|
(PAGE 2)
|
Budgeted Item |
Sub Total |
TOTAL |
Actually Spent |
% of Take Home Pay |
|
|
|
|
|
| *Clothing |
_______ |
_______ |
_______ |
_______ |
*Children |
_______ |
|
_______ |
|
*Adults |
_______ |
|
_______ |
|
*Cleaning/Laundry |
_______ |
_______ |
_______ |
_______ |
| Medical/Health |
|
|
|
|
Disability Insurance |
_______ |
|
_______ |
|
Health Insurance |
_______ |
|
_______ |
|
Doctor Bills |
_______ |
|
_______ |
|
Dentist |
_______ |
|
_______ |
|
Optometrist |
_______ |
|
_______ |
|
Drugs |
_______ |
_______ |
_______ |
_______ |
|
Personal |
|
|
|
|
Life Insurance |
_______ |
|
_______ |
|
Child Care |
_______ |
|
_______ |
|
*Baby Sitter |
_______ |
|
_______ |
|
*Tolietries |
_______ |
|
_______ |
|
*Cosmetics |
_______ |
|
_______ |
|
*Hair Care |
_______ |
|
_______ |
|
Education/Adult |
_______ |
|
_______ |
|
School Tuition |
_______ |
|
_______ |
|
School Supplies |
_______ |
|
_______ |
|
Child Support |
_______ |
|
_______ |
|
Alimony |
_______ |
|
_______ |
|
Subscriptions |
_______ |
|
_______ |
|
Organization Dues |
_______ |
|
_______ |
|
Gifts (inc. Christmas) |
_______ |
|
_______ |
|
Miscellaneous |
_______ |
|
_______ |
|
*BLOW $$ |
_______ |
_______ |
_______ |
_______ |
|
|
|
|
|
| PAGE 2 TOTAL |
|
_______ |
_______ |
|
*** Items with an (*) should be paid for with CASH
|
