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					 Name:                                                   Profession:                                                Date:
 Name:                                                   Profession:
 Mail Address:                                           Home Phone:                                     Email 1:
 City, State, ZIP:                                       Cell Phone:                                     Email 2:                            Checking
 Own / Rent          Own                                 Fax:
                                                                    Income Statement                                                         Savings
                                       Income                                          Auditor                                               Money Market
                     Description                          Cash Flow     Pay Frequency (Circle One for Each)                                  Stocks/Mutual
 Salary                                                 0 $       -     Weekly / Bi-Weekly / Monthly / Average
                                                        0 $       -     Weekly / Bi-Weekly / Monthly / Average
                                                          $         -   Weekly / Bi-Weekly / Monthly / Average
                                                          $         -   Weekly / Bi-Weekly / Monthly / Average
 Int/Dividends                                            $         -                                                                        Other: List Se
 Inc From Investment                                      $         -                                                                        Real Estate / V
 Real Estate                                              $         -   How much of your real estate and/or         $        -
                                                          $         -   Business income is passive?                 $        -
                                                          $         -                                               $        -
 Businesses                                               $         -
                                                          $         -                                 Total Monthly Income       $   -
                                       Expenses
 Taxes                                                    $         -
 Home Mortgage                                            $         -
 School Loan Payment                                      $         -
 Car Payment                                              $         -                                                                        Business
 Credit Card Payments                                     $         -
 Retail Payment                                           $         -
 Living Expenses                                          $         -
 Child Expenses                                           $         -
 Bank Loan Payment                                        $         -
                                                                                        $        -    Total Expenses             $   -  Real Assets
                                                                                                      Monthly                           $       -
o (Monthly Expenses / Monthly Income)                         #DIV/0!                   $        -    Cash Flow                      $0 Asset/Debt
             850752ab-13f0-4bf6-b7d9-69e1e7643ca9.xls                            Form To Use                                             Page 1 of 6
                                                                     Balance Sheet
                        Assets                                                                                 Liabilities
                                              Interest Rate   Total Balance    Description     Original Term    Interest Rate       # of Pmts   Total Owed
                                                          $       -                            1st                                              $         -
                                                                              Home
                                                          $       -                            2nd                                              $         -
                                                                              Mortgage
                                                          $       -                            HELOC                                            $         -
                                                          $       -           School Loans                                                      $         -
                          # of Shares         Cost/Share Total Value                                                                            $         -
                                                          $       -           Car Loans                                                         $         -
                                                          $       -                                                                             $         -
                                                       $      -   Credit Cards                                                                  $         -
                                                       $      -                                                                                 $         -
r: List Separately                                     $      -                                                                                 $         -
Estate / Vehicles                        Equity/Down Value/Cost                                                                                 $         -
         Checking                         $        -   $      -                                                                                 $         -
                                          $        -   $      -   Retail Debt                                                                   $         -
                                          $        -   $      -                                                                                 $         -
                                          $        -   $      -   Bank /                                                                        $         -
                                          $        -   $      -   Personal                                                                      $         -
                                                                  Loans
                                          $        -   $      -                                                                                 $         -
                                          $        -   $      -                                                                                 $         -
                                          $        -   $      -                                                                                 $         -
                                                                  REI
                                          $        -   $      -                                                                                 $         -
                                                                  Mortgages
                                      Equity/Inventory Value/Cost                                                                               $         -
                                             $      -         $         -                                                                       $         -
                                             $      -         $         -                                                                       $         -
                                             $      -         $         -                                                                       $         -
                                             $      -         $         -     Liability                                                         $         -
                                             $      -         $         -     (Business                                                         $         -
         Asset/Debt                          $      -         $         -     Loans)                                                            $         -
          #DIV/0!                           Net Worth                    $0                                                                     $         -
          #DIV/0!            #DIV/0!        Income/Debt           #DIV/0!   Total Liabilities                                   $          -               $0
          850752ab-13f0-4bf6-b7d9-69e1e7643ca9.xls                               Form To Use                                                        Page 2 of 6
 Name:                                                      Profession:                                                  Date:
 Name:                                                      Profession:
 Mail Address:                                              Home Phone:                                    Email 1:
 City, State, ZIP:                                          Cell Phone:                                    Email 2:                                    Checking
 Own / Rent          Own                                    Fax:
                                                                      Income Statement                                                                 Savings
                                       Income                                             Auditor                                                      Money Market
                     Description                            Cash Flow     Pay Frequency (Circle One for Each)                                          Stocks/Mutual
 Salary                                                 0                 Weekly / Bi-Weekly / Monthly / Average
                                                        0                 Weekly / Bi-Weekly / Monthly / Average
                                                                          Weekly / Bi-Weekly / Monthly / Average
                                                                          Weekly / Bi-Weekly / Monthly / Average
 Int/Dividends                                                                                                                                         Other: List Se
 Inc From Investment                                                                                                                                   Real Estate / V
 Real Estate                                                              How much of your real estate and/or             $        -
                                                                          Business income is passive?                     $        -
                                                                                                                          $        -
 Businesses
                                                                                                        Total Monthly Income               $   -
                                       Expenses
 Taxes                                                                                                                  Income Factor               1
 Home Mortgage                                                                                                        Expenses Factor               1
 School Loan Payment                                                                                                     Assets Factor              1
 Car Payment                                                                                                          Liabilities Factor            1 Business
 Credit Card Payments
 Retail Payment                                                                                                    All Category Factor
 Living Expenses                                            $         -
 Child Expenses                                             $         -
 Bank Loan Payment
                                                                                           $        -   Total Expenses                     $   -  Real Assets
                                                                                                        Monthly                                   $       -
o (Monthly Expenses / Monthly Income)                           #DIV/0!                    $        -   Cash Flow                              $0 Asset/Debt

