12-Month Period ending _________________
INCOME |
Monthly Amount |
Times 12 |
Annual Amount |
Salary and wages |
$ |
X 12 |
$ |
Bonuses, commissions, tips |
$ |
X 12 |
$ |
Self-employment income |
$ |
X 12 |
$ |
Interest and dividends |
$ |
X 12 |
$ |
Alimony/child support received |
$ |
X 12 |
$ |
Gifts received |
$ |
X 12 |
$ |
Pension income |
$ |
X 12 |
$ |
Social Security income |
$ |
X 12 |
$ |
Public assistance, unemployment, |
$ |
X 12 |
$ |
Other income: |
|||
__________________________________ |
$ |
X 12 |
$ |
__________________________________ |
$ |
X 12 |
$ |
__________________________________ |
$ |
X 12 |
$ |
TOTAL INCOME |
$ |
X 12 |
$ |
OUTFLOW |
Monthly Amount |
Times 12 |
Annual Amount |
Savings/investing |
$ |
X 12 |
$ |
Federal & state taxes |
$ |
X 12 |
$ |
Mortgage or rent |
$ |
X 12 |
$ |
Home repair/maintenance |
$ |
X 12 |
$ |
Property taxes |
$ |
X 12 |
$ |
Disability insurance |
$ |
X 12 |
$ |
Life insurance |
$ |
X 12 |
$ |
Home/renter's insurance |
$ |
X 12 |
$ |
Auto insurance |
$ |
X 12 |
$ |
Credit card/loan payment |
$ |
X 12 |
$ |
Utilities & telephone |
$ |
X 12 |
$ |
Food (include dining out) |
$ |
X 12 |
$ |
Clothing |
$ |
X 12 |
$ |
Grooming |
$ |
X 12 |
$ |
Gasoline |
$ |
X 12 |
$ |
Auto repair/maintenance |
$ |
X 12 |
$ |
Other transportation |
$ |
X 12 |
$ |
Medical care |
$ |
X 12 |
$ |
Education |
$ |
X 12 |
$ |
Child care |
$ |
X 12 |
$ |
Alimony/child support |
$ |
X 12 |
$ |
Entertainment |
$ |
X 12 |
$ |
Vacations |
$ |
X 12 |
$ |
Gifts/charitable contributions |
$ |
X 12 |
$ |
Laundry/cleaning |
$ |
X 12 |
$ |
Other: |
|||
__________________________________ |
$ |
X 12 |
$ |
__________________________________ |
$ |
X 12 |
$ |
__________________________________ |
$ |
X 12 |
$ |
TOTAL OUTFLOW |
$ |
X 12 |
$ |
NET CASH FLOW |
$ |
X 12 |
$ |
Investments are not a deposit or other obligation of, or guaranteed by, the bank, are not FDIC insured, not insured by any federal government agency, and are subject to investment risks, including possible loss of principal.