number in 13A.  Multiply line 
11B by line 12A.  Enter this number 
in 13B.] 
 
 
 
Additional Support — Health Insurance, Child Care & Other 
 
Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (01/11) 
 
- 15 - 
CHILD SUPPORT GUIDELINES WORKSHEET 
 
A. FATHER 
B. MOTHER 
TOTAL 
14.  
a. Total Monthly Child Care Costs  
[Child care costs should not exceed 
the level required to provide quality 
care from a licensed source.  See 
section 61.30(7), Fla. Stat. for more 
information.] 
 
 
 
b. Total Monthly Child(ren)’s 
Health Insurance Cost.  [This is 
only amounts actually paid for 
health insurance on the 
child(ren).] 
 
 
 
c. Total Monthly Child(ren)’s 
Noncovered Medical, Dental and 
Prescription Costs. 
 
 
 
d. Total Monthly Child Care & 
Health Costs [Add lines 
14a+14b+14c] 
 
 
 
 
15. Additional Support Payments 
Multiply the number on line 14d by 
the percentage on line 3A to 
determine the Father’s share. 
Enter answer on line 15A. 
Multiply the number on line 14d by 
the percentage on line 3B to 
determine the Mother’s share. 
Enter answer on line 15B. 
 
 
 
Statutory Adjustments/Credits 
16.  
a. Monthly child care payments 
actually made 
 
 
 
b. Monthly health insurance 
payments actually made 
 
 
 
 
Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (01/11) 
 
- 16 - 
CHILD SUPPORT GUIDELINES WORKSHEET 
 
A. FATHER 
B. MOTHER 
TOTAL 
c. Other payments/credits actually 
made for any noncovered 
medical, dental and prescription 
medication expenses of the 
child(ren) not ordered to be 
separately paid on a percentage 
basis. [See § 61.30 (8), Florida 
Statutes] 
 
 
 
 
17. Total Support Payments actually 
made [Add 16a through 16c] 
 
 
 
18. Total Additional Support Transfer 
Amount [Line 15 minus line 17; Enter 
any negative number as zero] 
 
 
 
 
19. Total Child Support Owed from 
Father to Mother [Add line 13A+18A] 
 
 
 
20. Total Child Support Owed from 
Mother to Father [Add line 13B+18B] 
 
 
 
21. Actual Child Support to Be Paid. 
[Comparing lines 19 and 20, Subtract 
the smaller amount owed from the 
larger amount owed and enter the 
result in the column for the parent 
that owes the larger amount of 
support] 
  $ 
$ 
 
 
ADJUSTMENTS TO GUIDELINES AMOUNT.  If you or the other parent is requesting the Court to award a 
child support amount that is more or less than the child support guidelines, you must complete and file 
Motion to Deviate from Child Support Guidelines, Florida Supreme Court Approved Family Law Form 
12.943. 
[check one only] 
a. __ Deviation from the guidelines amount is requested.  The Motion to Deviate from Child 
Support Guidelines, Florida Supreme Court Approved Family Law Form 12.943, is attached. 
b. __ Deviation from the guidelines amount is NOT requested.  The Motion to Deviate from Child 
Support Guidelines, Florida Supreme Court Approved Family Law Form 12.943, is not attached. 
 
IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW: [fill in 
all blanks] 
I, {full legal name and trade name of nonlawyer}  
, 
a nonlawyer, located at {street}  
, {city}  
, 
{state}   
 
, {phone}  
 
, helped {name}  
, 
who is the [check one only]       petitioner or       respondent, fill out this form. 
 
Instructions for Florida Family Law Rules of Procedure Form 12.996(a), Income Deduction Order (10/10) 
 
- 17 - 
INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE FORM 
12.996(a), INCOME DEDUCTION ORDER (10/10) 
 
When should this form be used? 
 
This form should be used in non-Title IV-D cases when the court has ordered that support be paid by the 
obligor’s payor through an income deduction order. 
 
