MONTHLY FAMILY EXPENSE WORKSHEET Name

Name: _________________________ GU ID: __________________

Instructions: To have a better understanding of your family’s financial circumstances, this form intends to capture your expenses. Total your monthly expenses,
then add educational expenses at the bottom of the grid. Carefully follow instructions at the bottom regarding educational expenses and educational debt.

I. Monthly Household and Maintenance

(a) Mortgage or rent payment (including homeowner’s
insurance and property tax)
(b) Electricity
(c) Gas
(d) Water and sewer
(e) Telephone
(f) Cable/TV/Internet
(g) Home Maintenance
(h) Other:
II. Monthly Family Living Support
(a) Groceries
(b) Clothing
(c) Laundry and dry cleaning
(d) Prescription drugs
(e) Child care
(f) Dependent care (i.e. grandparents)
(g) Unreimbursed medical/dental expenses
(h) Medical premiums
(i) Dental insurance
(j) Life Insurance
(k) Other:
III. Monthly Transportation
(a) Automobile Payments
(b) Gasoline
(c) Auto insurance
(d) Auto maintenance
(e) Other:
IV. Monthly Leisure/Entertainment
(a) Movies/theater/books/magazines/newspapers
(b) Restaurants
(c) Club Memberships
(d) Travel/Vacations
(e) Other:
V. Miscellaneous Monthly Expenses
(a) Installment loan payments
(b) Credit card debt payments
(c) Educational debt payments
(d) Other:
TOTAL MONTHLY LIVING EXPENSES:
(Add all above expenses. Do not include educational expenses.)
TOTAL EDUCATIONAL EXPENSES/MONTH:
(Do not include educational debt).
 

Parent Signature: ___________________________ Date: __________ Student Signature: ___________________________ Date: __________