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Expense Worksheet

(a)	Housing
1	Rent...............................
2	Mortgage & amortization............
3	Real estate taxes..................
4	Condominium charges................
5	Cooperative apt maintenance........       
		Housing Total:.............

(b)	Utilities
1	Fuel Oil...........................
2	Gas................................
3	Electricity........................
4	Telephone..........................
5	Water..............................       
		Utilities Total:...........

(c)	Food
1	Groceries..........................
2	School lunches.....................
3	Lunches at work....................
4	Liquor/alcohol.....................
5	Home entertainment.................
6	Other..............................       
		Food Total:................

(d)	Clothing
1	Husband............................
2	Wife...............................
3	Children...........................
4	Other..............................       
		Clothing Total:............

(e)	Laundry
1	Laundry at home....................
2	Dry cleaning.......................
3	Other..............................       
		Laundry Total:.............

(f)	Insurance
1	Life...............................
2	Homeowner's/tenant's...............
3	Fire,theft & liability.............
4	Automotive.........................
5	Umbrella policy....................
6	Medical plan & FSA.................
7	Dental plan........................
8	Optical plan.......................
9	Disability.........................
10	Worker's Compensation..............
11	Other..............................       
		Insurance Total:...........

(g)	Unreimbursed medical
1	Medical............................
2	Dental.............................
3	Optical............................
4	Pharmaceutical.....................
5	Surgical,nursing, hospital.........
6	Other..............................       
		Unreimbursed medical Total:

(h)	Household maintenance
1	Repairs............................
2	Furniture,furnishing,household.....
3	Cleaning supplies..................
4	Appliances,including maintenance...
5	Painting...........................
6	Sanitation/carting.................
7	Gardening/Landscaping..............
8	Snow removal.......................
9	Extermination......................
10	Other..............................       
		Household maintenance Total:

(i)	Household help
1	Babysitter.........................
2	Domestic(housekeeper,maid,etc).....
3	Other..............................       
		Household help Total:......

(j)	Automotive
 	Year         Make      Personal/Business
1	Payments...........................
2	Gas & Oil..........................
3	Repairs............................
4	Car Wash...........................
5	Registration & license.............
6	Parking & tolls....................
7	Other..............................       
		Automotive Total:..........

(k)	Educational
1	Nursery & pre-school...............
2	Primary & secondary................
3	College............................
4	Post-graduate......................
5	Religious instruction..............
6	School transportation..............
7	School supplies & books............
8	Tutoring...........................
9	School events......................
10	Other..............................       
		Educational Total:.........

(l)	Recreational
1	Summer camp........................
2	Vacations..........................
3	Movies.............................
4	Theatre,ballet,etc.................
5	Video rentals......................
6	Tapes,CDs,etc......................
7	Cable Television...................
8	Team sports........................
9	Country club/pool club.............
10	Health club........................
11	Sporting goods.....................
12	Hobbies............................
13	Music/dance lessons................
14	Sports lessons.....................
15	Birthday parties...................
16	Other..............................       
		Recreational Total:........

(m)	Income taxes
1	Federal............................
2	State..............................
3	City...............................
4	Social Securtiy & Medicare.........       
		Income taxes Total:........

(n)	Miscellaneous
1	Beauty parlor/barber...............
2	Beauty aids/cosmetics/drug items...
3	Cigarettes/tobacco.................
4	Books,magazines,newspapers.........
5	Children's allowances..............
6	Gifts..............................
7	Charitable contributions...........
8	Religious organization dues........
9	Union & organization dues..........
10	Commutation & transportation.......
11	Veterinarian/pet expenses..........
12	Child support payment..............
        (prior marriage)
13	Loan payments......................
14	Unreimbursed business expenses.....       
		Miscellaneous Total:.......

(o)	Other
1	                     ..............
2	                     ..............
3	                     ..............
4	                     ..............       
		Other Total:...............

			TOTAL EXPENSES:....
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