This form includes several blanks that must be filled in as applicable.  The obligor is the person who is 
obligated to pay the support ordered by the court and the obligee is the person entitled to receive the 
support awarded by the court. 
 
In Paragraph 1, one of the three lines must be checked off. The court order that establishes the support 
award and/or the settlement or mediation agreement entered into between the parties should state the 
effective date of the Income Deduction Order. The appropriate effective date should be checked off in 
Paragraph 1. 
 
The blank lines in Paragraph 2 should be completed tracking the same terms of support as are in the 
court order that establishes the support award and/or the settlement or mediation agreement.  The first 
blank in each line should state the amount of the support payment and the second blank in each line 
should state the time period that covers said support award.  For example, if the child support is $100 
per month the first blank would say $ “100” and the second blank in that line would say “month”.  
Similarly, if the payments are to be payable weekly, then the second blank would say “week”.  If there 
are any arrearages owed at the time the Income Deduction Order is entered, they must be included in 
the line for arrears, along with the amount and frequency of the payments due for the arrears, which 
shall be no less than 20% of the current support obligation.  If the payments are to be payable through 
the State Disbursement Unit, the actual dollar amount of the service fee for the support awarded in 
your case (4% of each payment not to exceed $5.25 per payment) should be included on the appropriate 
line. 
 
Paragraph 6 must be completed to show what percentage, if any, of a one-time payment made to the 
obligor should be applied to any arrearage in support that may be due to the obligee.  
 
You must complete the schedule in paragraph 7 to show the amount of child support for all the minor 
children at the time of the entry of this order and the amount of the child support that will be owed for 
any remaining child(ren) after one or more of the children are no longer entitled to receive child 
support. You should also show in the schedule the day, month, and year that the child support 
obligation terminates for each minor child. The date child support terminates should be listed as the 
child’s 18th birthday unless the court has found that section 743.07(2), Florida Statues, applies, or the 
parties have otherwise agreed to a different date. You should use the record existing at the time of this 
order for the basis of computing all child support obligations. 
 
 
Instructions for Florida Family Law Rules of Procedure Form 12.996(a), Income Deduction Order (10/10) 
 
- 18 - 
What should I do next? 
 
For this order to be effective, it must be signed by the judge. This form should be typed or printed in 
black ink. After completing this form, you must first send a copy to the other party or his or her 
attorney, if he or she is represented by an attorney, for approval or objection to the form before you 
send it to the judge assigned to your case. If the opposing party or his or her attorney, if represented, 
approves the form order, you may send the original proposed order and two copies to the judge 
assigned to your case with a letter telling the judge that you have first sent a copy of this proposed order 
to the opposing counsel or party, if unrepresented, and that they have no objection to the judge signing 
this order.  If the other party or his or her attorney, if represented, has an objection to the proposed 
order as completed by you, you must tell the judge that you have sent a copy of this proposed order to 
the opposing party or his or her counsel, if represented, and that they specifically object to the entry of 
the proposed form Income Deduction Order. You must also send stamped self-addressed envelopes to 
the judge addressed to you and the opposing party or his or her attorney, if represented.  You should 
keep a copy for your own records. If the judge signs the Income Deduction Order, the judge will mail 
you and the opposing party (or their attorney) copies of the signed order in the envelopes you provide 
to the court. 
 
Where can I look for more information? 
 
Before proceeding, you should read “General Information for Self-Represented Litigants” found at the 
beginning of these forms.  The words that are in “bold underline” in these instructions are defined 
there. For further information see section 61.1301, Florida Statutes. 
 
Special Instructions... 
 
When the Income Deduction Order becomes effective (either immediately or delayed until arrearage), 
you must then also send a copy of the Income Deduction Order to the obligor’s employer along with a 
Notice to Payor, Florida Family Law Rules of Procedure Form 12.996(b), for the Income Deduction 
Order to take effect. 
 
It is your responsibility to determine what extra steps and/or forms, if any, must be taken, supplied, 
and/or filed to insure the Income Deduction Order is implemented. 
 
