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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,
and/or disability benefits

$

X 12

$

Other income:

__________________________________

$

X 12

$

__________________________________

$

X 12

$

__________________________________

$

X 12

$

TOTAL INCOME

$

X 12

$

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
(Income less Outflow)

$

X 12

$