MY CASH FLOW STATEMENT
For the year ended
INCOME (in dollars, do not use commas)
Weekly
Monthly
Yearly
% of Total Income
Make an entry in the monthly column. The other columns will be completed automatically. If an income source doesn't
apply to you, skip it.Include all of your income BEFORE deductions. Also include all investment income even if
it is not withdrawn or is automatically reinvested.
Job
Spouse's/Partner's
Job
Other jobs
Self-employment
income
Alimony
and Child Support
Social Security
Pensions
and Annuities
Interest and Dividends
Other income
HOUSEHOLD AND LIVING EXPENSES
Weekly
Monthly
Yearly
% of Total Income
Utilities:
Phone, gas, electric, cable, cell phone, etc.
Housing: Mortgage, Rent,
co-op/condo maintenance
fees
Not including insurance
premiums.
Medical
& Dental: Not
reimbursed or paid by insurance
These
expenses can be difficult to nail down. Estimate as well as you can. Think of a typical week.
Food: Groceries, take-out, restaurants
Services
: day care, cleaning, gardeners, repairmen
Furnishings
& Maintenance
Personal
care: Clothing, haircuts, makeup, laundry, etc.
Recreation: Travel, entertainment, sports, hobbies, books
Gifts
and charitable contributions
Other
DEBT REPAYMENTS
Weekly
Monthly
Yearly
% of Total Income
Add the interest and fees you paid over the last
twelve months. Allocate the rest of
your credit card payments into the categories on which the money was spent.
Credit
Card 1 Interest and Fees Only
Credit
Card 2 Interest and Fees Only
Credit
Card 3 Interest and Fees Only
Car Loan 1 Interest
Ask
your lender for a breakdown of interest and principal you paid on each loan
over the past twelve months. If you
can't get this infrormation, enter your entire payment in the principal
boxes.
Car Loan 1 Principal
Car Loan 2 Interest
Car Loan 2 Principal
Bank Loan Interest
Bank Loan Principal
Other Interest
Other Principal
INSURANCE
Weekly
Monthly
Yearly
% of Total Income
Include insurance premium contributions that are
deducted from your paycheck. Also
include Medicare Part B premiums deduction from your Social Security.
Health
Disability
Life
Long-Term Care
Homeowner's/Renter's/Fire
Automobile
Liability
Other
SAVINGS
Weekly
Monthly
Yearly
% of Total Income
Include any deductions made from paychecks
toward retirement plans or automatic invesment and savings plans. Also include any interest that remained in
an account or dividends that were reinvested.
Money
Market, CD, Savings Account
Stocks & Bonds
Retirement Plans
Other
TAXES
Weekly
Monthly
Yearly
% of Total Income
Federal Income
State Income
Local Income
Social security
Property
Other