Estimated Budget Template

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Budget Estimate
Name:
Date
Income (weekly, bi-weekly, semi-monthly or
Head of Household
Spouse
Total
monthly)
Gross Salary
$
$
$
Payroll Tax Deduction
$
$
$
Insurance Deduction on Paycheck
$
$
$
Other Deductions (401K, Dues)
$
$
$
Other Income (unemployment, child care, social
$
$
$
security
Net Monthly Income
$
$
$
Average Monthly Expenses
Amount
Rent or Mortgage?
$
YES or NO – circle one
Does Mortgage include taxes?
YES or NO – circle one
Does Mortgage include insurance?
Electricity and gas used for heating and cooking
$
Water
$
Phone
$
Cable TV
$
Garbage Collection
$
Food
$
Day Care, Child Care, School Expenses
$
Clothing, Laundry
$
Personal Care Products
$
Dental, Medical Visits and Prescription Drugs
$
Gasoline and Car Maintenance
$
Recreation, Entertainment and Miscellaneous
$
Health Insurance
$
Life Insurance
$
Car/Truck Insurance
$
Taxes (real estate & personal property- NOT
$
INCOME)
Installment Payments (car, furniture, or other
$ (both payments)
secured debts)
Item: $
$
Court ordered child support or alimony payments
$
Other regular monthly living expenses (specify)
$
Total
$
Budget Estimate Form Moellring & Ambler

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