Month ________________________
|
INCOME |
|
| Salary and wages | $ |
| Bonuses, commissions, tips | $ |
| Self-employed income | $ |
| Interest and dividends | $ |
| Alimony/child support received | $ |
| Gifts received | $ |
| Pension income | $ |
| Social Security income | $ |
| Public Assistance and/or unemployment | $ |
| Disability benefits | $ |
|
Other income: |
$ |
|
TOTAL INCOME |
$ |
|
OUTFLOW |
|
|
Savings/investing |
$ |
|
Federal & state taxes |
$ |
|
Mortgage or rent |
$ |
|
Home repair/maintenance |
$ |
|
Property taxes |
$ |
|
Disability insurance |
$ |
|
Life insurance |
$ |
|
Home/renter's insurance |
$ |
|
Auto insurance |
$ |
|
Credit card/loan payment |
$ |
|
Utilities & telephone |
$ |
|
Food (include dining out) |
$ |
|
Clothing |
$ |
|
Grooming |
$ |
|
Gasoline |
$ |
|
Auto repair/maintenance |
$ |
|
Other transportation |
$ |
|
Medical care |
$ |
|
Education |
$ |
|
Child care |
$ |
|
Alimony/child support |
$ |
|
Entertainment |
$ |
|
Vacations |
$ |
|
Gifts/charitable contribution |
$ |
|
Laundry/cleaning |
$ |
|
Other: |
$ |
|
TOTAL OUTFLOW |
$ |
|
CASH BALANCE |
|
