PYRAMID LAKE TRIBAL COURT

Tribal code

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What actually matters in this document.

Text

P.O. BOX 257/221 HIGHWAY 447

NIXON, NV 89424

PETITION TO ESTABLISH CHILD

CUSTODY, SUPPORT,

&/OR VISTATION

Purpose of this packet: Unmarried parents of children want a court order to establish custody,

support, and/or visitation.

Use this Packet if: 1) You and the other parent do not agree about custody, visitation, medical

or other care, education, and/or child support;

2. The minor children have lived within the Pyramid Lake Paiute Tribe Reservation

boundaries for at least six weeks prior to filing or since birth;

3. The children previously lived on the Pyramid Lake Paiute Tribe Reservation boundaries

for six or more weeks and have been gone from the Pyramid Lake Paiute Tribe

Reservation boundaries for less than six months, and one of the parents continues to

live within the Pyramid Lake Paiute Tribe Reservation boundaries; or

4. Parties have had sufficient minimum contact with the Pyramid Lake Paiute Tribe and/or

the Pyramid Lake Reservation.

Contents:

1. Instructions

2. Legal Assistance Information

3. Family Court Information Sheet

4. Petition to Establish Custody, Support, and/or Visitation

a. Appendix A: Gross monthly income worksheet

b. Appendix B: Child Support Worksheet

5. General Financial Disclosure Form

6. Summons

7. Declaration of Personal Service

Before filling in any portion of the petition, read all materials and, if needed, request

clarification from court staff.

PETITION FOR CHILD CUSTODY/SUPPORT/VISITATION

INSTRUCTIONS:

 Step 1: Fill out the following forms:

o Confidential Family Court Information Sheet

o Petition to Establish Custody and Visitation

o Appendix A: Gross Monthly Income Worksheet

o Appendix B: Child Support Worksheet

o General Financial Disclosure Form

o Summons

You will be given a case number when your documents are filed with the Court.

Fill out the top section of the Summons and lower section with your name and contact

information. Court staff will complete the Summons with a signature, date, and stamp once it

has been submitted completely to the Court.

Use blue or black ink only to fill out the forms and neatly print the information requested. DO

NOT USE WITE-OUT or other correction fluid/tape on the forms. The Petition will not be

accepted by the Court personnel if correction fluid/tape is used.

 Step 2: File your forms

o If you plan on returning to the Courthouse to file the Petition, wait to sign the

Petition in front of staff or bring it in already notarized.

o Once the Petition is completed and ready to be filed, submit filing fee ($50.00),

civil service fee ($15.00), and Petition to Court personnel.

▪ If the Respondent resides in another area (Off of the Pyramid Lake Paiute

Reservation), you will be subject to a civil service fee that is determined

by that county. You will be responsible to reach out the that Jurisdiction

for their processes and for the fee; even if an application to Waive Filing

Fees (hereinafter “Application”) is submitted.

o If you submit your Petition with an Application to Waive Filing Fees, the Petition

will not be filed until a decision on the Application is rendered. Should the Judge

approve the Application, your petition will be filed, however, if it is denied, you

will be contacted and must pay the filing fee prior to the Petition being filed. If

the Application is approved, no filing fees will be assessed for 30 days of the

approved application.

 Step 3: Serve the Documents

o The respondent must be personally served with the Petition and Summons

within 120 days after the petition is filed or your case may be dismissed. Serve

the respondent with the following documents:

▪ Petition to Establish Custody and Visitation including Appendix A and

Appendix B

▪ Summons

▪ General Financial Disclosure Form

PETITION FOR CHILD CUSTODY/SUPPORT/VISITATION

6/24/2025

PETITION FOR CHILD CUSTODY/SUPPORT/VISITATION

You will receive file-stamped copies of these documents from Court Staff once all paperwork is

submitted and processed.

Personal service cannot be completed by you.

It can be completed by:

• The Pyramid Lake Police Department;

• Civil Division of the Sheriff’s Office in the County in which the person you are serving

resides or works; or

• A responsible adult over the age of 18 years that is not party to the case; or A private

process service.

Personal service is completed by a person other than yourself by delivering to the party a

served copy of the Petition to Establish Custody and Visitation including Appendix A and

Appendix B, the Summons, and General Financial Disclosure Form.

If a party personally refuses to accept service, service shall be deemed performed if the person

is informed of the purpose of the service and offered copies of the papers served.

If you are unable to serve the respondent, or do not know where they are, you may

electronically file an Ex Parte Motion requesting permission to serve the respondent by

alternative service. This form is available upon request.

 Step 4: Declaration/Proof of Service

o After the Respondent is personally served, fill out the top portion of the

Declaration of Service with your contact information, The Petitioner and

Respondent names, and case number.

o The rest of the Declaration of Service form MUST be completed by the person

who served the documents (NOT YOU).

 Step 5: File the Declaration of Service

o Mail/Email/Fax/Or bring in person the original of the completed Declaration of

Service to the Pyramid Lake Tribal Court.

o Once the Declaration of Service is file stamped in Court staff will give you a copy

for your records.

o NOTE*: Once the Respondent is served, he/she will have 20 calendar days to

respond to the Petition. If the respondent files an Answer and Counterclaim, you

may reply with an Answer to Counterclaim.

o If the respondent files an Answer and Counterclaim and you do not file an

Answer to Counterclaim, a default may be entered against you.

o If the Respondent chooses not to respond, the full 20 calendar days will be

allocated. You may then contact the Court to request a Default packet.

PETITION FOR CHILD CUSTODY/SUPPORT/VISITATION

6/24/2025

PETITION FOR CHILD CUSTODY/SUPPORT/VISITATION

LEGAL ASSISTANCE INFORMATION

ATTENTION: THIS PACKET IS ONLY PROVIDED AS A COUTESY; THIS IS NOT A SUBSTITUTE FOR

THE ADVICE OF AN ATTORNEY OR ADVOCATE. Counsel is Always Recommended for Legal

Matters.

The laws governing the Pyramid Lake Paiute Reservation allow any person to represent

him/herself in any legal action heard in the Pyramid Lake Tribal Court. However, filing

Petitions/Applications/Complaints with the court and representing yourself in the courtroom

can involve complex legal matters. This packet only addresses a few legal issues involved in

bringing your matter before the Court.

When appearing pro se, Latin for “on one’s own behalf”, you are responsible for understanding

the law that governs your case and for filing the correct legal documents. The laws and rules are

set out in the Pyramid Lake Law & Order Code, the Federal Rules of Civil Procedure and the

Pyramid Lake Tribal Court Procedures.

When you return to the court and sign these documents for filing, the court assumes that all

documents are read carefully and all potential outcomes of litigation in this matter are

understood.

The Court may upon request send you an updated list of approved advocates/attorneys for the

Pyramid Lake Tribal Court.

Note: The penalty for knowingly and/or willfully making a false statement under penalty of

Perjury §3.4.704 is a Class A Offense carrying a Maximum sentence of One (1) year

incarceration and/or maximum fine: Five Thousand Dollars ($5,000.00). §3.4.114.

If there are any further questions, please do not hesitate to call the Pyramid

Lake Tribal Court at (775) 574-1094.

PETITION FOR CHILD CUSTODY/SUPPORT/VISITATION

6/24/2025

Examples of Custody Schedules

These custody schedules are provided to you as examples. You may select a pre-set

schedule as shown in Options 1 – 4, or you may create your own visitation schedule in

Option 5.

Option 1 - Week On / Week Off (Joint physical custody)

•

Both parents will have exactly equal time with the minor child(ren)

The minor child(ren) will spend one week with Parent 1 and the following week

with Parent 2

This schedule will alternate every week throughout the year

The exchange time and day will always remain the same every week, for example,

every Sunday evening at 7 p.m. (or at whichever time you agree)

Depending on the time and day you agree on for exchanges, they might coincide

with pick ups or drop offs at school

NOTE: This schedule is often used when the parents have (a) school-age child(ren)

Parent 1’s custodial days with the minor child

Parent 2’s custodial days with the minor child

This is an example of

evening exchanges.

You may pick any

day and time for

exchanges.

Option 1: Week On / Week Off Custody Schedule

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Schedule

continues the

rest of the year.

REV 4.24.23 BK

Custody schedules

Option 2 – Two / Two / Five / Five (Joint physical custody)

•

Both parents will have exactly equal time with the minor child(ren)

The children will spend every Monday and Tuesday with Parent 1, every

Wednesday and Thursday with Parent 2, and alternate the weekends (Friday

through Sunday) with each parent

This way the children will spend 2 days with Parent 1, 2 days with Parent 2,

followed by 5 days with Parent 1, and 5 days with Parent 2

The exchanges all take place at the same time of day, for example, if you decide to

exchange the child(ren) at 7 a.m., then all custodial exchanges will take place at 7

a.m. (or at whichever time you agree)

Depending on the time you agree on for exchanges, they might coincide with pick

ups or drop offs at school

NOTE: This schedule is often used when the parents have (a) preschool or young

school-age child(ren)

Parent 1’s custodial days with the minor child

Parent 2’s custodial days with the minor child

This is an example of

morning exchanges

Option 2: Two / Two / Five / Five Custody Schedule

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Monday

Schedule

continues the

rest of the year

REV 4.24.23 BK

Custody schedules

Option 3: Repeating Two / Two / Three (Joint physical custody)

•

Both parents will have exactly equal time with the minor child(ren)

On week one, the minor child(ren) will spend two days with Parent 1, followed by

two days with Parent 2, ending the week with three days with Parent 1

On week two, the minor child(ren) will spend two days with Parent 2, followed by

two days with Parent 1, ending the week with three days with Parent 2

The exchanges all take place at the same time of day, for example, if you decide

to exchange the child(ren) at 7 a.m., then all custodial exchanges will take place at

7 a.m. (or at whichever time you agree)

Depending on the time you agree on for exchanges, they might coincide with pick

ups or drop offs at school

NOTE: This schedule is often used when the parents have (a) very young

child(ren)

Parent 1’s custodial days with the minor child

This is an example of

morning exchanges

Parent 2’s custodial days with the minor child

Option 3: Repeating Two/Two/Three Custody Schedule

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Monday

Schedule

continues the

rest of the year.

