Revised Monthly budget Form by linxiaoqin


									                                                    Monthly Budget Form
Name                                                                                                          Date

Address                                                                                                   Post Code

                                                                        To assist you in completing this calculator please click on the link below
Children                                                                            and read our Budget Calculator guidance notes

Non - Dependants                                              

                                                     Income and expenditure
                         Enter the amount of regular payments for all items on a monthly basis. For example if you
                         pay or receive an item weekly times the amount of the item by 52 and divide by 12 to enter
                                                     the appropriate monthly amount.

Wages/Salary                                    £                            Housing Costs                               £
Your Take Home Pay                                                           Rent/ Mortgage
Partner's Take Home Pay                                                      Secured Loans/2nd Mortgage
Regular Overtime/Bonus/Commission                                            Council Tax
Benefits                                                                     Ground Rent/Service Charge
Housing Benefit                                                              Mortgage Endowment Policies/ISA
Council Tax Benefit                                                          House Contents/Buildings Insurance
Jobseekers' Allowance                                                        Utilities
Income Support                                                               Water/Sewerage
Child Benefit                                                                Gas
Child Tax Credit                                                             Electricity
Working Tax Credit                                                           Coal and other Fuels (eg bottled Gas)
Maternity Pay/Allowance                                                      Housekeeping
Bereavement Benefits                                                         Food and General Housekeeping
Statutory Sick Pay                                                           Clothing
Incapacity Benefit                                                           Washing Machine Rental/Laundrette
Employment Support Allowance                                                 Children
Carer's Allowance                                                            Childcare
Disability Living Allowance (care)                                           School Meals/Trips
Disability Living Allowance (mobility)                                       Nappies/Baby Items
Industrial Disablement Benefit                                               Children's Pocket Money
Severe Disablement Allowance                                                 Other Important Items
Attendance Allowance                                                         Court Fines/Orders
Pensions                                                                     Maintenance
Retirement Pension                                                           Life Assurance
Occupational Pension                                                         HP/Conditional Sale
Private Pension                                                              TV Licence
Annuity                                                                      Telephone
War Pension                                                                  Travel
Partner's Pension                                                            Fares (eg to work/school etc)
Pension Credit                                                               Car Running Costs
Other Income                                                                 Car Loan
Maintenance                                                                  Motability Car
Student Grant/Loan                                                           Health
Income from Lodgers/Property                                                 Prescriptions
Son's/Daughters Contribution                                                 Care Costs/Special Needs
Other Income - Please Specify:                                                                Total Priority Expenditure £
                                                                             Other Expenditure
                         Total Monthly Income £                              TV/ Video/ Satilite/ Cable
                                                                             Appliance Rental
Savings                                                                      Entertainment
Bank                                                                         Cigarettes, Sweets, Alcohol
Building Society                                                             Subscriptions, Papers, Magazines
Other Investments                                                            Credit/ Store Cards
e.g Shares                                                                   Catalogues
(Please Detail)                                                              Unsecured Loans
Rent From Properties                                                         Eating Out/ Take Aways/ Lunches
How many properties do you own?                                                                 Total Other Expenditure £

                                  Total Savings £                                             Total Monthly Expenditure £
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                                                  Monthly Budget Form
Name                                                                                                       Date

Address                                                                                             Post Code

Priority Arrears and Monthly Payments
Arrears For:             Total Arrears        Agreed Payment              Date Repayments End
Secured Loan
Council Tax 09/10
Council Tax 08/09
Council Tax
Council Tax
Inland Rev
NI Conts
Total                    £                    £

Budget Summary
Based on your expenditure and agreed repayments for your priority debts: Subtract your Total Expenditure from your Total Income.
If you have a positive (+) amount this is your avalible income, if you have a negative (-) amount this is your shortfall.

                                 Monthly          Yearly (times by 12)
Total Income             £                    £                           If you have a shortfall in this summary it means that you are
Total Expenditure        £                    £                           spending more money than you receive each month.
                                                                          For more information or to seek help please read our Budget
Shortfall                £                    £
                                                                          Calculator guidance notes.
Available Income         £                    £
Savings Total            £

                     Non-Priority Debts
            Non Priority Debts                                            Balance             Monthly Payment        Yearly Payment

                                                                          £                   £                      £

                     Statement of Truth

I confirm that this information is a true reflection of my current financial situation.

Signed……………………………………………………..                                              Date……………………………………

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