FORM 5b Personal Budget - Other Expenses

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FORM # 5 PART B

PERSONAL BUDGET FOR TAX EVALUATION - CONFIDENTIAL
5. OTHER NECESSARY EXPENSES
Enter your name and date below, then proceed down to the budget. Enter your average monthly expenses for each item listed below. Your average should be for a period of the last three months. An estimate is ok if you think it is reasonably accurate.
IMPORTANT: Try to avoid duplicating expenses already covered in Part A
NAME
DATE:

MonthDayYearHourMinutesAM/PM Option
36. Legal and accounting fees paid for representation with IRS or state tax problems
37. Charitable contributions
38. Child care
39. Court-ordered child or domestic support payments
40. Dependent care (separate from child care)
41. Education
42. Current health care out-of-pocket expenses (not insurance or delinquent medical bills
43. Health insurance
44. Involuntary deductions
44b: Explain involuntary deductions
45. Life insurance
46. Life insurance is:

TermWhole termOtherUnk.
46b. Insurance has a current cash-out amount of:
47. Payments on secured debts [not including vehicles or mortgage]
48. Credit cards
49. Delinquent medical bills
50. Current income taxes
51. Delinquent income taxes (if currently in an installment plan)
52. Tax installment payments are for:

Federal income taxesState income taxesFederal payroll taxesState payroll taxesState sales taxesOther tax
53. Internet expenses
54. Payments on debts incurred to pay prior taxes
55. Other: describe payments on other debts not falling into any of the above:
56. Explain any unusually high expenses in any of the above categories
Enter any questions you have about how to categorize an expense item.
Enter the message as it's shown*
NOW PRINT FOR YOUR RECORDS AND PRESS "SUBMIT FORM"

You will be brought to Form # 6 - Assets
Should be Empty:

IMPORTANT: Try to avoid duplicating expenses already covered in Part A