Indicate how much you pay for each item each month…

Rent or your home mortgage



Electricity and heating



Water and sewage



Telephone service/long distance



Any and all other utility bills



Home maintenance, including repairs and general upkeep



Food



Clothing



Laundry and dry cleaning



Medical and dental expenses



Transportation (not including car payments)



Entertainment, recreation, wilde_newspapers, magazines



Charitable contributions



Insurance not deducted from paycheck



a.) homeowner's or renter's insurance



b.) life insurance



c.) health insurance



d.) auto insurance



e.) other insurance



Taxes not deducted from paycheck



Installment payments for car, furniture, etc.



Alimony, maintenance, support paid to others



Payments of support for dependents not living at home



Expenses from operation of business

Additional Expenses (707(b) Expenses)

Mandatory payroll deductions not listed



Court ordered payments not already listed



Education necessary to maintain employment



Education for a physical or mentally disabled child



Childcare



Disability insurance (If not listed on line 14)



Health savings accounts



Care for elderly, chronically ill, or disabled family members



Protection from family violence



Education expense for your children under 18



Non-mandatory contributions to retirement accounts(including loan repayment)



Other expenses not listed above