Title: In Re: Amendments to Florida Family Law Rules of Procedure - Form 12.902(e)
Citation: N/A
Docket Number: SC21-1174
State: Florida
Issuer: Florida Supreme Court
Date: January 13, 2022

Supreme Court of Florida 
 
____________ 
 
No. SC21-1174 
____________ 
 
IN RE:  AMENDMENTS TO FLORIDA FAMILY LAW RULES 
OF PROCEDURE—FORM 12.902(e). 
 
January 13, 2022 
 
PER CURIAM. 
This matter is before the Court for consideration of proposed 
amendments to Florida Family Law Rule of Procedure Form 
12.902(e) (Child Support Guidelines Worksheet).  See Fla. R. Gen. 
Prac. & Jud. Admin. 2.140(b)(1).  We have jurisdiction.  See art. V, § 
2(a), Fla. Const. 
The Florida Bar’s Family Law Rules Committee (Committee) 
filed a report proposing amendments to form 12.902(e).  The 
Committee and the Board of Governors of The Florida Bar approved 
the proposed amendments.  The Committee published its proposal 
for comment prior to filing it with the Court and received one 
comment in support of the proposed amendments.  After the 
Committee filed its report, the Court published the proposal for 
- 2 - 
 
comment.  One comment was received in support of the proposed 
amendments, and the Committee filed a response. 
Having considered the proposed amendments, the comment, 
and the Committee’s response, the Court hereby amends Florida 
Family Law Rule of Procedure Form 12.902(e) (Child Support 
Guidelines Worksheet) as proposed by the Committee, with a minor 
modification. 
First, a sentence is added to the instructions for form 
12.902(e) providing that if the parties’ combined monthly net 
income is not listed on the Child Support Guidelines Chart, child 
support is to be calculated as provided by law.  However, we modify 
the sentence to specifically reference section 61.30(6), Florida 
Statutes (Child support guidelines; retroactive child support), which 
explains how to calculate the child support amount if the obligor 
parent’s net income is less than the amount in the guidelines 
schedule or if the parties’ combined monthly net income is greater 
than the amount in the guidelines schedule. 
Additionally, throughout the form’s instructions, references to 
the Rules of Judicial Administration are amended to reflect the 
updated name, the Rules of General Practice and Judicial 
- 3 - 
 
Administration.  See In re Amends. to Fla. Rules of Jud. Admin.—
2020 Regular-Cycle Report, 310 So. 3d 374 (Fla. 2021). 
Accordingly, Form 12.902(e) is hereby amended as set forth in 
the appendix to this opinion.  The form is fully engrossed and ready 
for use.  The form may also be accessed and downloaded from the 
Florida State Courts’ website at 
https://www.flcourts.org/Resources-Services/Court-
Improvement/Family-Courts/Family-Law-Self-Help-
Information/Family-Law-Forms.  The amendments shall become 
effective April 1, 2022, at 12:01 a.m. 
It is so ordered. 
CANADY, C.J., and POLSTON, LABARGA, LAWSON, MUÑIZ, 
COURIEL, and GROSSHANS, JJ., concur. 
 
THE FILING OF A MOTION FOR REHEARING SHALL NOT ALTER 
THE EFFECTIVE DATE OF THESE AMENDMENTS. 
 
Original Proceeding – Florida Family Law Rules of Procedure 
 
Ashley Elizabeth Taylor, Chair, Family Law Rules Committee, 
Tampa, Florida, Joshua E. Doyle, Executive Director, and Mikalla 
Andies Davis, Staff Liaison, The Florida Bar, Tallahassee, Florida, 
 
 
for Petitioner 
 
Heather L. Apicella, Chair, Family Law Section of The Florida Bar, 
Boca Raton, Florida, Kristin R.H. Kirkner, Co-Chair, Rules and 
Forms Committee, Family Law Section of The Florida Bar, Tampa, 
- 4 - 
 
Florida, and Jack A. Moring, Co-Chair, Rules and Forms 
Committee, Family Law Section of The Florida Bar, Crystal River, 
Florida, 
 
 
Responding with comments
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (04/22) 
- 5 - 
 
APPENDIX 
 
INSTRUCTIONS FOR FLORIDA FAMILY LAW RULES OF PROCEDURE  
FORM 12.902(e) 
 CHILD SUPPORT GUIDELINES WORKSHEET (04/22) 
 
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 this document 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 filed with the court and served on the other party or his or her attorney. The 
copy you are serving to the other party must be either mailed, emailed, or hand-delivered to the opposing 
party or his or her attorney on the same day indicated on the certificate of service. If it is mailed, it must 
be postmarked on the date indicated in the certificate of service. Service must be in accordance with 
Florida Rule of General Practice and Judicial Administration 2.516. 
 