REV 4.24.23 BK

Custody schedules

Option 4: Every Other Weekend (Primary physical custody)

•

One parent (the primary custodian/custodial parent) will have more time with the

minor child(ren)

The minor child(ren) will spend every other weekend with the noncustodial parent

All remaining time will be spent with the primary custodian/custodial parent

The exchanges can be scheduled in the mornings or evenings, at whatever time

you agree

Primary custodian’s days with the minor child(ren)

Noncustodial parent’s days with the minor child(ren)

This is an example of

evening exchanges

Option 4: Every Other Weekend

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Schedule

continues the

rest of the year.

Option 5: Create your own

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

REV 4.24.23 BK

Custody schedules

IN THE PYRAMID LAKE TRIBAL COURT IN AND FOR THE

PYRAMID LAKE INDIAN RESERVATION

WASHOE COUNTY, NEVADA

Plaintiff/Petitioner,

vs.

Defendant/Respondent.

)

) Case No. PL.____________________________

)

) CONFIDENTIAL FAMILY COURT

)

) INFORMATION SHEET

)

PLAINTIFF/PETITIONER INFORMATION

DEFENDANT/RESPONDENT INFORMATION

Name:________________________________ Name:_______________________________

_____________________________________

Social Security #: _______________________

Date of Birth: _________________________

Interpreter Needed? __ YES __ NO

If yes, language? ______________________

Telephone #: __________________________

Residential Address: ____________________

_____________________________________

City, State, & Zip: ______________________

____________________________________

Mailing Address: _______________________

_____________________________________

CONFIDENTIAL INFORMATION SHEET (FAMILY COURT)

Email Address: ________________________

_____________________________________

Are you employed? __ YES __ NO

If yes, name of employer: ________________

_____________________________________

Employer Address: _____________________

_____________________________________

Employer Phone #: _____________________

Driver License #: _______________________

Tribal Affiliation & Enrollment #: __________

_____________________________________

Ethnicity: __ Native American/Alaskan Native

__ White (Not Hispanic)

__ African American

__ Hispanic

__ Asian or Pacific Islander

__ Other

CHILDREN INVOLVED IN THIS CASE:

NAME:______________________________ SSN:___________________ DOB: ____________

If there are more than five children, list their names, SSN, and DOB on a separate sheet of

paper and attach to this form.

Does this case involve family violence: _____ YES _____ NO

CONFIDENTIAL INFO SHEET

6/24/2025

Name: __________________________

Address: ________________________

________________________________

Telephone: ______________________

Email: __________________________

Self-Represented Litigant

IN THE PYRAMID LAKE TRIBAL COURT IN AND FOR THE

PYRAMID LAKE INDIAN RESERVATION

WASHOE COUNTY, NEVADA

__________________________________

Plaintiff,

vs.

__________________________________

Respondent.

)

Case No. PL.DM-CS-____________________

PETITION TO ESTABLISH CHILD

CUSTODY, SUPPORT, AND/OR

VISITATION

Every section of this packet must be completed. If more room is needed for ANY

section, attach additional sheets.

1. Residency

 The Parties and minor children have lived within the Pyramid Lake Paiute Tribe

Reservation boundaries for at least six weeks prior to filing or since birth;

-OR-

 The children previously lived in the Pyramid Lake Paiute Tribe Reservation

boundaries for six or more weeks and have been gone from the Pyramid Lake

Paiute Tribe Reservation boundaries for less than six months, and one of the

-1

PETITION TO ESTABLISH CHILD CUSTODY, SUPPORT, &/OR VISITATION

-REVISED 6/25/2025

parents continues to live within the Pyramid Lake Paiute Tribe Reservation

boundaries;

-OR-

 Parties have had sufficient minimum contact with the Pyramid Lake Paiute

Tribe and/or the Pyramid Lake Reservation.

2. Jurisdiction

 No other custody case for the minor child(ren) named in this petition has ever

been filed in another court and no other court has previously issued a custody

order for the minor child(ren) named in this petition.

-OR-

 A custody case for the minor child(ren) named in this petition has been filed in

another court but no custody order has been issued.

-OR-

 Another court has previously issued a custody order for the minor child(ren)

named in this petition. If you mark this box, STOP; this is not the correct

packet for you.

3. Tribal Enrollment/Affiliation

The child(ren) is/are enrolled member(s) of:

☐ Pyramid Lake Paiute Tribe; Enrollment #: ___________________________________

☐ Eligible for enrollment for the Pyramid Lake Paiute Tribe

☐ Not applicable

☐ Other: ___________________________________________________________________

I am an enrolled member of:

☐ Pyramid Lake Paiute Tribe; Enrollment #: ___________________________________

☐ Eligible for enrollment for the Pyramid Lake Paiute Tribe

☐ Not applicable

-2

PETITION TO ESTABLISH CHILD CUSTODY, SUPPORT, &/OR VISITATION

-REVISED 6/25/2025

☐ Other: ____________________________________________________________________

The other parent is an enrolled member of:

☐ Pyramid Lake Paiute Tribe; Enrollment #: ____________________________________

☐ Eligible for enrollment for the Pyramid Lake Paiute Tribe

☐ Not applicable

☐ Other: ____________________________________________________________________

4. Pregnancy

Is either party currently pregnant?

Petitioner ☐ is -OR- ☐ is not pregnant at this time.

Respondent ☐ is -OR- ☐ is not pregnant at this time.

If either party is pregnant, is the other party the parent of the unborn child?

☐ YES -OR- ☐ NO

What is the child’s due date (month, day, & year)? _______________________________

5. Addresses

a. I reside at the following address ☐ with –or– ☐ without the minor child(ren):

_____________________________________________________________________________

Fully describe your last contact with the minor child(ren), the date, whether it was in

person or by telephone, who was present at the time of the contact, etc.:

_____________________________________________________________________________

______________________________________________________________________________

b. The other parent resides at the following address ☐ with –or– ☐ without the

minor child(ren): ______________________________________________________________

______________________________________________________________________________

-3

PETITION TO ESTABLISH CHILD CUSTODY, SUPPORT, &/OR VISITATION

-REVISED 6/25/2025

Fully describe the other parent’s last contact with the minor child(ren), the date,

whether it was in person or by telephone, who was present at the time of the

contact, etc.: ________________________________________________________________

_____________________________________________________________________________

6. Minor Children

On the lines below, provide the information requested regarding each minor child

born to or adopted by the parties. You MUST LIST where the child currently lives,

where the child has lived for the PAST 5 YEARS, and the name(s) and current

address(es) of the person(s) with whom the child lived at each address.

Childs Name:

Date child

moved Here

Childs Address

(Street Address, City, State)

Date of Birth:

__ M ___ F

Person(s) with whom Child

Lived

(Name & Current Address)

Relationship to

Child

Date of Birth:

__ M ___ F

Person(s) with whom Child

Lived

(Name & Current Address)

Relationship to

Child

Childs Name:

Date child

moved Here

Childs Address

(Street Address, City, State)

-4

PETITION TO ESTABLISH CHILD CUSTODY, SUPPORT, &/OR VISITATION

-REVISED 6/25/2025

Childs Name:

Date child

moved Here

Childs Address

(Street Address, City, State)

Date of Birth:

__ M ___ F

Person(s) with whom Child

Lived

(Name & Current Address)

Relationship to

Child

Date of Birth:

__ M ___ F

Person(s) with whom Child

Lived

(Name & Current Address)

Relationship to

Child

Date of Birth:

__ M ___ F

Person(s) with whom Child

Lived

(Name & Current Address)

Relationship to

Child

Childs Name:

Date child

moved Here

Childs Address

(Street Address, City, State)

Childs Name:

Date child

moved Here

Childs Address

(Street Address, City, State)

-5

PETITION TO ESTABLISH CHILD CUSTODY, SUPPORT, &/OR VISITATION

-REVISED 6/25/2025

7. Other Related Court Cases

a) Are there any other Court cases in which either party has participated as a

party, witness, or in any other way concerning custody, visitation, or support

of the child(ren) listed above? ☐ YES

☐ NO

If yes, please complete the following:

Name(s) of child(ren) involved: _____________________________________________

__________________________________________________________________________

Court: _________________________________ Case #: __________________________

b) Are there any court cases that could affect this case, including proceedings

for enforcement and proceedings relating to domestic violence, protective

orders, termination of parental rights, adoptions, guardianships,

dependency (child abuse and neglect), and parentage actions?

☐ YES ☐ NO

If yes, please complete the following:

Name(s) of child(ren) involved: _____________________________________________

__________________________________________________________________________

Court: _________________________________ Case #: __________________________

Type of Case: __________________________ Date of Last Order: ________________

c) Is/Are there any person(s) not a party to this court case who has/have

physical custody of the child(ren) or claim(s) a right to legal custody,

physical custody, or visitation with the minor child(ren)?

☐ YES ☐ NO

If yes, please complete the following:

Name(s) of child(ren) involved: _____________________________________________

__________________________________________________________________________

Name(s) and address(es) of person(s) claiming custody or visitation rights:

__________________________________________________________________________

8. Parentage

Place an “X” in all boxes that apply.

 Both parents signed a voluntary acknowledgement of parentage, at birth or

later.

