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Monthly Bills / Expenses:
Mortgage / Monthly Rent	$_______________
Second Mortgage(s)	$_______________
Home Maintenance & Repairs (Estimate @ 3% of Home Value / 12 Months)	$_______________	Subtotal:$_______________
Federal Tax Payments	$_______________
State / County Tax Payments	$_______________	Included in Mortgage? Yes___ No___
Local Tax Payments	$_______________	Included in Mortgage? Yes___ No___
Home Owners Insurance	$_______________	Included in Mortgage? Yes___ No___
Mortgage Insurance	$_______________	Included in Mortgage? Yes___ No___
		Subtotal:$_______________
Food / Groceries	$_______________
Clothing Expenses	$_______________	Subtotal:$_______________
Life Insurance Premium(s)	$_______________
Medical Insurance & Expenses	$_______________
Dental Expenses	$_______________
Eye Care Expenses	$_______________	Subtotal:$_______________
Car Payment(s)	$_______________
Car Insurance Premium(s)	$_______________
Maintenance / Repairs	$_______________
Monthly Fuel Expenses	$_______________	Subtotal:$_______________
Personal Loan Payments	$_______________
Education Loan Payments	$_______________
Child Support / Alimony	$_______________
Child Care / Day Care Expenses	$_______________	Subtotal:$_______________
Revolving Credit Card Payments:
Credit Card Payment (1)	$_______________
Credit Card Payment (2)	$_______________
Credit Card Payment (3)	$_______________
Credit Card Payment (4)	$_______________
Credit Card Payment (5)	$_______________
Credit Card Payment (6)	$_______________
Credit Card Payment (7)	$_______________
Credit Card Payment (8)	$_______________
Credit Card Payment (9)	$_______________
Credit Card Payment (10)	$_______________	Subtotal:$_______________
Utilities
Phone / Communication Services	$_______________
Gas / Oil	$_______________
Light / Electric	$_______________
Cable	$_______________
Water & Sewage	$_______________	Subtotal:$_______________
Misc. Expenses
Personal Grooming	$_______________
Family Activities	$_______________
Lunches / Outside Dining	$_______________	Subtotal:$_______________
Total Expense Amount:	$_______________
Income Sources:
Net Pay	$_______________
Spouse's Net Pay	$_______________
Military Pension(s)	$_______________
Retirement Pension(s)	$_______________
Child Support Payment(s)	$_______________
Alimony / Spousal Support Payments	$_______________	Subtotal:$_______________
Net Income to Expense Variance:	$_______________	Deficiency / Surplus Amt. (Net Income less Total Expenses)