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PA Child Support Program

Child Support Estimator - Entry Form

Fields marked with * are mandatory

County of Residence:			Select County: Adams Allegheny Armstrong Beaver Bedford Berks Blair Bradford Bucks Butler Cambria Cameron Carbon Centre Chester Clarion Clearfield Clinton Columbia Crawford Cumberland Dauphin Delaware Elk Erie Fayette Forest Franklin Fulton Greene Huntingdon Indiana Jefferson Juniata Lackawanna Lancaster Lawrence Lebanon Lehigh Luzerne Lycoming McKean Mercer Mifflin Monroe Montgomery Montour Northampton Northumberland Perry Philadelphia Pike Potter Schuylkill Snyder Somerset Sullivan Susquehanna Tioga Union Venango Warren Washington Wayne Westmoreland Wyoming York
Number of Children in This Child Support Action:			*
			Noncustodial Parent		Custodial Party
Gross Income:		$	* Annually Bi-monthly Bi-weekly Monthly Quarterly Semi-monthly Weekly	$	* Annually Bi-monthly Bi-weekly Monthly Quarterly Semi-monthly Weekly
Tax Filing Status:			Head of Household Married Filing Jointly Married Filing Separately Single		Head of Household Married Filing Jointly Married Filing Separately Single
Number of Dependents Claimed on Taxes:
State Tax Rate:			%*		%*
Local Tax Rate:			%*		%*
Alimony, Spousal Support and Alimony Pendente Lite:		$	per Month	$	per Month
Child Care Expenses:		$	per Month	$	per Month
Health Insurance Premium for Children in This Child Support Action:		$	per Month	$	per Month
Union Dues:		$	per Month	$	per Month
Non-Voluntary Retirement:		$	per Month	$	per Month
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