Aer Form 600 - Commander'S Referral Program Application For Army Emergency Relief (Aer) Financial Assistance Page 3

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Army Emergency Relie f (AER) Budget Sheet
For use of this form see the AER Section Reference Manual
SSN or AER Client ID:
Name:
Complete blocks 1 through 8 ensuring block 8 reflects a balance.
AMOUNT
1
BASE MONTHLY ENTITLEMENTS
2
FIXED MONTHLY EXPENDITURES
AMOUNT
Military/Retired Pay
Food
a
a
BAS
b
Rent/Mortgage
b
BAH
c
Utilities (Electricity/Water/Sewer/Gas)
c
Special Duty Pay
d
Phone/Internet/Cable
d
e
Cell Phone
e
Spouse Income
Survivor Income
f
f
Other
g
g
Other
Other
O t h e r O O t h e r O
h
h
Other
Other
i
Other
i
Other
Other
j
j
Other
Other
k
Other
k
l
l
Other
Total Indebtedness from block 3f
$0.00
TOTAL MONTHLY EXPENDITURES
TOTAL MONTHLY ENTITILEMENTS
1l
2l
$0.00
$0.00
(block 5)
(block 6)
INDEBTEDNESS (Transfer amount of monthly payments from block 3f to block 2l)
(
3
DATE
DATE
DATE
BALANCE
ORIGINAL
MONTHLY
PURPOSE
CREDITOR
LAST PYMT
VERIFIED
INCURRED
DUE
AMOUNT
AMOUNT
a
b
c
d
e
TOTAL MONTHLY PAYMENTS
3 f
TOTAL DUE
$0.00
$0.00
DEDUCTIONS (INCLUDED IN GROSS ENTITLEMENTS )
4
AMOUNT
ITEM
AMOUNT
ITEM
Federal Income Tax
a
g
T
SP
Social Security (FICA)
b
h
Other
Medicare
Other Allotment 1
c
i
Other Allotment 2
d
State Income Tax
j
Other Allotment 3
Insurance (SGLI/TSGLI/FSGLI)
k
e
Other Allotment 4
Dental Plan
f
l
4 m
TOTAL DEDUCTIONS
$0.00
$0.00
5
TOTAL MONTHLY ENTITLEMENTS (amount from Box 1l)
6
$0.00
TOTAL MONTHLY EXPENDITURES (amount from Box 2l)
7
TOTAL DEDUCTIONS (amount from Box 4m)
$0.00
8
(-)
BALANCE: + OR
$0.00
NOTE:
A Soldier’s monthly surplus does not automatically dictate rendering a decision to provide a loan. Full or
Partial grants should be considered in every case.
RESET BUTTON
(Local Reproduction Authorized).
Previous editions of this form are obsolete.
AER FORM 57R, dated 14 July 2015

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