 Parentage was established through a Court proceeding:

i. Name of Court: _________________________________________________

ii. County & State of Court: _________________________________________

-6

PETITION TO ESTABLISH CHILD CUSTODY, SUPPORT, &/OR VISITATION

-REVISED 6/25/2025

iii. Case Number: __________________________________________________

iv. Type of Proceeding (Adoption, Child support, etc.): ________________

________________________________________________________________

v. Date order was filed: ___________________________________________

 Parentage has not been established.

9. Legal Custody of the Minor Child(ren)

Place an “X” in the box to select ONLY ONE of the options below.

Who should have LEGAL CUSTODY of the minor child(ren)? Legal custody means

having legal responsibility for the child(ren) and making major decisions regarding the

child(ren), including the child(ren)’s health, education, and religious upbringing.

 Both Parties: JOINT Legal Custody

-OR-

 Petitioner: SOLE Legal Custody

-OR-

 Respondent: SOLE Legal Custody

10. Physical Custody of the Minor Child(ren)

Place an “X” in the box to select ONLY ONE of the options below.

Who should have PHYSICAL CUSTODY of the minor child(ren)? Physical custody

refers to the amount of time that the child(ren) physically spends in the care of each

parent.

 Both Parties: JOINT Physical Custody

-OR-

 Petitioner: PRIMARY Physical Custody

-OR-

 Respondent: PRIMARY Physical Custody

-OR-

 Petitioner: SOLE Physical Custody (Respondent receives no visitation)

-OR-

 Respondent: SOLE Physical Custody (Petitioner receives no visitation)

-7

PETITION TO ESTABLISH CHILD CUSTODY, SUPPORT, &/OR VISITATION

-REVISED 6/25/2025

11. Custody/Visitation and Exchange Schedule

A. Regular Custodial Schedule

Place an “X” in a box to select ONLY ONE of the custody schedules provided

below.

If you select Option 5 or would like to modify Options 1 - 4, write in your

proposed schedule below. A visual description of each custody schedule is

provided with this packet.

☐ Option 1 - Week On / Week Off (Joint physical custody): The minor child(ren) will

spend one week with one parent and will spend the following week with the other parent.

This schedule will alternate every week throughout the year.

Both parents will have exactly equal time with the minor child(ren); Depending on the time

and day you agree upon for exchanges, they might coincide with pick-ups and/or drop-offs

at school.

The exchanges will be at (time) __________ ☐ a.m. –or– ☐ p.m. and will take place on (day

of the week) _______________at (location) _________________________________________.

☐ Petitioner –or– ☐ Respondent will have the child(ren) the first week following granting of

the Order Establishing Custody, Visitation and/or Child Support.

NOTE: This schedule is often used when the parents have (a) school-age child(ren).

☐ Option 2 - Two / Two / Five / Five (Joint physical custody): The minor child(ren) will

spend every Monday and Tuesday with one parent, every Wednesday and Thursday with

the other parent, and alternate the weekends (Friday through Sunday) with each parent.

Both parents will have exactly equal time with the minor child(ren); Depending on the time

and day you agree upon for exchanges, they might coincide with pick-ups and/or drop-offs

at school.

The exchanges will be at (time) __________ ☐ a.m. –or– ☐ p.m. and will take place at

(location) ____________________________________________________________________.

☐ Petitioner –or– ☐ Respondent will have the child(ren) every Monday and Tuesday.

☐ Petitioner –or– ☐ Respondent will have the child(ren) every Wednesday and Thursday.

☐ Petitioner –or– ☐ Respondent will have the child(ren) the first weekend following

granting of the Order Establishing Custody, Visitation and/or Child Support and the parties

will alternate each weekend thereafter.

NOTE: This schedule is often used when the parents have (a) preschool or young schoolage child(ren).

-8

PETITION TO ESTABLISH CHILD CUSTODY, SUPPORT, &/OR VISITATION

-REVISED 6/25/2025

☐ Option 3 - Repeating Two / Two / Three (Joint physical custody): The minor

child(ren) will spend two days with one parent, then two days with the other parent, three

days with one parent, two days with the other parent, two days with one parent, three days

with the other parent, alternating throughout the year.

Both parents will have exactly equal time with the minor child(ren); Depending on the time

and day you agree upon for exchanges, they might coincide with pick-ups and/or drop-offs

at school.

The exchanges will be at (time) __________ ☐ a.m. –or– ☐ p.m. and will take place at

(location) ____________________________________________________________________.

☐ Petitioner –or– ☐ Respondent will have the child(ren) first the first Monday following

granting of the Order Establishing Custody, Visitation and/or Child Support.

NOTE: This schedule is often used when the parents have (a) very young child(ren).

☐ Option 4 - Every Other Weekend (Primary physical custody): The minor child(ren)

will spend every other weekend and any other mutually agreed-upon time with ☐ Petitioner

–or– ☐ Respondent. All remaining time will be spent with the other parent, who has

primary physical custody. If the weekend falls on a three-day weekend, it will include the

holiday.

The exchanges will be Friday at (time) ____________ ☐ a.m. –or– ☐ p.m. and Sunday at

(time) _____________ ☐ a.m. –or– ☐ p.m. and will take place at (location):

____________________________________________________________________________.

☐ Petitioner –or– ☐ Respondent will have the child(ren) the first weekend following

granting of the Order Establishing Custody, Visitation and/or Child Support.

☐ Option 5 - I request the following schedule (Be as specific as possible regarding

exchange days, times, and locations as the schedule must be specific enough to be

enforced by the Court. For example, “Petitioner will have the children every spring break,

every fall break, every summer break except for the first and last week of summer break,

and one-half of winter break with the parents alternating the first and second week each

year. Petitioner shall provide transportation to pick up the children from Respondent’s

home in Reno, Nevada, and Respondent shall provide transportation to pick up the

children from Petitioner’s home in Nixon, Nevada. Respondent will have the children all

other remaining times. Petitioner may visit the children in Reno with at least 30-days’

written notice.”): ____________________________________________________________________

____________________________________________________________________________________

-9

PETITION TO ESTABLISH CHILD CUSTODY, SUPPORT, &/OR VISITATION

-REVISED 6/25/2025

____________________________________________________________________________________

___________________________________________________________________________________

____________________________________________________________________________________

NOTE: This schedule is often used when the parents are unable to exercise joint physical

custody due to the parents residing at a great distance from one another.

B. Summer Break Visitation Schedule

Place an “X” in a box to select ONLY ONE of the summer visitation schedules

provided below. If you select Option 3, or would like to modify Options 1 or 2,

write in your proposed visitation schedule below. If one or both parents want an

additional block of time, describe it in Option 3.

☐ Option 1 – Summer Break will follow the Parents Regular Custodial Schedule.

☐ Option 2 – Alternating One-Week Timeshares: The minor child(ren) will spend

one week with ☐ Petitioner –or– ☐ Respondent and spend the following week

with the other parent. This will alternate for the remainder of the summer break.

☐ Option 3 – Schedule described below: I request the following summer

visitation schedule (Be as specific as possible as the schedule must be specific enough to

be enforced by the Court. For example: “Petitioner will have the children the first week

after school lets out and the last week prior to school resuming. Respondent will have the

remainder of the summer break.”): ___________________________________________________

____________________________________________________________________________________

- 10

PETITION TO ESTABLISH CHILD CUSTODY, SUPPORT, &/OR VISITATION

-REVISED 6/25/2025

C. Holiday Visitation Schedule

Please fill out the holiday visitation schedule below. School breaks, religious

holidays (e.g., Yom Kippur, Easter, Eid al-Fitr, etc.) or school holidays (e.g.,

Labor Day, Nevada Day, etc.) will follow the parents’ regular custodial schedule,

unless marked below or detailed in the “Other” sections below.

Holiday

Exchange Times

Even

Numbered

Years

1st Half of Spring Break

It begins upon school release and ☐ Petitioner

ends at 9 a.m. halfway through the ☐ Respondent

break.

☐ Petitioner

It begins at 9 a.m., halfway

through the break and ends when

school resumes.

☐ Petitioner

☐ Respondent

Beginning at 7 p.m. the evening

before Mother’s Day; it ends 9

a.m. the morning after.

☐ Petitioner

☐ Respondent

It begins 7 p.m. evening before

Father’s Day; ends 9 a.m. the

morning after.

☐ Petitioner

☐ Respondent

Begins 7 p.m. on July 3rd; ends 9

a.m. on July 5th.

☐ Petitioner

☐ Respondent

Begins 7 p.m. on October 30th;

ends 9 a.m. on November 1st.

☐ Petitioner

☐ Respondent

Begins upon release of school and

ends when school resumes.

☐ Petitioner

☐ Respondent

Begins upon release of school and

ends when school resumes.

☐ Petitioner

☐ Respondent

Begins upon release of school and

ends at 9 a.m. on December 26th.

☐ Petitioner

☐ Respondent

2nd Half of Winter Break Begins at 9 a.m. on December

26th and ends when school

resumes.

☐ Petitioner

☐ Respondent

Other:

☐ Petitioner

2nd Half of Spring Break

Mother’s Day

Father’s Day

4th of July

Halloween

Fall Break

Thanksgiving Break

1st Half of Winter Break

(Includes Christmas

Day)

Old Numbered

Years

☐ Respondent

- 11

PETITION TO ESTABLISH CHILD CUSTODY, SUPPORT, &/OR VISITATION

-REVISED 6/25/2025

Other:

☐ Respondent

Other:

☐ Petitioner

☐ Respondent

☐ Petitioner

☐ Respondent

☐ Petitioner

☐ Respondent

☐ Petitioner

☐ Respondent

☐ Petitioner

☐ Respondent

Other:

12. Transportation for Exchanges

Place an “X” in a box to select ONLY ONE of the statements below and complete

the requested information.

☐ Transportation will be provided by the parent ☐ picking up – or - ☐ dropping off the

child(ren).

