INCOME AND EXPENSE STATEMENT

Name(s)
For the

Ended
INCOME

Wages and salaries

Self-employment income
Bonuses and commissions
Investment income

Name: Burt
Name: Emily
Name:

64,000.00
36,000.00

(I) Total Income $

100,000.00

Interest received
Dividends received
Rents received
Sale of securities
Other

Pensions and annuities

Other income

EXPENSES

Rent/mortgage payment
(include insurance and taxes, if applicable)
Repairs, maintenance, improvements
Gas, electric, water
Utilities
Phone
Cable TV and other
Groceries
Food
Dining out
Auto loan payments
Transportation
License plates, fees, etc.
Gas, oil, repairs, tires, maintenance
Health, major medical, disability insurance
Medical
(payroll deductions or not provided by employer)
Doctor, dentist, hospital, medicines
Clothes, shoes, and accessories
Clothing
Homeowners (if not covered by mortgage payment)
Insurance
Life (not provided by employer)
Auto
Income and social security
Taxes
Property (if not included in mortgage)
Appliances, furniture, and other Loan payments
major purchases
Purchases and repairs
Personal care
Laundry, cosmetics, hair care
Recreation and entertainment Vacations
Other recreation and entertainment
Other items
Housing

(II) Total Expenses

11,028.00

1,990.00
640.00
680.00
5,902.00
2,150.00
2,800.00
600.00
2,300.00
1,300.00
1,600.00
30,752.00
2,210.00

5,000.00
4,000.00

72,952.00

CASH SURPLUS (OR DEFICIT) [(I)-(II)] $

27,048.00