Budget Spreadsheet Template

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CAUSE NO. D-1-FM-
IN THE MATTER
§
IN THE DISTRICT COURT OF
OF THE
§
MARRIAGE OF
§
§
§
AND
§
_____ COUNTY, TEXAS
§
§
AND IN THE INTEREST OF
§
§
§
MINOR CHILDREN
§
____ JUDICIAL DISTRICT
PROPOSED SUPPORT DECISION AND INFORMATION OF ____________________
A
GROSS MONEY EARNED PER MONTH:
1 Gross Wages and Salary Income
$
-
2 Commissions, tips and bonuses:
$
-
3 Self-employment income
$
-
4 Rental income (net of expenses
$
-
other than depreciation & insurance):
5 All other income actually received:
$
-
TOTAL GROSS MONEY EARNED PER MONTH:
$
-
B
ACTUAL DEDUCTION PER MONTH (Attach most recent pay stub from each employer.)
1 Income tax withholding:
$
-
2 FICA (Social Security ):
$
-
FICA (Medicare):
$
-
3 Health and Dental Insurance:
$
-
4 Union Dues:
$
-
5 Other (specify):
$
-
TOTAL ACTUAL DEDUCTIONS PER MONTH:
$
-
C
NET MONEY ACTUALLY RECEIVED PER MONTH:
$
-
D
STATUTORY NET DEDUCTIONS ALLOWED PER MONTH
1 Income tax withholding for a single person
claiming one personal exemption and standard
deduction
$
-
2 FICA (Social Security)
$
-
3 Health Insurance attributable to child(ren)
$
-
4 Medicare:
$
-
STATUTORY NET DEDUCTIONS PER MONTH
$
-
E
STATUTORY NET RESOURCES PER MONTH
$
-
IMM
Page 1
Budget

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