INCOME

 * * * MONTHLY * * *

Take Home Pay (all family members)

Child Support/Alimony

.

Pension/Social Security

.

Disability/Other Insurance

.

Interest/Dividends

 .

Other

Total Income

 .

EXPENSES

Life Insurance

.

Health/Disability Insurance

.

Vehicle Insurance

.

Homeowner’s or Other Insurance

.

Car Payments

.

Other Loan Payments

.

Savings/Pension Contribution

.

Utilities (gas, water, electric, phone)

.

Credit Card Payments

.

Car Upkeep (gas, maintenance, etc.)

.

Clothing

.

Personal Care Products (shampoo, cologne, etc.)

.

Groceries

.

Food Outside the Home (restaurant meals and carryout)

.

Medical/Dental/Prescriptions

.

Household Goods (hardware, lawn, and garden)

.

Recreation/Entertainment

.

Child Care

.

Education (continuing education, classes, etc.)

.

Charitable Donations

.

Miscellaneous

____________________

Total Expenses

____________________

Remaining Income After Expenses

(Subtract Total Income from Total Expenses)

.