-OR☐ Transportation will be provided as follows (explain how transportation will be

provided):

____________________________________________________________________________________

13. Best Interest of the Child(ren)

Answer each question. Describe, in detail, why the requested custody and visitation

schedule is in the best interest of the child(ren).

a. Is/Are the child(ren) old enough (14 years or older) and are capable of having a

preference concerning custody and/or visitation? (check one)

☐ No.

☐ Yes. If known, what is their preference and why? ___________________________

___________________________________________________________________________

__________________________________________________________________________.

- 12

PETITION TO ESTABLISH CHILD CUSTODY, SUPPORT, &/OR VISITATION

-REVISED 6/25/2025

b. Is one parent more likely to allow the child(ren) to have frequent contact and a

continuing relationship with the other parent? (check one)

☐ No.

☐ Yes, (Name of parent) _______________________________ is because __________

__________________________________________________________________________

__________________________________________________________________________.

c. How do you and the other parent get along? _________________________________

__________________________________________________________________________

__________________________________________________________________________.

d. Are you and the other parent able to cooperate to meet the needs of the

child(ren)? (check one)

☐ No, because: ___________________________________________________________

__________________________________________________________________________

☐ Yes

e. Describe your mental and physical health: ___________________________________

___________________________________________________________________________

Describe the other parents mental and physical health: _______________________

___________________________________________________________________________

f. What physical, developmental, and emotional needs does/do the child(ren)

have? ____________________________________________________________________

__________________________________________________________________________

g. What do you and your child(ren) do together? ________________________________

__________________________________________________________________________

What does the other parent do with the child(ren) when they are together? _____

__________________________________________________________________________

h. Will the proposed custody and/or visitation schedule allow the child(ren) to

maintain a relationship with their siblings? (check one)

☐ Not Applicable

☐ No

☐ Yes

- 13

PETITION TO ESTABLISH CHILD CUSTODY, SUPPORT, &/OR VISITATION

-REVISED 6/25/2025

i. Has there been a history of parental abuse or neglect of the child(ren) or any

siblings of the child(ren), or a history of domestic violence against the child(ren),

you, or the other parent, or any other person who lives with the child(ren)?

(check all that apply)

☐ No

☐ Yes, I have a history; the abuse, neglect, and/or act of domestic violence was

(include case number(s), if any and if known): ________________________________

___________________________________________________________________________

__________________________________________________________________________.

☐ Yes, the other parent has a history; the abuse, neglect, and/or act of

domestic violence was (include case number(s), if any and if known): __________

___________________________________________________________________________

__________________________________________________________________________.

j. Have either you or the other parent committed an act of abduction against the

child(ren) or any other child? (check all that apply):

☐ No

☐ Yes, I have a history; the act of abduction was (include case number(s), if any

and if known): _____________________________________________________________

___________________________________________________________________________

__________________________________________________________________________.

☐ Yes, the other parent has a history; the act of abduction was (include case

number(s), if any and if known): _____________________________________________

___________________________________________________________________________

__________________________________________________________________________.

k. Is there a nomination of a guardian? (check one)

☐ No

☐ Yes, the name(s) of the nominated guardian(s) is/are: _____________________

__________________________________________________________________________.

14. Gross Monthly Income

Fill in the information requested below. Attached as Appendix A to the Petition is the

Gross Monthly Income Worksheet, which will assist you with calculating your and

the other parent’s gross monthly income. If you do not know the other parent’s

information, put “unknown” in the space below.

- 14

PETITION TO ESTABLISH CHILD CUSTODY, SUPPORT, &/OR VISITATION

-REVISED 6/25/2025

The gross monthly incomes (GMI) of the parties are:

a. Petitioner’s GMI: $ ___________________

b. Respondent’s GMI: $ _________________

15. Existing Child Support Order(s)

If there is an existing child support order, place an “X” in the box below and enter

the case number for your child support case.

☐ Child support has been established through (the court) _______________________

in child support Case Number: ________________________________________________.

(If you do not wish to modify child support or if it is a recent order, SKIP TO SECTION

17.)

16. Child Support Calculation

Fill in the information requested and place an “X” in the boxes below. Attached as

Appendix B to the Petition is the Child Support Worksheet, which will assist you with

calculating child support. If you do not know the other parent’s information, put

“unknown” in the space below.

Based upon the completed and attached Child Support Worksheet in Appendix B of

the Petition, child support under the law would be as follows:

a. Petitioner’s Base Child Support Obligation is: $ _________________

b. Respondent’s Base Child Support Obligation is: $ _________________

c. The Total Child Support Obligation by law would be $ _________________ per

month, paid by (check one) ☐ Petitioner –or– ☐ Respondent.

d. The Court should adjust the child support obligation based upon the following

factors (check all that apply):

ADJUSTMENT FACTORS

☐

Any special education needs of the child(ren)

☐

A parent’s legal responsibility to support others

☐

Value of services contributed by either parent

☐

Any public assistance paid to support the child(ren)

☐

Cost of transportation of the child(ren) to and from visitation

☐

The relative income of both households

☐

The obligor’s ability to pay

☐

Any other necessary expenses for the benefit of the child(ren)

- 15

PETITION TO ESTABLISH CHILD CUSTODY, SUPPORT, &/OR VISITATION

-REVISED 6/25/2025

17. Child Support Payment Plan

Place an “X” in a box to select ONLY ONE of the two statements below.

☐ The parent paying child support should make the payments directly to the other

parent by the (enter day of the month, e.g., 1st, 2nd, 3rd, etc.) _______________ day

of each month starting on (date) __________________________.

–or–

☐ A wage assignment should be put in place and payment should be enforced

through the District Attorney’s Office.

18. Childcare Expenses

Place an “X” in a box to select ONLY ONE of the two statements below.

☐ Neither parent has any childcare expenses.

–or–

☐ Childcare is $____________________ per month and should be paid by (check one):

☐ Petitioner –or– ☐ Respondent –or– ☐ both parties equally –or– other: ___________

______________________________________________________________________________

19. Health Care for Child(ren)

Complete the statements below by placing an “X” in a box to select your answers.

a. The child(ren) is/are, or should be covered by the following health insurance

policy (check one):

☐ Indian Health Services

☐ Medicaid

☐ Private/Employer insurance of (check one): ☐ Petitioner ☐ Respondent

☐ Other: _____________________________________________________________

b. The monthly premium is $____________________ and should be paid for by (check

one) Place an “X” in a box to select ONLY ONE of the two statements and

complete the requested information. Petitioner –or– ☐ Respondent –or– ☐ both

parties equally –or– ☐ other:

___________________________________________________________________________

20. Tax Deduction

Place an “X” in a box to select ONLY ONE of the two statements and complete the

requested information.

- 16

PETITION TO ESTABLISH CHILD CUSTODY, SUPPORT, &/OR VISITATION

-REVISED 6/25/2025

☐ Petitioner –or– ☐ Respondent should claim the child(ren) as dependents for tax

purposes every year.

-or☐ The tax deduction should be shared as follows: _______________________________

_____________________________________________________________________________

_____________________________________________________________________________.

21. School Enrollment and Extracurricular Activities

Place an “X” in a box to select ONLY ONE of the three statements.

The minor child(ren) should attend:

a. ☐ The school(s) zoned for my address.

–orb. ☐ The school(s) zoned for Respondent’s address.

–or-

c. ☐ Other: _________________________________________________________________

_________________________________________________________________________

d. Costs for extracurricular activities should be determined as follows: ___________

___________________________________________________________________________

22. Additional Relief

Do you have any other requests you would like the Court to consider?

Place an “X” in a box to select ONLY ONE of the two statements below.

☐ No additional relief is requested.

–or–

☐ I request the additional relief listed below: ___________________________________

_____________________________________________________________________________

____________________________________________________________________________

______________________________________________________________________________

- 17

PETITION TO ESTABLISH CHILD CUSTODY, SUPPORT, &/OR VISITATION

-REVISED 6/25/2025

23. I reserve the right to amend this Petition, and to request additional and/or modified

relief.

24. I ask for judgment as follows:

a. That I be granted my requests regarding custody, visitation, and/or child support

as set forth above; and

b. For other and further relief the Court may deem just and proper in this action.

25. Verification

I (your name),

, under penalty of

perjury, makes the following assertions: That I am the Petitioner, in the aboveentitled action; that I have read the foregoing PETITION TO ESTABLISH CHILD

CUSTODY, SUPPORT, AND/OR VISITATION and know the contents thereof; that the

same is true of my own knowledge, except for those matters therein contained

stated upon information and belief, and as to those matters, I believe them to be

true.

Done and dated this

day of

, 2025.

Petitioner Printed Name

Petitioners Signature

Subscribed and sworn to before me on this

day of

, 2025.

Notary Public/Court Clerk

- 18

PETITION TO ESTABLISH CHILD CUSTODY, SUPPORT, &/OR VISITATION

-REVISED 6/25/2025

IN THE PYRAMID LAKE TRIBAL COURT

IN AND FOR THE PYRAMID LAKE INDIAN RESERVATION

WASHOE COUNTY, NEVADA

AFFIDAVIT

I (your name),

, being first duly sworn on oath,

affirm that I am the affiant in this cause that the statements made herein are true and

correct to the best of my knowledge, recollection and belief, as follows:

_______________________________________

DATE:

AFFIANT SIGNATURE:

Subscribed and Sworn to before me on this

day of

, 2025.

Notary Public/Court Clerk

- 19

PETITION TO ESTABLISH CHILD CUSTODY, SUPPORT, &/OR VISITATION

-REVISED 6/25/2025

PLEASE PROVIDE THE FOLLOWING CASE INFORMATION TO THE COURT WHEN

SUBMITTING THE PETITION.

