Official Form B 6j - Schedule J: Your Expenses - United States Courts Page 2
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1
2
3Debtor 1
_______________________________________________________
Case number
_____________________________________
(if known)
First Name
Middle Name
Last Name
Your expenses
$_____________________
Additional mortgage payments for your residence, such as home equity loans
5.
5.
Utilities:
6.
Electricity, heat, natural gas
$_____________________
6a.
6a.
Water, sewer, garbage collection
$_____________________
6b.
6b.
Telephone, cell phone, Internet, satellite, and cable services
$_____________________
6c.
6c.
Other. Specify: _______________________________________________
$_____________________
6d.
6d.
Food and housekeeping supplies
$_____________________
7.
7.
Childcare and children’s education costs
$_____________________
8.
8.
Clothing, laundry, and dry cleaning
$_____________________
9.
9.
Personal care products and services
$_____________________
10.
10.
Medical and dental expenses
$_____________________
11.
11.
Transportation. Include gas, maintenance, bus or train fare.
12.
$_____________________
Do not include car payments.
12.
Entertainment, clubs, recreation, newspapers, magazines, and books
$_____________________
13.
13.
Charitable contributions and religious donations
$_____________________
14.
14.
1
Insurance.
15.
Do not include insurance deducted from your pay or included in lines 4 or 20.
Life insurance
$_____________________
15a.
15a.
Health insurance
$_____________________
15b.
15b.
Vehicle insurance
$_____________________
15c.
15c.
Other insurance. Specify:_______________________________________
$_____________________
15d.
15d.
Taxes. Do not include taxes deducted from your pay or included in lines 4 or 20.
16.
$_____________________
Specify: ________________________________________________________
16.
Installment or lease payments:
17.
$_____________________
Car payments for Vehicle 1
17a.
17a.
$_____________________
Car payments for Vehicle 2
17b.
17b.
$_____________________
Other. Specify:_______________________________________________
17c.
17c.
$_____________________
Other. Specify:_______________________________________________
17d.
17d.
Your payments of alimony, maintenance, and support that you did not report as deducted
18.
18.
$_____________________
from your pay on line 5, Schedule I, Your Income (Official Form B 6I).
Other payments you make to support others who do not live with you.
19.
19.
$_____________________
Specify:_______________________________________________________
Other real property expenses not included in lines 4 or 5 of this form or on Schedule I: Your Income.
20.
$_____________________
Mortgages on other property
20a.
20a.
$_____________________
Real estate taxes
20b.
20b.
$_____________________
Property, homeowner’s, or renter’s insurance
20c.
20c.
$_____________________
Maintenance, repair, and upkeep expenses
20d.
20d.
$_____________________
Homeowner’s association or condominium dues
20e.
20e.
Official Form B 6J
Schedule J: Your Expenses
page 2
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