Financial Statement - Expense Name* First Last Email* CAUSE NO.DATE OF INFORMATION: 1. HOUSING:a. House Paymentb. Insurance (Homeowner or Tenant)c. Homeowners Associationd. Property Taxe. Household Maintenance (Repair & Service)f. Yard Service/Maintenanceg. Utilities (Gas, water, electric)h. Maidi. Cable/Direct TVj. DSLk. Pooll. Mobile Telephonem. Telephone2. VEHICLE AND TRANSPORTATION:a. Car Paymentsb. Insurancec. Gasoline & Oild. Tags, Inspectione. Maintenance & Repair3. PERSONAL INSURANCE:a. Medical, Dental & Healthb. Life Insurance4. FOOD, CLOTHING AND PERSONAL:a. Groceries, cleaning products, hygiene, etcb. Restaurant mealsc. School/work lunches5. HEALTH CARE: (Not Paid by Insurance)a. Physicians/Dentists/Orthodontists/Specialistsb. Prescription Drugs6. CHILD CARE7. ENTERTAINMENT8. PERSONALa. Groomingb. Clothingc. Cleaning and Laundry7. OTHER PAYMENTS (i.e. credit cards, loans, pets, church)a. Child Supportb.c.d.TOTAL MONTHLY EXPENSES
