MONTHLY BUDGET OF EXPENSES

MONTHLY BUDGET OF EXPENSES Name Date / / This form is designed for planning to meet future needs. Complete the “present column,” the “projected self” column if you may be moving, and the „projected child‟ column for child-related expenses other than providing a home and food. Work on “projected spouse” column together or in mediation conference. Present A. HOUSING Rent Mortgage Second Mortgage Real Estate Tax Home Insurance Other Subtotal Projected Self Projected Spouse Projected Child Present B. UTILITIES Electricity Gas/Heating Oil Telephone Cell Phone Water Other Subtotal Projected Self Projected Spouse Projected Child Present C. HOUSEHOLD OPERATION Repairs Appliance Contracts Pest Control Gardening Yard Work Domestic Help Cable TV Pets Other Subtotal Projected Self Projected Spouse Projected Child TOTALS – PAGE ONE Present D. FOOD Groceries Lunches – Business/School Meals Out Take-Out Other Subtotal Projected Self Projected Spouse Projected Child Present E. CLOTHING Subtotal Projected Self Projected Spouse Projected Child Present F. TRANSPORTATION Gas and Oil Auto Repair/Maintenance Licenses Auto Taxes Insurance (monthly average) Car Payments Parking Other Subtotal Projected Self Projected Spouse Projected Child Present G. HEALTH, MEDICAL AND DENTAL INSURANCE Medical/Hospital Insurance Dental Insurance Medical Care (Uncovered) Dental Care (Uncovered) Prescription Drugs Counseling Disability Insurance Life Insurance Other Subtotal Projected Self Projected Spouse Projected Child TOTALS – PAGE TWO Present H. CHILDREN’S EXPENSES Day Care Private School Tuition College Tuition (Current) Room and Board Books and Fees Activities/Lessons Activities/Lessons Babysitting Allowance Summer Camp Travel Expense Special Events Other Subtotal Projected Self Projected Spouse Projected Child Present I. EDUCATION (SELF) Tuition Books and Fees Conferences Other Subtotal Projected Self Projected Spouse Projected Child Present J. PERSONAL EXPENSES Toiletries OTC Medicines Dry Cleaning/Laundry Hair Care Dues (Professional) Dues (Personal) Charities Church/Synagogue Other Subtotal Projected Self Projected Spouse Projected Child TOTALS – PAGE THREE Present K. ENTERTAINMENT Movie Rentals Cultural Sports Magazines and Books Newspaper Other Subtotal Projected Self Projected Spouse Projected Child Present L. VACATION Travel Lodging Meals Other Subtotal Projected Self Projected Spouse Projected Child Present M. GIFTS Birthdays Holidays Weddings Other Subtotal Projected Self Projected Spouse Projected Child Present A. HOUSING Rent Mortgage Second Mortgage Real Estate Tax Home Insurance Other Subtotal Projected Self Projected Spouse Projected Child TOTALS – PAGE FOUR Present N. OTHER Projected Self Projected Spouse Projected Child Subtotal Projected Self Projected Spouse Projected Child Present O. INSTALLMENT PAYMENTS (From Chart Below) Subtotal TOTALS – PAGE FIVE TOTALS Page One Page Two Page Three Page Four Page Five GRAND TOTAL Present Projected Self Projected Spouse Projected Child INSTALLMENT DEBT PAYMENT CREDITOR BALANCE OWED MONTHLY PAYMENT IF CLEARED IN ONE YEAR MINIMUM REGULAD MONTHLY PAYMENT ACTUAL MONTHLY PAYMENT TOTAL MONTHLY BALANCE