| MONTHLY INCOME |
| Take-Home Pay: |
________________________________________ |
| Other Reliable Income Sources: |
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| TOTAL MONTHLY INCOME: |
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| MONTHLY EXPENSES |
| Food, Household Items: |
________________________________________ |
| Car or Other Loans: |
________________________________________ |
| Credit Cards: |
________________________________________ |
| Clothing: |
________________________________________ |
| Medical Expenses: |
________________________________________ |
| Life Insurance: |
________________________________________ |
| Other Insurance (Auto, Health): |
________________________________________ |
| Telephone: |
________________________________________ |
| Commuting: |
________________________________________ |
| Education: |
________________________________________ |
| Savings: |
________________________________________ |
| Entertainment: |
________________________________________ |
| Other Expenses: |
________________________________________ |
| TOTAL MONTHLY EXPENSES: |
________________________________________ |
| Total Monthly Income: |
________________________________________ |
| Less Total Monthly Expenses: |
________________________________________ |
| MONTHLY INCOME FOR HOUSING: |
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