Statement Of Income And Expenses - Family Court Of St Louis County, Missouri Page 2
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4B. Additional Income from Rentals, Dividends, Business Enterprises, Social Security, A.F.D.C., V.A. Benefits,
Pensions, Annuities, Bonuses, Commissions and all other sources (give monthly average and list sources of income).
___________________
$
___________________
$
___________________
$
___________________
$
Average Monthly Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . $
C. TOTAL AVERAGE NET MONTHLY INCOME
$
D. Your Share of the Gross Income Shown on Last Year's Federal Income Tax Return
$
2. EXPENSES REQUIRED TO MAINTAIN PREVIOUS STANDARD OF LIVING STATED ON A MONTHLY AVERAGE
A. Rent or Mortgage Payments
$
B. Utilities
1. Gas
$
2. Water
$
3. Electricity
$
4. Telephone
$
5. Trash Service
$
$
C. Automobiles
1. Gas and Oil
$
2.
Maintenance (routine)
$
3.
Taxes and License
$
4.
Payment on Auto Loan
$
$
D. Insurance
1.
Life
$
2. Health and Accident.
$
3. Disability
$
4. Homeowners
$
(if not included in mortgage pmt)
5. Automobile
$
$
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