             850752ab-13f0-4bf6-b7d9-69e1e7643ca9.xls                             Data Entry Form                                                  Page 3 of 6
                                                                    Balance Sheet
                        Assets                                                                                    Liabilities
                                              Interest Rate   Total Balance    Description        Original Term    Interest Rate       # of Pmts   Total Owed
                                                                                                  1st
                                                                              Home
                                                                                                  2nd
                                                                              Mortgage
                                                                                                  HELOC
                                                                              School Loans
ks/Mutuals/CDs            # of Shares         Cost/Share Total Value
                                                                              Car Loans


                                                                              Credit Cards

r: List Separately                                      $      -
Estate / Vehicles                           Equity/Down Value/Cost


                                                                              Retail Debt

                                                                              Bank /
                                                                              Personal
                                                                              Loans



                                                                              REI
                                                                              Mortgages
                                      Equity/Inventory        Value/Cost




                                                                              Liability
                                                                              (Business
         Asset/Debt                          $      -   $       -             Loans)
          #DIV/0!                           Net Worth            $0
          #DIV/0!            #DIV/0!        Income/Debt   #DIV/0!   Total Liabilities                                              $          -              $0

          850752ab-13f0-4bf6-b7d9-69e1e7643ca9.xls                              Data Entry Form                                                       Page 4 of 6
                              Living Expenses


Living Expenses

Wealth Account                                    Other ideas
Giving Account                                    Internet
Savings Account
Auto Gas
Auto Ins
Auto Registration
Auto Service
Cell Phone
Electric
Heat
Phone
Water
Dining
Food
Life Insurance
Medical / Health
Clothes
Entertainment
Vacation/Travel
Lawn
Private School
Home Repair / Emergency
Home Misc
Books / Personal Education
Gifts Given
Personal/Misc
                                     $0


Childcare
Babysitting
Other Child
                                      0




                  850752ab-13f0-4bf6-b7d9-69e1e7643ca9.xls
                                  Living Expenses


Other "Assets":

Boat
Clothes
ATV
TV
Game Consoles
Riding Lawn Mower
Harley
Golf Clubs
Jewelry
Tools
Art
Antiques
Collectables
Furniture
Appliances
Computer
Laptop
Misc




                  Total      $0




                   850752ab-13f0-4bf6-b7d9-69e1e7643ca9.xls

				
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posted:4/20/2012
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