Child Care Wage Project Monthly Income/expenses Worksheet Page 2
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2Child Care WAGE$® Project Monthly Income & Expenses Worksheet Page 2
Expenses
Based on the children listed on the opposite side, how much do you spend in your home program ON AVERAGE each month in the following
categories? The amounts you claim as expenses will be used to determine your hourly rate. Any item listed in the “other” category must be
identified to be included in the calculation.
Expenses worksheet
monthly average
1
Food
monthly average
2
Toys
monthly average
Assistant/substitute care
3
monthly average
4
Crafts/supplies
monthly average
5
Transportation for business
($0.56 per mile) Multiply # of miles by $.56.
monthly average
6
Training fees
monthly average
7
Gifts for children/families
monthly average
8
Other, not including housing expenses
(Please specify:________________________)
9
Total monthly expenses
The information provided on both sides of this document is true and accurate to the best of my knowledge.
___________________________________________________
______________
Signature
Date
_________________________________________________________
__________________________________
Print name
County of employment
XXX-XX-______________
Last four digits of your Social Security number
Return form to:
Child Care WAGE$® Project
Phone 919-967-3272
Child Care Services Association
Fax 919-967-2945
P.O. Box 901
Chapel Hill, NC 27514
To be completed by WAGE$ Project Counselor:
Total monthly income
Expenses, (Line 9)
Gross monthly earnings
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