Domestic Relations Income & Expense Form

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Domestic Relations Income & Expense Form

Expenses Of

Name

v.

List

$

Per

From

Nets

Monthly Expenses

1. Household

Mortgage/Rent

Second Mortgage

Property Tax

House Repairs

Homeowner’s Insurance

Homeowner Association

Condo Fee

TOTAL

2. Utilities
Electricity

Water

Telephone

Cable T.V.

Gas/Heating

Lawn Care

Exterminator

Maid Service

Pool Care

Cellular Phone

Pager Service

TOTAL

3. Living Expenses
Groceries

Lunches

Laundry

Uniforms/Personal

Grooming

Clothing

TOTAL

Recreation
Entertainment

Vacations

Hobbies

Newspapers

Magazines

TOTAL

Health Expenses
Glasses/Contacts

Prescriptions

Therapist

Doctor

Dentist

Insurance

TOTAL

Automobile
Payment

Insurance

Repair

Parking

Tolls/Fees

License/Tags/Inspec.

TOTAL

Child Expenses
School Tuition

School Supplies

Lunch Money

Day Care

School Clothes

Sport Activities

Tutor

Lessons

TOTAL

Miscellaneous
Child Support

Spousal Support

Child Support

Gas/Oil

Christmas/Birthday

Church/Charity

Life Insurance

Retirement/IRA’s

Property Tax

Attorney Fees

Spas/Clubs

Veterinarian

Pet Grooming

TOTAL

Charge Accounts
Creditor
Charge

TOTAL

TOTAL OF ALL LIVING EXPENSES

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