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Monthly Income and Expense Worksheet
Client name:
Spouse name:
Monthly Combined Household Income
$
Other Income (Including alimony or child support)
$
Total Income:
$
Cost of Living/Incoming Bills of Living/Incoming Bills
Food
$
Household items
$
Clothing
$
Laundry / Dry Cleaning
$
Utilities (Electric, Gas, Water, Trash, Etc.)
$
Telephone (Cellular, Pager, Internet)
$
Auto Gas and Maintenance
$
Education (Tuition, school supplies)
$
Auto Insurance
$
Home Owner's/Renter's Insurance
$
Life Insurance
$
Medical Care (Insurance, Cobra, prescriptions, dentist)
$
Entertainment
$
Child Care/Child Support/Alimony
$
Cable TV/Satellite
$
Personal Care (hair cut, vitamins, nails, etc.)
$
Gifts/Contributions/Donations
$
Mortgage/Rent
$
Auto Loans/Lease
$
Student Loans/Taxes
$
Miscellaneous/Other
$
Total:
$
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