Nebraska DHHS System: Application for Child Support Services: Income and Hours

Your Information
Child Information
Court Order Information
- Court Order Information
- Court Order Summary
Health Coverage Information
- Health Coverage Information
Application Summary
- Application Summary
- Confirmation

Income and Hours

Note: an asterisk [*] indicates a required field.

* Monthly Gross Income (includes tips, commision and bonuses)

* Monthly amounts are calculated by:

Multiplying weekly amount by 52 and dividing by 12;

Multiplying bi-weekly amounts by 26 and dividing by 12;

Multiplying semi-monthly amounts by 24 and dividing by 12;

PayRoll Deductions:

* Health Insurance

* Vision Insurance

* Dental Insurance

* Retirement

* What percent of your income/salary is withheld for retirement?

* Is retirement mandatory?

Yes

Hours worked each week:

* Regular

* Overtime

* Regular Hourly Wage

* Overtime Rate of Pay

* Is overtime mandatory?

Yes