IMPORTANT INFORMATION REGARDING E-FILING 
 
The Florida Rules of General Practice and Judicial Administration now require that all petitions, 
pleadings, and documents be filed electronically except in certain circumstances. Self-represented 
litigants may file petitions or other pleadings or documents electronically; however, they are not 
required to do so. If you choose to file your pleadings or other documents electronically, you must do so 
in accordance with Florida Rule of General Practice and Judicial Administration 2.525, and you must 
follow the procedures of the judicial circuit in which you file. The rules and procedures should be 
carefully read and followed.  
 
IMPORTANT INFORMATION REGARDING E-SERVICE ELECTION 
 
After the initial service of process of the petition or supplemental petition by the Sheriff or certified 
process server, the Florida Rules of General Practice and Judicial Administration now require that all 
documents required or permitted to be served on the other party must be served by electronic mail (e-
mail) except in certain circumstances. You must strictly comply with the format requirements set forth 
in the Florida Rules of General Practice and Judicial Administration. If you elect to participate in 
electronic service, which means serving or receiving pleadings by electronic mail (e-mail), or through the 
Florida Courts E-Filing Portal, you must review Florida Rule of General Practice and Judicial 
Administration 2.516. You may find this rule at www.flcourts.org through the link to the Rules of General 
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (04/22) 
- 6 - 
 
Practice and Judicial Administration provided under either Family Law Forms: Getting Started, or Rules 
of Court in the A-Z Topical Index.  
 
SELF-REPRESENTED LITIGANTS MAY SERVE DOCUMENTS BY E-MAIL; HOWEVER, THEY ARE NOT 
REQUIRED TO DO SO. If a self-represented litigant elects to serve and receive documents by email, the 
procedures must always be followed once the initial election is made.  
 
To serve and receive documents by e-mail, you must designate your e-mail addresses by using the 
Designation of Current Mailing and E-mail Address, Florida Supreme Court Approved Family Law Form 
12.915, and you must provide your e-mail address on each form on which your signature appears. 
Please CAREFULLY read the rules and instructions for: Certificate of Service (General), Florida Supreme 
Court Approved Family Law Form 12.914; Designation of Current Mailing and E-mail Address, Florida 
Supreme Court Approved Family Law Form 12.915; and Florida Rule of General Practice and Judicial 
Administration 2.516.  
 
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 you want to keep your address confidential because you have been found by a judge to be the victim 
of sexual battery, aggravated child abuse, aggravated stalking, harassment, aggravated battery or 
domestic violence, do not enter the address, telephone, and fax information at the bottom of this form.  
Instead, file 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 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. 
If the parties’ combined monthly net income is not listed on the below chart, then calculate child support 
as provided by law in section 61.30(6), Florida Statutes. 
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 
 
 
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (04/22) 
- 7 - 
 
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 
(04/22) 
- 8 - 
 
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 
2600.00 
2650.00 
2700.00               
2750.00                 
2800.00 
568 
578 
588 
597 
607 
880 
896 
912 
927 
941 
1101 
1121 
1141 
1160 
1178 
1242 
1265 
1287 
1308 
1328 
1354 
1379 
1403 
1426 
1448 
1447 
1473 
1500 
1524 
1549 
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet 
(04/22) 
- 9 - 
 
Combined 
Monthly 
Available 
Income 
 
One 
Child 
 
Two 
Children 
 
Three 
Children 
 
Four 
Children 
 
Five 
Children 
 
Six 
Children 
 
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 
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 
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet 
(04/22) 
- 10 - 
 
Combined 
Monthly 
Available 
Income 
 
One 
Child 
 
Two 
Children 
 
Three 
Children 
 
Four 
Children 
 
Five 
Children 
 
Six 
Children 
 
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 
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 
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet 
(04/22) 
- 11 - 
 
Combined 
Monthly 
Available 
Income 
 
One 
Child 
 
Two 
Children 
 
Three 
Children 
 
Four 
Children 
 
Five 
Children 
 
Six 
Children 
 
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 
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 
Instructions for Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet 
(04/22) 
- 12 - 
 
Combined 
Monthly 
Available 
Income 
 
One 
Child 
 
Two 
Children 
 
Three 
Children 
 
Four 
Children 
 
Five 
Children 
 
Six 
Children 
 
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 
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 (04/22) 
 
- 13 - 
 
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 all used]: (    ) e-mailed (     ) mailed (    ) faxed (     ) hand delivered to the person(s) listed 
below on {date}  
 
__________. 
 
Other party or his/her attorney: 
Name:  _____________________________ 
Address: ____________________________ 
City, State, Zip:  _______________________ 
Telephone Number: ___________________ 
Fax Number: _________________________ 
E-mail Address(es): ____________________ 
 
 
 