Remember, a person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out 
these forms, that person must give you a copy of a Disclosure from Nonlawyer, Florida Family Law Rules 
of Procedure Form 12.900(a), before he or she helps you. A nonlawyer helping you fill out these forms 
also must put his or her name, address, and telephone number on the bottom of the last page of every 
form he or she helps you complete. 
 
Florida Family Law Rules of Procedure Form 12.996(a), Income Deduction Order (10/10) 
 
- 19 - 
IN THE CIRCUIT COURT OF THE _____________________ JUDICIAL CIRCUIT, 
IN AND FOR ______________________________ COUNTY, FLORIDA 
 
 
 
Case No: ________________________ 
 
Division: ________________________ 
 
_________________________________, 
                      Petitioner, 
and 
 
_________________________________, 
Respondent. 
 
 
INCOME DEDUCTION ORDER (Non-Title IV-D Case) 
 
TO: 
 ANY PRESENT OR SUBSEQUENT EMPLOYERS/PAYORS OF OBLIGOR 
 
{name} ________________________________________________________ 
 
 
YOU ARE HEREBY ORDERED to make regular deductions from all income due and payable to the 
above-named obligor in accordance with the terms of this order as follows: 
 
1. This Income Deduction Order shall be effective 
[Choose only one] 
 
      
immediately. 
       
upon a delinquency in the amount of $___________ but not to exceed one month’s payment, 
pursuant to the order establishing, enforcing, or modifying the obligation. 
 
      
beginning {date} __________________. 
 
2. You shall deduct: 
$ 
 per  
 for child support. Child support shall be automatically reduced or terminated 
consistent with the schedule in paragraph 7. 
 
 
$ 
 per  
 for permanent alimony 
 
 
$ 
 per  
 for rehabilitative alimony 
 
 
$ 
 per  
 for  
 arrears totaling $ 
 
 
The deduction for arrears shall be no less than 20% of the current support obligation.  After the full 
amount of any arrears is paid, you shall deduct for attorneys’ fees and costs owed until the full amount 
is paid.  
 
 
 
 
 
$ 
 per  
 for attorneys’ fees and costs totaling $  
 
 
 
 
 
 
$ 
 per  
 for State of Florida Disbursement Unit fee 
 
 
 
  
 (4% of each payment not to exceed $5.25 per payment) 
 
Florida Family Law Rules of Procedure Form 12.996(a), Income Deduction Order (10/10) 
 
- 20 - 
 
 
$ 
  Total amount of income to be deducted each pay period 
3. You shall pay the deducted amount to the “State of Florida Disbursement Unit”, and mail it to the 
State of Florida Disbursement Unit P.O. Box 8500, Tallahassee, FL 32314-8500, (tel.) (877) 769-0251. 
All payments must include the obligor’s name (last, middle, first), obligor’s social security number, 
obligee’s name (last, middle, first), name of county where court order originated, and case number.  
All payments must be made by check, money order, cashier’s check, certified check, or through the 
Internet with access provided by the State of Florida www.floridasdu.com. No credit will be given for 
any payments made directly to the obligee without a court order permitting direct payments. 
 
4. If a delinquency accrues after the order establishing, modifying, or enforcing the obligation has been 
entered and there is no order for repayment of the delinquency or a preexisting arrearage, a payor 
shall deduct an additional 20 percent of the current support obligation or other amount agreed to 
by the parties until the delinquency and any attorneys’ fees and costs are paid in full. No deduction 
may be applied to attorneys’ fees and costs until the delinquency is paid in full.  
 
5. You shall not deduct in excess of the amounts allowed under the Consumer Credit Protection Act, 15 
U.S.C. §673(b), as amended.  
 
