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FINANCIAL INFORMATION - EXPENSES

Home:

If mortgage:

$

Average principal:

Average Interest:

homeowner's or renter's insurance:

$

$

Real property taxes:

$

Maintenance and repair:

$

General Expenses

Healthcare costs:

Child care:

Groceries and supplies:

Eating out:

Gas service:

Electricity:

Water:

Trash:

Life insurance:

Savings, investments:

Charitable Contributions:

Other:

Expenses paid by others:

$

$

$

$

$

$

$

$

$

$

$

$

$

Telephone:

Laundry and cleaning:

Clothes:

Education:

Entertainment/vacation:

Car insurance:

Fuel:

Repairs:

Bus:

Monthly payments not mentioned above:

$

$

$

$

$

$

$

$

$

$

Installment Payments and Debts not listed above

Paid To

For

Amount

$

$

$

$

$

$

Balance

$

$

$

$

$

$

Last Payment Date

Deductions

Required union dues:

Required retirement payments (not social security, FICA, 401K, IRA):

Medical, hospital, dental, and other health insurance premiums (monthly):

Child support paid for children in other relationships:

Spousal support paid for a different marriage:

Partner support paid for a different marriage:

Necessary job-related expenses not reimbursed by employer:

$

$

$

$

$

$

$

Summons

Civil Restraining Orders

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