Cash Flow Statement
Keill & Associates | www.keillandassociates.ca | Please fill in as much as you can.
Basic Information
Cash Flow Statement For
*
First Name
Last Name
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Income
Income
Rows
Monthly ($)
Annual ($)
Notes
Line 1 — Employment
Line 2 — Other Income
Line 3 — Total Income
Deductions
Deductions
Rows
Monthly ($)
Annual ($)
Notes
Line 4 — Income Tax
Line 5 — CPP / EI
Line 6 — Reg'd Pension Plan
Line 7 — Union Dues
Line 8 — Total Deductions
Line 9 — Gross Income for Living
Expenses — Family and Living
Expenses — Family and Living
Rows
Monthly ($)
Annual ($)
Notes
Line 10 — Food
Line 11 — Clothing and Personal Care
Line 12 — Communications and Internet
Line 13 — Childcare
Line 14 — Other
Line 15 — Total Family and Living
Expenses — Housing
Expenses — Housing
Rows
Monthly ($)
Annual ($)
Notes
Line 17 — Mortgage / Rent
Line 18 — Property Tax and Condo Fees
Line 19 — Utilities (heat, electric, water)
Line 20 — Insurance
Line 21 — Maintenance / Upkeep
Line 22 — Other
Line 23 — Total Housing
Expenses — Transportation
Expenses — Transportation
Rows
Monthly ($)
Annual ($)
Notes
Line 24 — Public Transit
Line 25 — Car Payments
Line 26 — Gas / Oil
Line 27 — Car Insurance
Expenses — Discretionary Lifestyle
Line 28 — Entertainment / Dining Out
Rows
Monthly ($)
Annual ($)
Notes
Line 28 — Entertainment / Dining Out
Line 29 — Travel
Rows
Monthly ($)
Annual ($)
Notes
Line 29 — Travel
Line 30 — Pets / Hobbies / Subscriptions
Rows
Monthly ($)
Annual ($)
Notes
Line 30 — Pets / Hobbies / Subscriptions
Line 31 — Gifts / Charity
Rows
Monthly ($)
Annual ($)
Notes
Line 31 — Gifts / Charity
Line 32 — Alcohol and Tobacco
Rows
Monthly ($)
Annual ($)
Notes
Line 32 — Alcohol and Tobacco
Line 33 — Other
Rows
Monthly ($)
Annual ($)
Notes
Line 33 — Other
Line 34 — Total Discretionary Lifestyle
Rows
Monthly ($)
Annual ($)
Notes
Line 34 — Total Discretionary Lifestyle
Expenses — Financial Obligations
Expenses — Financial Obligations
Rows
Monthly ($)
Annual ($)
Notes
Line 35 — Life Insurance
Line 36 — Savings
Line 37 — Loan Payments
Line 38 — Credit Card Payments
Line 39 — Total Financial Obligations
Line 40 — Total Expenses
Submit
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