| Expenses |
 |
| Rent/Mortgage (include taxes, principal, and insurance) |
 |
| Life Insurance |
 |
| Health/Disability Insurance |
 |
| Vehicle Insurance |
 |
| Homeowners or Other Insurance |
 |
| Car Payments |
 |
| Other Loan Payments |
 |
| Savings/Pension Contribution |
 |
| Utilities (gas, water, electric, phone) |
 |
| Credit Card Payments |
 |
| Car Upkeep (gas, maintenance) |
 |
| Clothing |
 |
| Personal Care Products (shampoo, shaving cream, etc.) |
 |
| Groceries |
 |
| Food prepared outside the home (restaurant meals and carry out) |
 |
| Medical/Dental/Prescriptions |
 |
| Household Goods (hardware, lawn and garden) |
 |
| Recreation/Entertainment |
 |
| Child Care |
 |
| Education (continuing education, lessons for children) |
 |
| Charitable Donations |
 |
| Miscellaneous |
 |
 |
 |
| Total Expenses = |
 |
 |
 |
| Remaining Income After Expenses = |
 |