{This portion must be completed or the petition will not be accepted.}

PETITIONER’S NAME: ________________________________________________________

MAILING ADDRESS: _________________________________________________________

PHYSICAL ADDRESS: ________________________________________________________

EMAIL ADDRESS: __________________________________________________________

PHONE NO(s): (CELL) ____________________________ (OTHER) _________________

RESPONDENT’S NAME: ______________________________________________________

MAILING ADDRESS: _________________________________________________________

PHYSICAL ADDRESS: ________________________________________________________

EMAIL ADDRESS: __________________________________________________________

PHONE NO(s): (CELL) ____________________________ (OTHER) _________________

$50.00 Filing Fee when Petition is returned and Filed with the Court

Service fee/Inside Jurisdiction $15.00

Service fee/Outside Jurisdiction TBD

- 20

PETITION TO ESTABLISH CHILD CUSTODY, SUPPORT, &/OR VISITATION

-REVISED 6/25/2025

APPENDIX A

Gross Monthly Income (GMI) Worksheet

This worksheet must be used to calculate each Party’s gross monthly income as required in

Section 14 (“Gross Monthly Income”) of the Petition packet.

____________________________________________________________________________________

Gross monthly income is the amount of money you make each month before taxes are

deducted. Gross monthly income includes income received from employment, social security

(not SSI), unemployment benefits, pension or retirement plan payments, income from interest

and investments, military allowances and veterans’ benefits, alimony, etc. Gross monthly income

DOES NOT include SSI, SNAP, TANF, cash benefits from the county, or child support received.

1. Calculate Gross Monthly Income (GMI) from Employment

To calculate your GMI from employment, use ONLY ONE of the tables below per

party:

Petitioner

Respondent

Annual Income

÷ by 12 months =

Employment GMI

Biweekly Income

x 26 pay periods

x 26 Pay periods

÷ by 12 months =

Employment GMI

Bimonthly Income

x 24 pay periods

÷ by 12 months =

Employment GMI

Hourly Wage

# of hours worked

per week

Hourly Wage

# of hours worked

per week

Hourly wage x

hours worked per

week

Hourly wage x

hours worked per

week

x 52 weeks

- 21

PETITION TO ESTABLISH CHILD CUSTODY, SUPPORT, &/OR VISITATION

-REVISED 6/25/2025

÷ by 12 months =

Employment GMI

Weekly Income

x 52 weeks

÷ by 12 months =

Employment GMI

Per Diem Rate

# of days worked

per week

Per Diem Rate

# of days worked

per week

Per diem rate x

days worked per

week

Per diem rate x

days worked per

week

x 52 weeks

÷ by 12 months =

Employment GMI

*Copy the amount of GMI from employment for each party into the table below.

2. Calculate Total Gross Monthly Income (GMI)

Now, add any additional money each Party receives each month from overtime pay

(if it is substantial, consistent and can be accurately determined), social security,

unemployment benefits, pension or retirement plan payments, income from

interest/investments, compensation for lost wages, military allowances, veteran’s

benefits, alimony, regular gifts from others, etc. Use the table below to add up each

Party’s total gross monthly income.

Petitioner

Respondent

Employment GMI

Social Security

Unemployment

Pension/Retirement

Interest/Investments $

TOTAL GMI =

You now have calculated each Party’s total gross monthly income. Each Party’s total gross

monthly income (GMI) as calculated above must be transferred to Section 14 on page 15 of the

Petition packet (under Gross Monthly Income).

- 22

PETITION TO ESTABLISH CHILD CUSTODY, SUPPORT, &/OR VISITATION

-REVISED 6/25/2025

APPENDIX B

Child Support Worksheet

This worksheet must be used to calculate each Party’s base child support obligation and the

total child support obligation as required in Section 16 (“Child Support Calculation”) of the

Petition for Custody.

____________________________________________________________________________________

1. Petitioners Base Child Support Obligation

How much is Petitioner’s gross monthly income (GMI)? _________________________________

a. If petitioners gross monthly income is $1,956.00 or less, use the attached Lowincome Child Support Schedule located on the last page of this Appendix to Identify

Petitioner’s base child support obligation and list it here: $_______________________

If petitioner’s gross monthly income (GMI) is $1,956.00 or less, stop here, and go to

Step 2.

If petitioner’s gross monthly income (GMI) is $1,957.00 or more, go to Step b.

b. Multiply the amount of Petitioner’s gross monthly income which is $6,000.00 or less

by:

.16 (1 child)

.22 (for 2 children)

.26 (for 3 children)

.28 (for 4 children)

Add .02 for each additional child

B $______________________

c. Multiply the amount of Petitioner’s gross monthly income which is more than

$6,000.00 but less than $10,000.00 by

.08 (for 1 child)

.11 (for 2 children)

.13 (for 3 children)

.14 (for 4 children)

Add .01 for each additional child

C $______________________

- 23

PETITION TO ESTABLISH CHILD CUSTODY, SUPPORT, &/OR VISITATION

-REVISED 6/25/2025

d. Multiply the amount of Petitioner’s gross monthly income which is more than

$10,000.00 by

.04 (for 1 child)

.06 (for 2 children)

.06 (for 3 children)

.07 (for 4 children)

Add .005 for each additional child

D $______________________

Petitioner’s base child support obligation (Add lines B, C, and D) $___________________

2. Respondent’s Child Support Obligation

How much is Respondent’s gross monthly income (GMI)? __________________________

a. If Respondent’s gross monthly income is $1,956.00 or less, use the attached Lowincome Child Support Schedule located on the last page of this Appendix to Identify

Petitioner’s base child support obligation and list it here: $_______________________

If Respondent’s gross monthly income (GMI) is $1,956.00 or less, stop here, and go

to Step 3.

If Respondent’s gross monthly income (GMI) is $1,957.00 or more, go to Step b.

b. Multiply the amount of Respondent’s gross monthly income which is $6,000.00 or

less by:

.16 (1 child)

.22 (for 2 children)

.26 (for 3 children)

.28 (for 4 children)

Add .02 for each additional child

B $______________________

c. Multiply the amount of Respondent’s gross monthly income which is more than

$6,000.00 but less than $10,000.00 by

.08 (for 1 child)

.11 (for 2 children)

.13 (for 3 children)

.14 (for 4 children)

- 24

PETITION TO ESTABLISH CHILD CUSTODY, SUPPORT, &/OR VISITATION

-REVISED 6/25/2025

Add .01 for each additional child

C $______________________

d. Multiply the amount of Respondent’s gross monthly income which is more than

$10,000.00 by

.04 (for 1 child)

.06 (for 2 children)

.06 (for 3 children)

.07 (for 4 children)

Add .005 for each additional child

D $______________________

Respondent’s base child support obligation (Add lines B, C, and D)

$___________________

3. The Toal Child Support Obligation

a. Primary Physical Custody

If a primary physical custody arrangement was selected in Section 10 of the Petition

for Custody packet (“Physical Custody of the Minor Child(ren)”), the non-custodial

parent should pay their base child support obligation calculated above to the parent

with primary physical custody of the child(ren). (The parent with primary physical

custody will have no child support obligation.)

____________________________________________________ (enter name of noncustodial parent)

should pay $_____________ (base child support obligation) to

____________________________________________________ (name of parent with

primary physical custody).

b. Joint Physical Custody

If a joint physical custody arrangement was selected in Section 10 of the Petition for

Custody packet (“Physical Custody of the Minor Child(ren)”), the total child support

obligation is calculated as follows:

Subtract the lower earning parent’s base child support obligation from the higher

earning parent’s base child support obligation.

