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Monthly Income Source of Income Monthly Amount Salary 1 (Monthly Take Home Pay) Employer Name _________________________________ Salary 2 (Monthly Take Home Pay) Employer Name _________________________________ Salary 3 (Monthly Take Home Pay) Employer Name _________________________________ Child Support/Alimony Interest and Dividends Bonuses Refunds Rental Income Total Monthly Income $ - U.S. Postal Service Federal Credit Union www.uspsfcu.org Basic Monthly Expenses List monthly expenses and their due date. Expenses that do not occur monthly will be included on Periodic Expense Worksheet. Expense Savings Account Savings Account IRA Contributions Investments Due Date Monthly Payment Adj. Monthly Pmt. Expense Dependent Care: Day Care Child Support Allowance Education: Tuition Books/Supplies Fees Clothing: Clothing Accessories Dry Cleaning/Laundry Personal: Postage/Film Hair Salon/Barber Shop/Nails Toiletries and Cosmetics Health Club Books/Tapes/CDs Internet/Computer Expenses Household Supplies Pet Food/Care Housekeeper Due Date* Monthly Payment Adj. Monthly Pmt. Housing 1st Mortgage / Rent Condo Fees/Lot Rent/Homeowner Dues 2nd Mortgage / Home Equity Loan Electricity Gas or Oil Heat Water and Sewer (only if billed monthly) Trash (only if billed monthly) Telephone Cell Phone / Pager Separate Long Distance Service Cable or Satellite TV Home Security System Living Expenses Food: Groceries Lunches (work and school) Snacks: Sodas, Coffee, Vending Mach. Transportation: Gasoline Bus Fare Car Pool Parking/Tolls/Etc. Insurance: Life Insurance Auto Insurance Health Insurance (if paid monthly) Health Care: Medical Co-pay Counseling Fees Prescription Medications/Vitamins Entertainment: Contributions: Checking/ATM Fees Cigarettes/Tobacco Charity Church/Synagogue Club/Union Dues Hobbies Movies/Plays/Concerts Meals Out/Delivered Food Sports Leagues / Betting Pools Parties/Beverages/Cover Charges Video Rentals Babysitter Fees Lottery Tickets Subtotal: Subtotal: $ $ - $ $ - $ - $ - Total Monthly Expenses: U.S. Postal Service Federal Credit Union www.uspsfcu.org Periodic Expenses List expenses that do not occur monthly (e.g., every other month, quarterly, etc.). Begin with the current month and plan the next 12 months. List the expenses in the month they occur. Savings Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Investments IRAs Housing Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Property Taxes/Insurance (if paid separately) Household Maintenance/Repair/Pest Water & Sewer Service Living Expenses Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Transportation: Vehicle License Vehicle Insurance Premiums, Deductible, Auto Club Vehicle Maintenance (oil changes/repairs) Deductibles - Health Care Tuition/Books Fees/Parking Health Care: Education: Personal: Hair Salon/ Barbershop/Nails Gifts (holidays, birthdays, Anniversaries) Clothing Purchased Quarterly/Semi-annually Income Tax Preparation Fees Amount of Tax Due (if owed) Subscriptions (e.g., magazines, music clubs, books, etc.) Dues (club, warehouse stores, homeowners) Pet Care (grooming/medical) Credit Card Annual Fees Safe Deposit Box Rental Entertainment: Vacation Summer Camp Hobbies/Sports Registration Other: Monthly Totals: Grand total = $ 0 0 0 0 0 0 0 0 0 0 0 0 Jan Feb Mar Apr Divided by 12 = $ Jul Per Month CALCULATIONS May Jun Aug Sep Oct Nov Dec 0 0 0 0 0 0 0 0 0 0 0 Last month's remaining balance Add this month's total deposit Subtotal Subtract total expenses Total remaining this month $ $ $ $ $ $ $ $ $ $ $ $ 0 0 0 0 0 0 0 0 0 0 0 0 U.S. Postal Service Federal Credit Union www.uspsfcu.org