| INCOME (net take- home per month |
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| EARNER |
INCOME SOURCE |
ESTIMATED |
ACTUAL |
| SELF |
Job |
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| |
Parents |
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Other |
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TOTAL INCOME |
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| Expenses (per month) |
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| Area |
Item |
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| Housing |
Rent or Mortgage Payment |
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| |
Utilities |
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Water |
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Telephone |
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| Food |
Groceries |
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Meals Out |
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Snacks |
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| Transportation |
Car Payment/ Lease Payment |
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Insurance |
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Gas |
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Maintenance |
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Bus/ Car Pool/ Other |
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| Priority Debt |
Child Care/ Alimony |
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Other Payments (Credit Card Installment Loans) |
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| Savings |
Emergency Savings |
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Long-Term Savings |
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| Health/ Personal |
Medical Costs |
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Insurance |
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Dry Cleaning/ Laundromat |
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Haircuts / Beauty Care |
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| Other |
Entertainment/ Hobbies |
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Church/ Charity |
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Children's Expenses |
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Newspapers/ Magazines/ Books |
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Miscellaneous |
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TOTAL EXPENSES |
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| TOTAL INCOME PER MONTH |
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| MINUS TOTAL EXPENSES PER MONTH |
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| BALANCE ( + OR -) |
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