Higher $ _______________________

Lower $ ________________________

__________________________________________________

Total Child Support Obligation

Name of higher income parent

$________________________

paid by ____________________

- 25

PETITION TO ESTABLISH CHILD CUSTODY, SUPPORT, &/OR VISITATION

-REVISED 6/25/2025

2025 Low-Income Child Support Schedule

Child Support Obligation of Low-Income Payers

At 75% to 150% of the 2025 Federal Poverty Guidelines

One Child

Monthly

Child

Income Percent Support

Up To

Amount

$978

10.56%

$103

$1,013

10.75%

$109

$1,048

10.95%

$115

$1,083

11.14%

$121

$1,118

11.34%

$127

$1,153

11.53%

$133

$1,188

11.73%

$139

$1,223

11.92%

$146

$1,258

12.11%

$152

$1,293

12.31%

$159

$1,327

12.50%

$166

$1,362

12.70%

$173

$1,397

12.89%

$180

$1,432

13.09%

$187

$1,467

13.28%

$195

$1,502

13.47%

$202

$1,537

13.67%

$210

$1,572

13.86%

$218

$1,607

14.06%

$226

$1,642

14.25%

$234

$1,677

14.45%

$242

$1,712

14.64%

$251

$1,747

14.83%

$259

$1,782

15.03%

$268

$1,817

15.22%

$277

$1,851

15.42%

$285

$1,886

15.61%

$294

$1,921

15.81%

$304

$1,956

16.00%

$313

Two Children

Child

Percent Support

Amount

14.52%

$142

14.79%

$150

15.05%

$158

15.32%

$166

15.59%

$174

15.86%

$183

16.12%

$191

16.39%

$200

16.66%

$209

16.92%

$219

17.19%

$228

17.46%

$238

17.73%

$248

17.99%

$258

18.26%

$268

18.53%

$278

18.79%

$289

19.06%

$300

19.33%

$311

19.60%

$322

19.86%

$333

20.13%

$345

20.40%

$356

20.66%

$368

20.93%

$380

21.20%

$392

21.47%

$405

21.73%

$418

22.00%

$430

Three Children

Child

Percent Support

Amount

17.16%

$168

17.48%

$177

17.79%

$186

18.11%

$196

18.42%

$206

18.74%

$216

19.05%

$226

19.37%

$237

19.69%

$248

20.00%

$259

20.32%

$270

20.63%

$281

20.95%

$293

21.26%

$305

21.58%

$317

21.90%

$329

22.21%

$341

22.53%

$354

22.84%

$367

23.16%

$380

23.47%

$394

23.79%

$407

24.11%

$421

24.42%

$435

24.74%

$449

25.05%

$464

25.37%

$479

25.68%

$493

26.00%

$509

Four Children

Child

Percent Support

Amount

18.48%

$181

18.82%

$191

19.16%

$201

19.50%

$211

19.84%

$222

20.18%

$233

20.52%

$244

20.86%

$255

21.20%

$267

21.54%

$278

21.88%

$290

22.22%

$303

22.56%

$315

22.90%

$328

23.24%

$341

23.58%

$354

23.92%

$368

24.26%

$381

24.60%

$395

24.94%

$409

25.28%

$424

25.62%

$439

25.96%

$453

26.30%

$469

26.64%

$484

26.98%

$500

27.32%

$515

27.66%

$531

28.00%

$548

Five Children

Child

Percent Support

Amount

19.80%

$194

20.16%

$204

20.53%

$215

20.89%

$226

21.26%

$238

21.62%

$249

21.99%

$261

22.35%

$273

22.71%

$286

23.08%

$298

23.44%

$311

23.81%

$324

24.17%

$338

24.54%

$351

24.90%

$365

25.26%

$380

25.63%

$394

25.99%

$409

26.36%

$424

26.72%

$439

27.09%

$454

27.45%

$470

27.81%

$486

28.18%

$502

28.54%

$518

28.91%

$535

29.27%

$552

29.64%

$569

30.00%

$587

Six Children

Child

Percent Support

Amount

21.12%

$207

21.51%

$218

21.90%

$229

22.29%

$241

22.67%

$253

23.06%

$266

23.45%

$279

23.84%

$291

24.23%

$305

24.62%

$318

25.01%

$332

25.39%

$346

25.78%

$360

26.17%

$375

26.56%

$390

26.95%

$405

27.34%

$420

27.73%

$436

28.11%

$452

28.50%

$468

28.89%

$484

29.28%

$501

29.67%

$518

30.06%

$535

30.45%

$553

30.83%

$571

31.22%

$589

31.61%

$607

32.00%

$626

Calculations:

The income in the first row is 75% of the monthly poverty level income for a one person household.

Child support amount in the first row is 66% of the amount calculated by applying the Nevada rate to the monthly income.

The income amount for the last row is 150% of the monthly poverty level income for a one person household.

2025 Federal Poverty Guidelines

Nevada Rates

Annual Monthly

One Child

16%

Household Size

Income Income

Two Children

22%

$15,650 $1,304

Three Children

26%

$21,150 $1,763

Four Children

28%

$26,650 $2,221

Five Children

30%

$32,150 $2,679

$37,650 $3,138

$43,150 $3,596

$48,650 $4,054

$54,150 $4,513

For families/households with more than 8 persons, add $5,500 for each additional person.

Federal Register :: Annual Update of the HHSPoverty Guidelines

- 26

PETITION TO ESTABLISH CHILD CUSTODY, SUPPORT, &/OR VISITATION

-REVISED 6/25/2025

Name: __________________________

Address: ________________________

________________________________

Telephone: ______________________

Email: __________________________

Self-Represented Litigant

IN THE PYRAMID LAKE TRIBAL COURT IN AND FOR THE

PYRAMID LAKE INDIAN RESERVATION

WASHOE COUNTY, NEVADA

__________________________________

Plaintiff,

vs.

__________________________________

Respondent.

) Case No. PL.DM-CS-____________________

)

) GENERAL FINANCIAL DISCLOSURE

) FORM

)

A. Personal Information:

1. What is your full name? (first, middle, last) ___________________________________

2. How old are you? ____________________________

3. What is your date of birth? _____________________

4. What is your highest level of education? _____________________________________

B. Employment Information:

1. Are you currently employed/ self-employed? (check one) ☐ No ☐ Yes

If yes, complete the table below. Attach an additional page if needed.

Date of Hire

Employer Name

Job Title

Work Schedule

(Days)

Work Schedule

(Shift Times)

2. Are you disabled? (check one) ☐ No ☐ Yes

If yes, what is your level of disability? ________________________________________

What agency certified you disabled? _______________________________________

What is the nature of your disability? _______________________________________

-1

GENERAL FINANCIAL DISCLOSURE FORM

-REVISED 6/25/2025

C. Prior Employment:

If you are unemployed or have been working at your current job for less than 2 years,

complete the following information.

Prior Employer: __________________________________ Date of Hire: ________________ Date of

Termination: ____________ Reason for Leaving: ___________________________

MONTHLY PERSONAL INCOME SCHEDULE

A. Year-to-date Income

As of the pay period ending _________ my gross year to date pay is________________.

B. Determine your Gross Monthly Income.

Hourly Wage

Hourly

Wage

Number of

hours

worked per

week

Weekly

Income

Weeks

Months

Annual

Income

Gross

Monthly

Income

Annual Salary

Annual

Income

Months

Gross Monthly

Income

C. Other Sources of Income

Source of Income

Frequency

Amount

12 Month

Average

Annuity or Trust Income

Bonuses

Car, Housing, or other

allowance:

Commissions or Tips:

Net Rental Income:

Overtime Pay

Pension/Retirement:

Social Security Income (SSI):

Social Security Disability (SSD):

Spousal Support

Child Support

Workman’s Compensation

-2

GENERAL FINANCIAL DISCLOSURE FORM

-REVISED 6/25/2025

Other:

Total Average Other Income Received

Total Average Gross Monthly Income (Add totals from B and C above)

D. Monthly Deductions

Type of Deduction

Court Ordered Child Support (automatically deducted

from paycheck)

Federal Health Savings Plan

Federal Income Tax

Amount for you:_______________

Health Insurance

For opposing party: ____________

For your Child(ren): ____________

Life, Disability, or Other Insurance Premiums

Medicare

Retirement, Pension, IRA, or 401(k)

Savings

Social Security

10 Union Dues

11 Other: (Type of Deduction)

Amount

Total Monthly Deductions (Lines 1 – 11)

BUSINESS/SELF-EMPLOYMENT INCOME & EXPENSE SCHEDULE

A. Business Income:

What is your average gross (pre-tax) monthly income/revenue from self-employment or

business? $___________________.

B. Business Expenses: (Attach an additional page if needed.)

Type of Business Expense

Frequency

Amount

Advertising

Car and truck used for business

Commissions, wages or fees

Business Entertainment/Travel

Insurance

Legal and professional

Mortgage or Rent

Pension and profit-sharing plans

Repairs and maintenance

12 Month Average

-3

GENERAL FINANCIAL DISCLOSURE FORM

-REVISED 6/25/2025

Supplies

Taxes and licenses

(include est. tax payments)

Other:

Total Average Business

Expenses

PERSONAL EXPENSE SCHEDULE (MONTHLY)

A. Fill in the table with the amount of money you spend each month on the following expenses

and check whether you pay the expense for you, for the other party, or for both of you.

Expense

Monthly Amount

I Pay

For ME

Other Party For Both

Alimony/Spousal Support

Auto Insurance

Car Loan/Lease Payment

Cell Phone

Child Support (not deducted from

pay)

Clothing, Shoes, Etc…

Credit Card Payments (minimum

due)

Dry Cleaning

Electric

Food (groceries & restaurants)

Fuel

Gas (for home)

Health Insurance (not deducted

from pay)

HOA

Home Insurance (if not included in

mortgage)

Home Phone

Internet/Cable

Lawn Care

Membership Fees

Mortgage/Rent/Lease

Pest Control

Pets

Pool Service

-4

GENERAL FINANCIAL DISCLOSURE FORM

-REVISED 6/25/2025

Property Taxes (if not included in

mortgage)

Security

Sewer

Student Loans

Unreimbursed Medical Expense

Water

Other:

Total Monthly Expenses

HOUSEHOLD INFORMATION

A. Fill in the table on the next page with the name and date of birth of each child, the person

the child is living with, and whether the child is from this relationship. Attached a separate

sheet if needed.

Childs Name

Childs

DOB

Whom is

this child

living

with?

Is this child Has this child

from this

been certified

relationship as special

needs/disabled?

1st

2nd

3rd

4th

B. Fill in the table below with the amount of money you spend each month on the following

expenses for each child.

Type of Expense

1st Child

2nd Child

3rd Child 4th Child

Cellular Phone

Child Care

Clothing

Education

Entertainment

Extracurricular & Sports

Health Insurance (if not deducted from pay)

Summer Camp/Programs

Transportation Costs for Visitation

Unreimbursed Medical Expenses

Vehicle

Other:

Total Monthly Expenses

-5

GENERAL FINANCIAL DISCLOSURE FORM

-REVISED 6/25/2025

C. Fill in the table on the next page with the names, ages, and the amount of money

contributed by all persons living in the home over the age of eighteen. If more than 4 adult

household members attached a separate sheet.

Name

Age

Relation to You (i.e. sister,

friend, cousin, etc.)

Monthly

Contribution

PERSONAL ASSEST AND DEBT CHART

A. Complete this chart by listing all of your assets, the value of each, the amount owed on

each, and whose name the asset or debt is under. If more than 15 assets, attach a separate

sheet.

Line

Description of Asset and

Debt Thereon

Gross

Value

Total

Amount

Owed

Net Value

Total Value of Assets (Add lines

1 – 15)

- $

Whose

Name is

on the

Account?

(You, your

spouse,

or both?

