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.

This must be income you have earned in addition to income you earned before your separation. For example it doesn't include anyo fo 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. Download this form and complete it on your device, or print it and complete it by hand.

If you have a disability or impairment and use assistive technology, there are other ways you can do your business with us. You can use self service or request someone to deal with us on your behalf. If you can’t access our forms, please contact us. We can help you access, complete and submit them.

Page last updated: 14 March 2019

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