 
Signature of Party or his/her Attorney 
Printed Name:  _________________________ 
Address: ______________________________ 
City, State, Zip:  _________________________ 
Telephone Number: _____________________ 
Fax Number: ___________________________ 
E-mail Address(es): ______________________ 
Florida Bar Number: _____________________ 
 
Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (04/22) 
 
 
- 14 - 
 
 
 
CHILD SUPPORT GUIDELINES WORKSHEET 
 
 
 
A. PETITIONER 
 
B. RESPONDENT 
 
TOTAL 
 
1. Present Net Monthly Income 
        Enter the amount from line 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  
      Petitioner’s percentage of  
      financial responsibility. Enter  
       answer on line 3A. Divide the  
       amount on line 1B by the total  
       amount on line 1 to get      
      Respondent’s percentage   
      of 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  
        Petitioner’s share of basic  
        obligation. Enter answer on line  
       4A. Multiply the number on line 2  
       by the percentage on line 3B to  
       Respondent’s share of basic  
       obligation.  
       Enter answer on line 4B. 
 
 
 
 
 
 
 
 
 
 
 
 
Additional Support — Health Insurance, Child Care & Other 
 
Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (04/22) 
 
 
- 15 - 
 
 
CHILD SUPPORT GUIDELINES WORKSHEET 
 
 
 
A. PETITIONER 
 
B. RESPONDENT 
 
TOTAL 
 
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), Florida Statutes,  
       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 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 Petitioner’s share. 
Enter answer on line 6A. Multiply the 
number on line 5d by the percentage 
on line 3B to determine the 
Respondent’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. 
 
 
 
 
 
 
 
 
 
Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (04/22) 
 
 
- 16 - 
 
 
CHILD SUPPORT GUIDELINES WORKSHEET 
 
 
 
A. PETITIONER 
 
B. RESPONDENT 
 
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 section 61.30 (8), 
Florida Statutes.) 
 
 
 
 
8.   Total Support Payments actually made 
 (Add 7a though 7c.) 
 
 
 
 
9. MINIMUM CHILD SUPPORT  
   OBLIGATION FOR EACH PARENT  
[Line 4 plus line 6; minus line 8.] 
 
 
 
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 Petitioner’s share.  
      Enter answer on line 11A.  Multiply  
      the number on line 10 by the  
     percentage on line 3B to  
      determine the Respondent’s share.  
      Enter answer on line 11B. 
  
 
 
 
 
 
 
Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (04/22) 
 
 
- 17 - 
 
 
CHILD SUPPORT GUIDELINES WORKSHEET 
 
 
 
A. PETITIONER 
 
B. RESPONDENT 
 
TOTAL 
12. Percentage of overnight stays with  
       each parent.  The child(ren) spend(s)  
      ____overnight stays with the  
     Petitioner 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 Respondent 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 
 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), Florida Statutes, 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 Medication Costs. 
 
 
 
d. Total Monthly Child Care & Health 
Costs [Add lines 14a + 14b + 14c.] 
 
 
 
 
Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (04/22) 
 
 
- 18 - 
 
 
CHILD SUPPORT GUIDELINES WORKSHEET 
 
 
 
A. PETITIONER 
 
B. RESPONDENT 
 
TOTAL 
15.  Additional Support Payments. 
       Multiply the number on line 14d by  
       the percentage on line 3A to  
       determine the Petitioner’s share.  
       Enter answer on line 15A. Multiply  
       the number on line 14d by the  
       percentage on line 3B to determine  
       the Respondent’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. 
 
 
 
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 
section 61.30(8), Florida 
Statutes.] 
 
 
 
 
 
 
17.  Total Support Payments actually  
         made [Add 16a though 16c.] 
 
 
 
18. Total Additional Support Transfer  
       Amount [Line 15 minus line 17;  
       enter any negative number as  
       zero.] 
 
 
 
 
19.  Total Child Support Owed from  
        Petitioner to Respondent [Add line  
       13A plus 18A.] 
 
 
  
 
 
 
 
  
        
 
 
 
 
 
 
 
20. Total Child Support Owed from  
       Respondent to Petitioner. [Add line  
       13B plus line 18B.] 
 
 
Florida Family Law Rules of Procedure Form 12.902(e), Child Support Guidelines Worksheet (04/22) 
 
 
- 19 - 
 
 
CHILD SUPPORT GUIDELINES WORKSHEET 
 
 
 
A. PETITIONER 
 
B. RESPONDENT 
 
TOTAL 
21. Presumptive 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] This form was prepared for the: {choose only one} ____ Petitioner ____ Respondent 
This form was completed with the assistance of: 
{name of individual}  
, 
{name of business} ____________________________________________________________, 
{address} ____________________________________________________________________,  
{city} __________________, {state} ____, {zip code} ______, {telephone number} _________