Vernon's Texas Rules Annotated - VTRA TX R WILLIAMSON CTY Ex. B EXHIBIT “B”. PROPOSED SUPPORT DECISION AND INFORMATION

Exhibit “B”

NO._______________________

IN THE MATTER OF

*

IN THE ________________________________________

THE MARRIAGE OF

*

*

_______________________________________________

*

_______________________________________________

AND

*

*

_______________________________________________

*

AND IN THE INTEREST OF

*

*

_______________________________________________

*

WILLIAMSON COUNTY, TEXAS

PROPOSED SUPPORT DECISION AND INFORMATION

OF ______________________________

I, ____________________, would testify under oath in open court that the attached information is true and correct. I understand that at such a court hearing I may be required to prove these amounts by testimony and by records such as pay vouchers, cancelled checks, receipts and bills.

    SIGNED this _____ day of __________, 20 ___.

____________________________________________

Signature of Party

I intend to ask the court to set support at $ _____ per month.

    SIGNED this _____ day of __________, 20 ___.

____________________________________________

Signature of Party of Attorney

GROSS MONTHLY EARNED PER MONTH

(1)

Gross wages and salary income

(2)

Commission, tips and bonuses

(3)

Self-employment income (net of expenses other than deprecation of tax credits)

(4)

Rental income (not of expenses other Deprecation).

(5)

All other income actually received (specify)

0.00

GROSS MONEY EARNED PER MONTH

0.00

(A)

(B)

ACTUAL DEDUCTIONS PER MONTH Attach most recent pay stub from each employer

(1)

Income tax withholding

(2)

FICA (Social Security)

(3)

Medicare

(4)

Health Insurance

(5)

Union Dues

(6)

Other (specify)

0.00

TOTAL ACTUAL DEDUCTIONS PER MONTH

0.00

(B)

(C)

NET MONEY ACTUALLY RECEIVED PER MONTH. SUBTRACT (B) FROM (A)

0.00

(C)

(D)

STATURORY NET RESOURCES DEDUCTIONS ALLOWED PER MONTH

(1)

(2)

(2)

FICA (Social Security)

(3)

Medicare

(4)

Health Insurance attributable to the Children

(5)

Union Dues

0.00

STATUTORY NET RESOURCES DEDUCTIONS ALLOWED PER MONTH

0.00

(D)

(E)

0.00

(D)

(F)

TOTAL MONEY EARNED PER MONTH BY ME AND MINOR CHILD(REN) LIVING WITH ME. For items which are not paid monthly, Express the amount as a monthly average.

(1)

Rent or house payment

(2)

Real property taxes (omit if part of house payment)

(3)

Residence maintenance (repairs, yard)

(4)

Insurance-home or renters (omit if part of house payment)

(5)

Utilities--Gas

(6)

Utilities--Electric and water

(7)

Telephone (including average long distance)

(8)

Utilities--Garbage service

(9)

Groceries and household items

(10)

Meals away from home

(11)

School lunches

(12)

Dental and orthodontia

(13)

Medical and prescriptions

(14)

Laundry and dry cleaning

(15)

Car payment

(16)

Gas and vehicle maintenance

(17)

Clothing and shoes

(18)

Insurance--Car

(19)

Insurance--Life

(20)

Insurance--Health (omit if payroll deduction)

(21)

Child care

(22)

Children's activities

(23)

Entertainment

(24)

Haircuts

(25)

Cable TV and newspaper

(26)

Total monthly payments on debts (list below at G and show total here)

SCHEDULE G--MONTHLY PAYMENTS ON DEBTS

(27)

Support or alimony to other Persons

(28)

Other (specify):

TOTAL MONEY NEEDED PER MONTH

(F)

0.00

(H) DIFFERENCE BETWEEN MONEY RECEIVED

(H)

AND MONEY NEEDED. SUBTRACT(F) FROM (C)

(I) PRESUMED CHILD SUPPORT--MULTIPLY (E) BY THE GUIDELINE PERCENTAGE ____ %

(I)

PROPOSED DISPOSITION OF OTHER ISSUES