6. You shall deduct ( Choose only one) (     ) the full amount, (     ) _____%, or (      ) none of the income 
which is payable to the obligor in the form of a bonus or other similar one-time payment, up to the 
amount of arrearage reported in the Income Deduction Order or the remaining balance thereof, and 
forward the payment to the State of Florida Disbursement Unit. For purposes of this subparagraph, 
“bonus” means a payment in addition to an obligor's usual compensation and which is in addition to 
any amounts contracted for or otherwise legally due and shall not include any commission 
payments due an obligor. 
 
7. Child Support Reduction/Termination Schedule.  Child support shall be automatically reduced or 
terminated as set forth in the following schedule: 
 
Please list 
children  
by initials 
from eldest to 
youngest 
 
Insert in this 
column the 
day, month, 
and year the 
child support 
obligation 
terminates for 
each 
designated 
child (see 
instructions) 
 
Insert in 
this column 
the amount 
of child 
support for 
all minor 
children 
remaining 
(including 
designated 
child).   
Child 1 
(Eldest) 
From the effective 
date of this Income 
 
child support  for Child 1 and 
all other younger  child(ren) 
 
 
Florida Family Law Rules of Procedure Form 12.996(a), Income Deduction Order (10/10) 
 
- 21 - 
Initials & year 
of birth: 
 
 
Deduction Order 
until the following 
date: 
should be paid in the 
following monthly amount: 
Child 2 
Initials & year 
of birth: 
 
 
After the date set 
forth in the row 
above until the 
following date:  
 
child support  for Child 2 and 
all other younger  child(ren) 
should be paid in the 
following monthly amount: 
 
Child 3 
Initials & year 
of birth:  
 
 
After the date set 
forth in the row 
above until the 
following date: 
 
child support  for Child 3 and 
all other younger  child(ren) 
should be paid in the 
following monthly amount: 
 
Child 4 
Initials & year 
of birth: 
 
 
After the date set 
forth in the row 
above until the 
following date: 
 
child support  for Child 4 and 
all other younger  child(ren) 
should be paid in the 
following monthly amount: 
 
Child 5  
Initials & year 
of birth: 
 
 
After the date set 
forth in the row 
above until the 
following date: 
 
child support  for Child 5 and 
all other younger  child(ren) 
should be paid in the 
following monthly amount: 
 
 
(Continue on additional pages for additional children) 
 
8. This Income Deduction Order shall remain in effect so long as the underlying order of support is 
effective or until further order of the court. 
 
STATEMENT OF OBLIGOR’S RIGHTS, REMEDIES, AND DUTIES 
 
9. The obligor is required to pay all amounts and fees specified within this Income Deduction Order. 
 
10. The amounts deducted may not be in excess of that allowed under the Consumer Credit Protection 
Act, 15 U.S.C. §1673(b) as amended. 
 
11. This income deduction order applies to all of the obligor’s current and subsequent payors and 
periods of employment. 
 
12. A copy of the Income Deduction Order will be served upon the obligor’s payor or payors. 
 
 
Florida Family Law Rules of Procedure Form 12.996(a), Income Deduction Order (10/10) 
 
- 22 - 
13. Enforcement of the Income Deduction Order may only be contested on the ground of mistake of 
fact regarding the amount owed pursuant to the order establishing, enforcing, or modifying the 
obligation, the arrearages, or the identity of the obligor, the payor, or the obligee. 
 
14. The obligor is required to notify the obligee and, when the obligee is receiving IV-D services, the IV-D 
agency, within 7 days of any changes in the obligor’s address, payors, and the addresses of the 
obligor’s payors. 
 
15. In a Title IV-D case, if an obligation to pay current support is reduced or terminated due to 
emancipation of a child and the obligor owes an arrearage, retroactive support, delinquency, or 
costs, income deduction continues at the rate in effect immediately prior to emancipation until all 
arrearages, retroactive support, delinquencies, and costs are paid in full or until the amount of 
withholding is modified. 
 
 
ORDERED on_____________________________. 
 
 
 
____________________________________ 
 
CIRCUIT JUDGE 
 
COPIES TO: 
Obligee 
Obligor 
Other: ____________________________________