Form 13.1 - Financial Statement (Property And Support Claims) Page 3

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Form 13.1:
Financial Statement (Property and
(page 3)
Court File Number:
Support Claims)
$0.00
Total
PART 2: EXPENSES
EXPENSE
Monthly Amount
Gas and oil
Automatic Deductions
Car insurance and license
CPP contributions
Repairs and maintenance
EI premiums
Parking
Income taxes
Car Loan or Lease Payments
Employee pension contributions
Union dues
$0.00
SUBTOTAL
Health
SUBTOTAL
$0.00
Health insurance premiums
Housing
Dental expenses
Rent or mortgage
Medicine and drugs
Property taxes
Eye care
Property insurance
Condominium fees
$0.00
SUBTOTAL
Repairs and maintenance
Personal
Clothing
$0.00
SUBTOTAL
Hair care and beauty
Utilities
Alcohol and tobacco
Water
Education
(specify)
Heat
Entertainment/recreation (including
Electricity
children)
Gifts
Telephone
Cell phone
Cable
SUBTOTAL
$0.00
Internet
Other expenses
Life insurance premiums
RRSP/RESP withdrawals
$0.00
SUBTOTAL
Vacations
Household Expenses
School fees and supplies
Groceries
Clothing for children
Household supplies
Children’s activities
Meals outside the home
Summer camp expenses
Pet care
Debt payments
Laundry and Dry Cleaning
Support paid for other children
Other expenses not shown above
SUBTOTAL
$0.00
(specify)
Childcare Costs
Daycare expense
SUBTOTAL
$0.00
Babysitting costs
$0.00
Total Amount of Monthly Expenses
SUBTOTAL
$0.00
Transportation
$0.00
Total Amount of Yearly Expenses
Public transit, taxis
PART 3: OTHER INCOME EARNERS IN THE HOME

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