-6

GENERAL FINANCIAL DISCLOSURE FORM

-REVISED 6/25/2025

B. Complete this chart by listing all of your unsecured debt, the amount owed on each

account, and whose name the debt is under. If more than 5 unsecured debts, attach a

separate sheet.

Line Description of Credit Card or Other

Unsecured Debt

Total Amount

Owed

Total Unsecured Debt (add lines 1 – 6)

Whose Name is

on the Account?

(You, your

spouse, or both?

CERTIFICATION

Attorney Information: Complete the following sentences:

1. I (have/have not) __________________________________ retained an attorney for this case.

2. As of the date of today, the attorney has been paid a total of $____________ on my behalf.

3. I have a credit with my attorney in the amount of $___________________________________.

4. I currently owe my attorney at total of $ _____________________________________________.

5. I owe my prior attorney at total of $ _________________________________________________.

IMPORTANT: Read the following paragraphs carefully and initial each one if applicable.

____ I swear or affirm under penalty of perjury that I have read and followed all instructions in

completing this Financial Disclosure Form. I understand that, by my signature, I guarantee the

truthfulness of the information on this Form. I also understand that if I knowingly make false

statements I may be subject to punishment, including contempt of court.

____ I have attached a copy of my 3 most recent pay stubs to this form.

____ I have attached a copy of my most recent YTD income statement/P&L statement to this form, if

self-employed.

____ I have attached a copy of my pay stubs to this form because I am currently unemployed.

____________________________________

Signature

___________________________________

Date

-7

GENERAL FINANCIAL DISCLOSURE FORM

-REVISED 6/25/2025

IN THE PYRAMID LAKE TRIBAL COURT IN AND FOR THE

PYRAMID LAKE INDIAN RESERVATION

WASHOE COUNTY, NEVADA

__________________________________

Plaintiff,

vs.

__________________________________

Respondent.

) Case No. PL.DM-CS-____________________

)

) SUMMONS

)

NOTICE YOU HAVE BEEN SUED. THE COURT MAY DECIDE AGAINST YOU WITHOUT YOU BEING HEARD

UNLESS YOU RESPOND WITHIN 20 CALENDAR DAYS. READ THE INFORMATION BELOW:

TO THE RESPONDENT: A Complaint or Petition has been filed by the Applicant against you for the relief

set forth in the Complaint/Petition(see attached). When service is by publication, add a brief statement

of the object of the action.

The object of this action is: _______________________________________________________.

If you intend to defend this lawsuit, within 20 days after this Summons is served on you,

exclusive of the day of service, you must do the following:

a. File with the Clerk of the Court, whose address is shown below, a formal written

response/answer to the Complaint/Petition in accordance with the rules of the Court,

and;

b. Serve a copy of your answer upon the attorney or plaintiff(s) whose name and address is

shown below.

Unless you respond, a default will be entered upon application of the Plaintiff/Applicant and

this Court may enter a judgment against you for the relief demanded in this

Complaint/Petition, which could result in the taking of money or property or other relief

requested in the Complaint/Petition.

If you intend to seek the advice of an attorney in this matter, you should do so promptly so

that your response may be filed on time.

Dated this ___________ day of _____________________, 20______.

Issued on behalf of Paintiff(s):

Name: _______________________________

Address: _____________________________

_____________________________________

Phone #: _____________________________

Email: _______________________________

CLERK NAME: ____________________________________

CLERK OF THE COURT

BY: ______________________________________________

DEPUTY CLERK SIGNATURE

Pyramid Lake Paiute Tribal Court

221 Hwy 447 / P.O. Box 257

Nixon, NV 89424

-1

CIVIL SUMMONS

-REVISED 6/25/2025

IN THE PYRAMID LAKE TRIBAL COURT IN AND FOR THE

PYRAMID LAKE INDIAN RESERVATION

WASHOE COUNTY, NEVADA

__________________________________

Plaintiff,

vs.

__________________________________

Respondent.

) Case No. PL.DM-CS-____________________

)

DECLARATION OF PERSONAL SERVICE

)

(To be filled out and signed by the person who served the Defendant or Respondent.)

I, ___________________________________________________________________________,

Declare:

(Name of person who completed service)

1. I am not a party to this action and am over 18 years of age.

2. I am not a licensed process server; I am a natural person serving legal process without

compensation, not more than three times per year, on behalf of a litigant who is a natural

person, and therefore I am not required to be licensed.

3. I was able to complete service.

4. I personally delivered and left the document(s) with:

☐ The person to the case (Defendant / Respondent). I served the document(s) on

the party at the location below.

______________________________________________________________________________

(Name of person served)

______________________________________________________________________________

(Street Address, City, State, and Zip Code of where served.)

☐ A person who lives with the person to the case. I served the document(s) on a

person of suitable age and discretion who lives with the party at the location below.

______________________________________________________________________________

(Name of person served)

______________________________________________________________________________

(Street Address, City, State, and Zip Code of where served.)

-1

DECLARATION OF PERSONAL SERVICE

-REVISED 6/25/2025

5. I served the following document(s): (check all that apply)

☐ Summons;

☐ Complaint / Petition;

☐ Notice of Case Management Conference

☐ Motion to __________________________________________________________________

☐ Other: _____________________________________________________________________

6. Service was completed on ____/____/____, at the hour of _______ ☐ A.M. -OR- ☐ P.M.

I declare under penalty of perjury under the law of the Pyramid Lake Paiute Tribe that the

foregoing is true and correct. *

(The information below is of the person who completes the service)

Date: ____________________

Signature: ____________________________________

Printed Name: ________________________________

Address: _____________________________________

_____________________________________________

Telephone #: _________________________________

Email: _______________________________________

NOTE: The penalty for knowingly and/or willfully making a false statement under penalty of

Perjury §3.4.704 is a Class A Offense carrying a Maximum sentence of One (1) year

incarceration and/or maximum fine: Five Thousand Dollars ($5,000.00). §3.4.114.

-2

DECLARATION OF PERSONAL SERVICE

-REVISED 6/25/2025

Monthly

Income

Up To

$978

$1,013

$1,048

$1,083

$1,118

$1,153

$1,188

$1,223

$1,258

$1,293

$1,327

$1,362

$1,397

$1,432

$1,467

$1,502

$1,537

$1,572

$1,607

$1,642

$1,677

$1,712

$1,747

$1,782

$1,817

$1,851

$1,886

$1,921

$1,956

One Child

Child

Percent Support

Amount

10.56%

$103

10.75%

$109

10.95%

$115

11.14%

$121

11.34%

$127

11.53%

$133

11.73%

$139

11.92%

$146

12.11%

$152

12.31%

$159

12.50%

$166

12.70%

$173

12.89%

$180

13.09%

$187

13.28%

$195

13.47%

$202

13.67%

$210

13.86%

$218

14.06%

$226

14.25%

$234

14.45%

$242

14.64%

$251

14.83%

$259

15.03%

$268

15.22%

$277

15.42%

$285

15.61%

$294

15.81%

$304

16.00%

$313

Calculations:

Two Children

Child

Percent Support

Amount

14.52%

$142

14.79%

$150

15.05%

$158

15.32%

$166

15.59%

$174

15.86%

$183

16.12%

$191

16.39%

$200

16.66%

$209

16.92%

$219

17.19%

$228

17.46%

$238

17.73%

$248

17.99%

$258

18.26%

$268

18.53%

$278

18.79%

$289

19.06%

$300

19.33%

$311

19.60%

$322

19.86%

$333

20.13%

$345

20.40%

$356

20.66%

$368

20.93%

$380

21.20%

$392

21.47%

$405

21.73%

$418

22.00%

$430

Three Children

Child

Percent Support

Amount

17.16%

$168

17.48%

$177

17.79%

$186

18.11%

$196

18.42%

$206

18.74%

$216

19.05%

$226

19.37%

$237

19.69%

$248

20.00%

$259

20.32%

$270

20.63%

$281

20.95%

$293

21.26%

$305

21.58%

$317

21.90%

$329

22.21%

$341

22.53%

$354

22.84%

$367

23.16%

$380

23.47%

$394

23.79%

$407

24.11%

$421

24.42%

$435

24.74%

$449

25.05%

$464

25.37%

$479

25.68%

$493

26.00%

$509

Four Children

Child

Percent Support

Amount

18.48%

$181

18.82%

$191

19.16%

$201

19.50%

$211

19.84%

$222

20.18%

$233

20.52%

$244

20.86%

$255

21.20%

$267

21.54%

$278

21.88%

$290

22.22%

$303

22.56%

$315

22.90%

$328

23.24%

$341

23.58%

$354

23.92%

$368

24.26%

$381

$395

24.60%

24.94%

$409

25.28%

$424

25.62%

$439

25.96%

$453

26.30%

$469

26.64%

$484

26.98%

$500

27.32%

$515

27.66%

$531

28.00%

$548

Five Children

Child

Percent Support

Amount

$194

19.80%

20.16%

$204

20.53%

$215

20.89%

$226

21.26%

$238

21.62%

$249

21.99%

$261

22.35%

$273

22.71%

$286

23.08%

$298

23.44%

$311

23.81%

$324

24.17%

$338

24.54%

$351

24.90%

$365

25.26%

$380

25.63%

$394

25.99%

$409

26.36%

$424

26.72%

$439

27.09%

$454

27.45%

$470

27.81%

$486

28.18%

$502

28.54%

$518

28.91%

$535

29.27%

$552

29.64%

$569

30.00%

$587

Six Children

Child

Percent Support

Amount

21.12%

$207

21.51%

$218

21.90%

$229

22.29%

$241

$253

22.67%

$266

23.06%

23.45%

$279

23.84%

$291

24.23%

$305

$318

24.62%

$332

25.01%

25.39%

$346

25.78%

$360

26.17%

$375

26.56%

$390

26.95%

$405

27.34%

$420

27.73%

$436

28.11%

$452

28.50%

$468

28.89%

$484

29.28%

$501

29.67%

$518

30.06%

$535

30.45%

$553

30.83%

$571

31.22%

$589

31.61%

$607

32.00%

$626

The income in the first row is 75% of the monthly poverty level income for a one person household.

