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Financial Survey
This form helps you calculate
what you are actually spending. In other words, where all
your money is really going.
Housing
Miscellaneous
Mortgage/rent
Toiletries
Property taxes
Office
supplies/postage
Property insurance
Dish & laundry supplies
Electricity
Personal hygiene
products
Cable TV
Habits (smoking, drinking, etc.)
Internet access
Heat/gas
Insurance
(other
than auto, home, health)
Water
Life
Sewer/septic
Disability
Wired phone
Umbrella liability
Cell phone
Others
House-related professional services
Child Care/
Adult or Child Education
Tuitions
Transportation
Fees
Car payments
Tutoring
Gasoline
Babysitting / child care
Oil changes
License fees
Charitable
Giving
Car insurance
Church
Taxes
Tithe
Repairs
Charitable
organizations
Others
Food
Groceries
Debt Payments
Snacks (at home or away)
Credit cards
Animal/pet feed
Student loans
Equity
loans
Entertainment
Cash
advance
Eating out
Bank
loans
Videos/movies
Friends/family loans
Vacations
Store loans
Outings/field trips
Delinquent
taxes
Sports
Others
Lessons
Subscriptions
Gift-giving (including Christmas,birthdays,etc.)
Income
Hobbies
Total
household take-home pay
Income from
side jobs
Clothing
Income from hobbies
New clothing
Other
income
Shoes
Uniforms
Specialty clothing (sports, costumes, etc.)
Medical
Medical insurance/co-pay
Prescriptions
Medical supplies
Dental
Eye care
Veterinary bills
Instructions:
Work in pencil in order to make corrections
and
revisions easier. It will probably take you between one and
two
hours to complete this form. Next to each item in this list,
write down how much you spend for that item per month. Be
honest
and write in how much you are actually spending, not how much you think
you should or how much you wish to in the Future. If an item
is
not a monthly expense, then divide it by how many months it covers to
convert it to a monthly amount. For example, if you pay a
life
insurance premium every six months, then divide it by six to get the a
mount per month. Any items that don't apply to you or that
you
don't spend any money on, write in zero. Write in any items
you
spend money on which are not already on this form, under the category
that makes the most sense for that expense. Under the
'Income'
category, write down all income, then covert it to income per month.
Use actual take-home pay for the 'Income' category.
In
other words, use your net not your gross income. If you're
not
sure how to convert your income to a monthly amount, then read the
article You Need A Plan.
Once
you have written in all of the monthly amounts for each item, add up
all of the items under each category and write the total for that
category next to the category name. As you write in each
category
total, circle it so it won't become confused with the other amounts
written on the form. For example. Under the food category,
you
would add up all the money you spend per month on groceries plus all
the money you spend on animal/pet feed plus all the money you spend on
snacks. You would write this total next to where it says
'Food'
and circle that total. Do the same for all categories.