| Recent Topics: |
| MONTHLY INCOME | |
| Take-Home Pay: | ________________________________________ |
| Other Reliable Income Sources: | ________________________________________ |
| TOTAL MONTHLY INCOME: | ________________________________________ |
| MONTHLY EXPENSES | |
| Food, Household Items: | ________________________________________ |
| Car or Other Loans: | ________________________________________ |
| Credit Cards: | ________________________________________ |
| Clothing: | ________________________________________ |
| Medical Expenses: | ________________________________________ |
| Life Insurance: | ________________________________________ |
| Other Insurance (Auto, Health): | ________________________________________ |
| Telephone: | ________________________________________ |
| Commuting: | ________________________________________ |
| Education: | ________________________________________ |
| Savings: | ________________________________________ |
| Entertainment: | ________________________________________ |
| Other Expenses: | ________________________________________ |
| TOTAL MONTHLY EXPENSES: | ________________________________________ |
| Total Monthly Income: | ________________________________________ |
| Less Total Monthly Expenses: | ________________________________________ |
| MONTHLY INCOME FOR HOUSING: | ________________________________________ |