Child support amount in the first row is 66% of the amount calculated by applying the Nevada rate to the monthly income.

The income amount for the last row is 150% of the monthly poverty level income for a one person household.

Nevada Rates

2025 Federal Poverty Guidelines

Annual

Monthly

One Child

16%

Household Size

Income

Two Children

22%

Three Children

26%

$15,650

$1,304

Four Children

28%

$21,150

$1,763

30%

Five Children

$26,650

$2,221

$32,150

$2,679

$37,650

$3,138

$43,150

$3,596

$48,650

$4,054

$54,150

$4,513

For families/households with more than 8 persons, add $5,500 for each additional person.

Federal Register :: Annual Update of the HHS Poverty Guidelines

Seven Children

Child

Percent Support

Amount

22.44%

$219

22.85%

$232

23.27%

$244

23.68%

$256

24.09%

$269

24.50%

$282

24.92%

$296

25.33%

$310

25.74%

$324

26.16%

$338

26.57%

$353

26.98%

$368

27.39%

$383

27.81%

$398

28.22%

$414

28.63%

$430

29.05%

$446

29.46%

$463

29.87%

$480

30.28%

$497

30.70%

$515

31.11%

$533

31.52%

$551

31.94%

$569

32.35%

$588

32.76%

$607

33.17%

$626

33.59%

$645

34.00%

$665

Eight Children

Child

Percent Support

Amount

23.76%

$232

24.20%

$245

24.63%

$258

25.07%

$272

25.51%

$285

25.95%

$299

26.38%

$313

26.82%

$328

27.26%

$343

$358

27.69%

28.13%

$373

28.57%

$389

29.01%

$405

29.44%

$422

$438

29.88%

30.32%

$455

30.75%

$473

31.19%

$490

31.63%

$508

32.07%

$526

32.50%

$545

32.94%

$564

33.38%

$583

33.81%

$602

34.25%

$622

34.69%

$642

35.13%

$663

35.56%

$683

36.00%

$704

Nine Children

Child

Percent Support

Amount

25.08%

$245

25.54%

$259

26.00%

$273

26.46%

$287

26.93%

$301

27.39%

$316

27.85%

$331

28.31%

$346

28.77%

$362

29.23%

$378

29.69%

$394

30.16%

$411

30.62%

$428

31.08%

$445

31.54%

$463

32.00%

$481

32.46%

$499

32.92%

$518

33.39%

$536

33.85%

$556

34.31%

$575

34.77%

$595

35.23%

$615

35.69%

$636

36.15%

$657

36.62%

$678

37.08%

$699

37.54%

$721

38.00%

$743

Ten Children

Child

Percent Support

Amount

26.40%

$258

26.89%

$272

27.37%

$287

27.86%

$302

28.34%

$317

28.83%

$332

29.31%

$348

29.80%

$364

30.29%

$381

30.77%

$398

31.26%

$415

31.74%

$432

32.23%

$450

32.71%

$469

33.20%

$487

33.69%

$506

34.17%

$525

34.66%

$545

35.14%

$565

35.63%

$585

36.11%

$606

36.60%

$626

37.09%

$648

37.57%

$669

38.06%

$691

38.54%

$714

39.03%

$736

39.51%

$759

40.00%

$783

11 Children

Child

Percent Support

Amount

27.72%

$271

28.23%

$286

28.74%

$301

29.25%

$317

29.76%

$333

30.27%

$349

30.78%

$366

31.29%

$383

31.80%

$400

32.31%

$418

32.82%

$436

33.33%

$454

33.84%

$473

34.35%

$492

34.86%

$511

$531

35.37%

35.88%

$551

36.39%

$572

36.90%

$593

37.41%

$614

37.92%

$636

38.43%

$658

38.94%

$680

39.45%

$703

39.96%

$726

40.47%

$749

40.98%

$773

41.49%

$797

42.00%

$822

12 Children

Child

Percent Support

Amount

29.04%

$284

29.57%

$300

30.11%

$316

30.64%

$332

31.18%

$349

31.71%

$366

32.25%

$383

32.78%

$401

33.31%

$419

33.85%

$438

34.38%

$456

34.92%

$476

35.45%

$495

35.99%

$515

36.52%

$536

37.05%

$557

37.59%

$578

38.12%

$599

$621

38.66%

39.19%

$643

39.73%

$666

$689

40.26%

40.79%

$713

41.33%

$736

41.86%

$760

42.40%

$785

42.93%

$810

43.47%

$835

44.00%

$861

13 Chi

Percent

30.36%

30.92%

31.48%

32.04%

32.59%

33.15%

33.71%

34.27%

34.83%

35.39%

35.95%

36.50%

37.06%

37.62%

38.18%

38.74%

39.30%

39.86%

40.41%

40.97%

41.53%

42.09%

42.65%

43.21%

43.77%

44.32%

44.88%

45.44%

46.00%

ildren

Child

Support

Amount

$297

$313

$330

$347

$364

$382

$400

$419

$438

$457

$477

$497

$518

$539

$560

$582

$604

$627

$649

$673

$696

$720

$745

$770

$795

$821

$847

$873

$900

14 Children

Child

Percent Support

Amount

31.68%

$310

32.26%

$327

32.85%

$344

33.43%

$362

34.01%

$380

34.59%

$399

35.18%

$418

35.76%

$437

36.34%

$457

36.93%

$477

37.51%

$498

38.09%

$519

38.67%

$540

39.26%

$562

39.84%

$585

40.42%

$607

41.01%

$630

41.59%

$654

42.17%

$678

42.75%

$702

43.34%

$727

43.92%

$752

44.50%

$777

45.09%

$803

45.67%

$830

46.25%

$856

46.83%

$883

47.42%

$911

48.00%

$939

15 Children

Child

Percent Support

Amount

33.00%

$323

33.61%

$340

34.21%

$359

34.82%

$377

35.43%

$396

36.04%

$415

36.64%

$435

37.25%

$455

37.86%

$476

38.46%

$497

39.07%

$519

39.68%

$541

40.29%

$563

40.89%

$586

41.50%

$609

42.11%

$633

42.71%

$657

43.32%

$681

43.93%

$706

44.54%

$731

45.14%

$757

45.75%

$783

46.36%

$810

46.96%

$837

47.57%

$864

48.18%

$892

48.79%

$920

49.39%

$949

50.00%

$978

16 Children

Child

Percent Support

Amount

34.32%

$336

34.95%

$354

35.58%

$373

36.21%

$392

36.85%

$412

37.48%

$432

38.11%

$453

38.74%

$474

39.37%

$495

40.00%

$517

40.63%

$539

41.27%

$562

41.90%

$585

42.53%

$609

43.16%

$633

43.79%

$658

44.42%

$683

45.05%

$708

45.69%

$734

46.32%

$760

46.95%

$787

47.58%

$814

48.21%

$842

48.84%

$870

49.47%

$899

50.11%

$928

50.74%

$957

51.37%

$987

52.00%

$1,017

17 Children

Child

Percent Support

Amount

35.64%

$349

36.30%

$368

36.95%

$387

37.61%

$407

38.26%

$428

38.92%

$449

39.57%

$470

40.23%

$492

40.89%

$514

41.54%

$537

42.20%

$560

42.85%

$584

43.51%

$608

44.16%

$633

44.82%

$658

45.48%

$683

46.13%

$709

46.79%

$735

$762

47.44%

48.10%

$790

48.75%

$818

49.41%

$846

50.07%

$874

50.72%

$904

51.38%

$933

52.03%

$963

52.69%

$994

53.34%

$1,025

54.00%

$1,056

18 Children

Child

Percent Support

Amount

$362

36.96%

37.64%

$381

38.32%

$402

39.00%

$422

39.68%

$444

40.36%

$465

41.04%

$487

41.72%

$510

42.40%

$533

43.08%

$557

43.76%

$581

44.44%

$605

45.12%

$630

45.80%

$656

46.48%

$682

47.16%

$708

47.84%

$735

48.52%

$763

49.20%

$791

49.88%

$819

50.56%

$848

51.24%

$877

51.92%

$907

52.60%

$937

53.28%

$968

53.96%

$999

54.64%

$1,031

55.32%

$1,063

56.00%

$1,096

19 Children

Child

Percent Support

Amount

38.28%

$374

38.98%

$395

39.69%

$416

40.39%

$437

$459

41.10%

$482

41.80%

42.51%

$505

43.21%

$528

43.91%

$552

$577

44.62%

$602

45.32%

46.03%

$627

46.73%

$653

47.44%

$679

48.14%

$706

48.84%

$734

49.55%

$762

50.25%

$790

50.96%

$819

51.66%

$848

52.37%

$878

53.07%

$908

53.77%

$939

54.48%

$971

55.18%

$1,002

55.89%

$1,035

56.59%

$1,068

57.30%

$1,101

58.00%

$1,135

20 Children

Child

Percent Support

Amount

39.60%

$387

40.33%

$409

41.06%

$430

41.79%

$453

42.51%

$475

43.24%

$498

43.97%

$522

44.70%

$547

45.43%

$571

46.16%

$597

46.89%

$622

47.61%

$649

48.34%

$676

49.07%

$703

49.80%

$731

50.53%

$759

51.26%

$788

51.99%

$817

52.71%

$847

53.44%

$877

54.17%

$908

54.90%

$940

55.63%

$972

56.36%

$1,004

57.09%

$1,037

57.81%

$1,070

58.54%

$1,104

59.27%

$1,139

60.00%

$1,174

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.