Income and Expense Report
Personal Details
Name
*
First Name
Last Name
E-mail
Co-Client Name (if applicable)
First Name
Last Name
Co-Client E-mail
Income
Annual Salary/ Employment Income
Self-Employment, if any
Interest/Dividends
Pension/Annuity income (annual)
Social Security (Annual - if receiving)
Alimony
Rental Property (net)
Other
Source of Other Income
Spouse Income
Annual Salary/ Employment Income
Self-Employment, if any
Interest/Dividends
Pension/Annuity income (annual)
Social Security (Annual - if receiving)
Alimony
Rental Property (net)
Other
Source of Other income
Total Household Income
Total Household Income
*
Expenses
Housing
Primary Mortgage (Monthly)
Other Mortgage (Monthly)
Property Taxes (Annually)
Property Insurance (Annually)
Assoc Fees (Monthly)
Home Maintenance (Monthly)
Other
Children
Day Care (Monthly)
Baby Supplies (Monthly)
Clothing (Monthly)
School Fees/etc. (Monthly)
College Savings (Monthly)
Other
Transportation
Car/Truck Payment(s) (Monthly)
Insurance (Monthly)
Gasoline (Monthly)
Oil Changes, Maintenance (Monthly)
Tolls/Parking/etc.. (Monthly)
Registration/License (Monthly)
Food and Beverage
Groceries (Monthly)
Dining Out (Monthly)
Misc/Fast Food (Monthly)
Large Items (Annually)
Other
Clothing
Formal/Work (Monthly)
Casual/Sport (Monthly)
Other
Furnishings/Supplies/Pets/Hobbies
Household Furnishings (Monthly)
Hobbies (Monthly)
Household Supplies (Monthly)
Pets (Food/Vet) (Monthly)
Other
Personal Care
Barber/Salon (Monthly)
Toiletries/Cosmetics (Monthly)
Gym/Fitness Center (Monthly)
Education/Continuing Ed. (Monthly)
Other
Medical/Dental/Rx
Medical premiums/copays/deduct (Monthly)
Dental premiums/copays/deduct (Monthly)
Prescription/Co-Pays (Monthly)
Other
Debt/Installment Payments
Credit Card (Monthly)
Gas Card (Monthly)
Other
Utilities
Electric/Gas (Monthly)
Water/Sewer (Monthly)
Telephone (Monthly)
Cell Phone (Monthly)
Cable/Satellite (Monthly)
Internet Access (Monthly)
Other
Entertainment
Entertainment (Monthly)
Vacations/Holidays
Vacations/Holidays (Annually
Gifts Given
Birthdays (Annually)
Christmas (Annually)
Charitable Contributions
Church (Monthly)
Other Charity
Totals
Total Expenses Monthly
*
Total Expenses Annually
*
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