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ARMA Financial Services, Inc.
FAMILY INFORMATION WORKSHEET
First Name
Last Name
Birth Date
Soc Sec #
Address
City
State, Zip
Home Phone
Cell Phone
Employer
Position
City
State, Zip
Work Phone
Parent Custodian
Childrens' Names DOB SSN Mother/Father Mother/Father
Attorney Phone
Address
Marital Asset Inventory
Asset Date Value Wife Husband
Retirement Assets
$ -
$ -
$ -
$ -
$ -
Sub-Total $ - $ - $ -
Liquid Assets
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
Sub-Total $ - $ - $ -
Cash Value Life Insurance
$ -
$ -
$ -
$ -
Sub-Total $ - $ - $ -
Real Estate
$ -
$ -
$ -
$ -
$ -
$ -
Sub-Total $ - $ - $ -
Personal Property
$ -
$ -
$ -
$ -
$ -
$ -
Sub-Total $ - $ - $ -
Business Interests
$ -
$ -
$ -
$ -
$ -
$ -
Sub-Total $ - $ - $ -
Sub-Total $ - $ - $ -
Percentage #DIV/0! #DIV/0! #DIV/0!
Equalizer $ - $ -
12/19/2010
PROJECTED EXPENSES
Date Prepared: Client: Spouse:
Monthly Annual Monthly Annual
Expenses Expenses Expenses Expenses
Home Expenses
Rent/Mortgage $ - $ -
Homeowners/Association Fee $ - $ -
Property Taxes $ - $ -
Telephone $ - $ -
Cellphone/pager $ - $ -
Internet $ - $ -
Security System $ - $ -
Cable/Satellite $ - $ -
Electricity $ - $ -
Gas/Fuel Oil/Propane/Wood $ - $ -
Water/Garbage/Sewer/Trash $ - $ -
Landscape Maintenance/lawn $ - $ -
Snow Removal $ - $ -
Exterminator $ - $ -
Gen'l Home Repairs/Maintenance $ - $ -
Home Improvements/Upgrades $ - $ -
Housecleaning $ - $ -
Miscellaneous Household/pool $ - $ -
Total Home Expenses $ - $ - $ - $ -
Food
Groceries $ - $ -
Dining Out $ - $ -
Total Food Expenses $ - $ - $ - $ -
Entertainment/Recreation
Entertainment (Excludes Dining Out) $ - $ -
Videos/CDs/DVDs $ - $ -
Movies and Theater $ - $ -
Hobbies $ - $ -
Classes/Lessons $ - $ -
Vacations/Travel $ - $ -
Memberships/Clubs $ - $ -
Total Entertainment/Recreation Expenses $ - $ - $ - $ -
Medical (After Insurance-Excludes Children)
Physicians $ - $ -
Dental/Orthodontist $ - $ -
Optometry/Glasses/Contacts $ - $ -
Prescriptions $ - $ -
Therapy $ - $ -
Total Medical Expenses $ - $ - $ - $ -
Insurance
Life Insurance $ - $ -
Health (PostDivorce) $ - $ -
Disabilty $ - $ -
Long Term Care $ - $ -
Home Insurance $ - $ -
Auto Insurance $ - $ -
Other Insurance (Boat, Umbrella,..) $ - $ -
Total Insurance Expenses $ - $ - $ - $ -
3 ddcd8d3a-f275-48c4-a77e-264feb258e80.xls Budget
PROJECTED EXPENSES
Date Prepared: Client: Spouse:
Transporation
Auto Payment $ - $ -
Fuel $ - $ -
Repair/Maintenance $ - $ -
License $ - $ -
Total Transportation Expenses $ - $ - $ - $ -
Clothing Expenses
Clothing-Self $ - $ -
Laundry/Dry Cleaning $ - $ -
Total Clothing Expenses $ - $ - $ - $ -
Miscellaneous
Postage $ - $ -
Gifts/Holiday Expenses $ - $ -
Vitamins/Non-Prescription Drugs $ - $ -
Toiletries $ - $ -
Beauty Salon/Hair/Nails $ - $ -
Pet Care/Vet $ - $ -
Books/Newspapers/Magazines $ - $ -
Donations $ - $ -
Education-Self (Non-Reimbursed) $ - $ -
Cash $ - $ -
Miscellaneous $ - $ -
Total Miscellaneous Expenses $ - $ - $ - $ -
Other Payments
Quarterly Taxes & Additional Tax Payments $ - $ -
Alimony/Maintenance Payments $ - $ -
Child Support Payments $ - $ -
Eldercare Expenses $ - $ -
Professional Fees (Financial Planning, Acc't, Legal) $ - $ -
Service Fees (Banks, Investment Accts, …) $ - $ -
Total Other Payments Expenses $ - $ - $ - $ -
Total Monthly Expenses (Excluding Children) $ - $ - $ - $ -
Monthly Annual Monthly Annual
Child Related Expenses
Education/Tuition $ - $ -
Babysitting $ - $ -
Daycare $ - $ -
Sports/Camps/Lessons $ - $ -
Hobbies $ - $ -
Toys/Games $ - $ -
Clothing $ - $ -
Medical (Not Covered by Insurance) $ - $ -
Dental/Orthodontics (Not Covered by Insurance) $ - $ -
Optometry/Glasses/Contacts (Not Covered by Insur) $ - $ -
Prescriptions (Not Covered by Insurance) $ - $ -
Allowances $ - $ -
Miscellaneous $ - $ -
Total Child Related Expenses $ - $ - $ - $ -
Total Monthly Expenses $ - $ - $ - $ -
4 ddcd8d3a-f275-48c4-a77e-264feb258e80.xls Budget
First
Homeowners/ Alert Media
Homeowners Property Jewelry GTE/Verizon Verizon Security One Cable/
Mortgage Fee Tax Insurance Telephone Cellphone System RoadRunner*
Jan-01
Feb-01
Mar-01
Apr-01
May-01
Jun-01
Jul-01
Aug-01
Sep-01
Oct-01
Nov-01
Dec-01
Jan-02
Feb-02
Mar-02
Apr-02 $ -
TOTAL $ - $ - $ - $ - $ - $ - $ - $ -
Ave/Month $ - $ - $ - $ - $ - $ - $ - $ -
Projected
Monthly $ 1,304.00 $ 10.00 $ 413.00 $ 66.00 $ 52.00 $ 22.00 $ 106.00
* Plan to add Roadrunner service in January 2001, there will be a $30/month additional cost, total estimated at $106..
