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Income-gap worksheet

Prompts only. Not a tax form and not a court form.

1. What do you usually bill or take home on a day you work?

2. How many work days does the packet, as it stands, take?

3. $50 × those days = federal attendance fee. Write the product. Or use the estimator.

4. Subtract the fee from your usual figure. That is the gap this page is for. It is not a claim the court must close it.

5. Do any clients, patients, or jobs move if you sit? List them. Do not send Harborline their files.

6. The court may still need you. Write what you would tell the clerk in one sentence of fact, using that court’s own form.

Self-employed pack Pay estimator