Outstanding Financial Obligations (Debts) Please be as thorough and accurate as possible when completing this section. All debts must be listed, including those to friends and relatives, as well as medical bills. Creditor Balance Monthly Pmt. Adj. Monthly Payment Due Date Interest Rate (%) Amount Past Due/Remarks Totals: $ - $ - $ - N/A N/A $ - U.S. Postal Service Federal Credit Union www.uspsfcu.org 674e583a-d6cc-45a8-b1b3-c12b910181e6.xls Cash Flow Statement Current Net Monthly Income (Take Home Pay) Subtract Basic Monthly Expenses + Adjusted Amount $0.00 $ $0.00 $ $0.00 $ $ Subtotal = Subtract Monthly Minimum for Periodic Expenses - - Subtotal = Subtract Outstanding Obligations (Debts) - $ $ $ #DIV/0! - $ $ $ - Final Surplus (+) or Deficit (-) = Debt to Income Ratio = Notes My counselor is Joan Burgess. Phone: 301-856-5000 or 800-877-7328 x.900 Email: email@example.com My next appointment is _______________________________________ at __________________ 11/15/2009 U.S. Postal Service Federal Credit Union www.uspsfcu.org Payday Planner Anticipated Pay Employer 1 Employer 2 Other Income Withdrawal from Periodic Savings Pay Date Pay Date Pay Date Pay Date Total Anticipated Pay And Periodic Savings Withdrawal $ Total Fixed Living Expenses, Debt Payments, and Other Payments $ - $ $ $ $ $ $ - $ $ $ $ $ $ - $ $ $ $ $ $ - What's left to live on? $ Gasoline $ Groceries/Meals Out/Snacks $ All Other Monthly Expenses $ What's left of your paycheck? $ To Be Paid: Fixed Living Expenses Savings Account Periodic Savings 1st Mortgage / Rent Condo Fees/Lot Rent/Homeowner Dues 2nd Mortgage / Home Equity Loan Electricity Gas or Oil Heat Water and Sewer Telephone Cell Phone / Pager Cable or Satellite TV Life Insurance Auto Insurance Day Care Child Support Internet/Computer Expenses 0 0 0 0 0 0 0 0 0 0 0 0 0 0 - $ Pay Date - $ Pay Date - $ Pay Date - Day Due Amount Due - Pay Date Subtotal Fixed Living Expenses $ - $ - $ - $ - Page 6 of 9 U.S. Postal Service Federal Credit Union www.uspsfcu.org Payday Planner To Be Paid: Debts 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Other Payment Other Payment Other Payment Day Due 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Amount Due - Pay Date Pay Date Pay Date Pay Date Subtotal Debt Payments $ - $ - $ - $ - Total Fixed Living Expenses, Debt Payments, and Other Payments $ - $ - $ - $ - Page 7 of 9 U.S. Postal Service Federal Credit Union www.uspsfcu.org Net Worth Statement As of ASSETS MONETARY ASSETS CASH ON HAND SAVINGS SAVINGS SAVINGS CHECKING CHECKING CHECKING OTHER RECEIVABLES TOTAL LIQUID ASSETS TANGIBLE ASSETS HOME PERSONAL PROPERTY AUTOMOBILE 1 AUTOMOBILE 2 RV OTHER ASSET(S) TOTAL TANGIBLE ASSETS INVESTMENT ASSETS RETIREMENT FUND (TSP/401k/403b) MUTUAL FUND STOCK STOCK LIFE INSURANCE IRA REAL ESTATE INVESTEMENT TOTAL INVESTEMENT ASSET TOTAL ASSETS $ - $ - $ $ - LIABILITIES SHORT-TERM LIABILITIES Amount carried over from 'Debts' worksheet $ - LONG-TERM LIABILITIES 1ST MORTGAGE BALANCE 2ND MORTGAGE BALANCE OTHER TOTAL LONG-TERM LIBALITIES TOTAL LIABILITIES $ $ - NET WORTH $ - FINANCIAL HEALTH RATIOS Liquidity #DIV/0! This number tells you how many months you can continue to live according to the means you have been accustomed to if you lose your income. Debt-Income Ratio #DIV/0! A debt-to-income ratio of 30-40% is considered healthy. You should be able to comfortably pay your creditors each month and accumulate adequate savings for retirement, emergencies and planned savings for planned future expenses. Debt-Asset Ratio #DIV/0! The lower your ratio the better. A ratio closer to 100% could indicate insolvency.
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