Application for Post Separation Income to be Excluded form (CS4120)

Use this form to apply to exclude additional income from your child support assessment. This is income you earned after you separated from the child's other parent.

Download and complete the Application for Post Separation Income to be Excluded form.

This must be income you have earned in addition to income you earned before your separation. For example it doesn't include any of the following:

  • income from a second job you had before separation
  • overtime if you were already doing overtime before separation
  • standard pay rises.

This PDF is fillable. You can fill it out on your device, or print it and complete it by hand.

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Page last updated: 10 December 2021