5 12/19/2010 11:17 PM
Michigan Grass Landscape
Detroit Consol'd Water & Cutting/ Orkin Tree Mtnc./
Edison Gas AOL Sewer* Fertilizing Exterminator Mtnc. Upgrades
Jan-01
Feb-01
Mar-01
Apr-01
May-01
Jun-01
Jul-01
Aug-01
Sep-01
Oct-01
Nov-01
Dec-01
Jan-02
Feb-02
Mar-02
Apr-02
TOTAL $ - $ - $ - $ - $ - $ - $ - $ -
Ave/Month $ - $ - $ - $ - $ - $ - $ - $ -
Projected
Monthly $ 141.00 $ 21.00 $ 83.00 $ 23.00 $ 17.00 $ 146.00
* Water and Sewer Rates to increase 9.5% in 2001.
General Home
Repair/Mtnc Grocery Doctor/ Health/Dental
Windows/ Lunches Store Restaurant Dentist Insurance Auto Auto
6 12/19/2010 11:17 PM
Carpets* (School) Items Meals Prescription (PostDivorce) Payment** Fuel/License
Jan-01
Feb-01
Mar-01
Apr-01
May-01
Jun-01
Jul-01
Aug-01
Sep-01
Oct-01
Nov-01
Dec-01
Jan-02
Feb-02
Mar-02
Apr-02
TOTAL $ - $ - $ - $ - $ - $ - $ - $ -
Ave/Month $ - $ - $ - $ - $ - $ - $ - $ -
Projected
Monthly $ 487.00 $ 400.00 $ 250.00 $ 200.00 $ 500.00 $ 125.00
** Auto Payment Projected to Start 6/01.
Entertainment
Auto Laundry/ Movies/ Local
Repair/Mtnc/ Auto Dry Plays/Videos/ Hobbies/ Trips & Memberships/
Car Wash Insurance Clothing Cleaning CDs/etc. Crafts Vacations Clubs*
Jan-01
7 12/19/2010 11:17 PM
Feb-01
Mar-01
Apr-01
May-01
Jun-01
Jul-01
Aug-01
Sep-01
Oct-01
Nov-01
Dec-01
Jan-02
Feb-02
Mar-02
Apr-02
TOTAL $ - $ - $ - $ - $ - $ - $ - $ -
Ave/Month $ - $ - $ - $ - $ - $ - $ - $ -
Projected
Monthly $ 100.00 $ 50.00 $ 300.00 $ 50.00 $ 120.00 $ 25.00 $ 600.00 $ 257.00
* See Report 6 for Details.
*** December 2000 expenses are actuals or estimates based on expenses incurred through 12/15/00.
Drug Store Hair/ Subscriptions Household
Postage Items/ Electrolysis/ Books/ Expenses
& Office Gifts/ Personal Personal Pet Newspapers/ (Linens,Kitchen
Supplies Holidays* Items Items Care Magazines Donations & BR Items)
Jan-01
Feb-01
Mar-01
Apr-01
8 12/19/2010 11:17 PM
May-01
Jun-01
Jul-01
Aug-01
Sep-01
Oct-01
Nov-01
Dec-01
Jan-02
Feb-02
Mar-02
Apr-02
TOTAL $ - $ - $ - $ - $ - $ - $ - $ -
Ave/Month $ - $ - $ - $ - $ - $ - $ - $ -
Projected
Monthly $ 300.00 $ 100.00 $ 36.00 $ 100.00 $ 50.00
Banking/ Aaron Kim Quarterly
Accounting/ College Tuition/ College Tuition/Fed'l & State
Service/FP Household Cash/ Aaron Housing/ Kim Housing/ Taxes & Tax
Legal Fees* Upgrades Misc** Misc Books*** Misc Books*** Payments
Jan-01
Feb-01
Mar-01
Apr-01
May-01
Jun-01
9 12/19/2010 11:17 PM
Jul-01
Aug-01
Sep-01
Oct-01
Nov-01
Dec-01
Jan-02
Feb-02
Mar-02
Apr-02
TOTAL $ - $ - $ - $ - $ - $ - $ - $ -
Ave/Month $ - $ - $ - $ - $ - $ - $ - $ -
Projected
Monthly $ 282.00 $ 200.00 $ 416.67 $ 350.00 $ 416.67
10 12/19/2010 11:17 PM
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