Schedule C "Monthly Income and Expenses" - Newfoundland and Labrador, Canada

The Newfoundland and Labrador Department of Justice and Public Safety has released this version of the "Schedule C - Monthly Income and Expenses" on April 1, 2007.

This form may be used by all Newfoundland and Labrador residents: download the printable PDF by clicking the link below and use it according to the applicable legal guidelines.

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Download Schedule C "Monthly Income and Expenses" - Newfoundland and Labrador, Canada

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SCHEDULE “C”
(04/07)
IN THE PROVINCIAL COURT OF NEWFOUNDLAND AND LABRADOR
COURT CENTRE: _____________________________
Court File No. ______________________________
NAME: _____________________________
DATE: _____________________________
MONTHLY INCOME AND EXPENSES
My gross monthly income is: $______________________
(Attach a record of earnings, a letter from your employer
or other written verification of your earnings.)
My employer and/or other source(s) of income is/are: _____________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
My social insurance number is: ____________________________
(optional)
DEDUCTIONS FROM INCOME
PERSONAL
HEALTH
Medical, Dental Premiums
CPP
$
Hair Care, Toiletries
$
(not deducted at source)
$
EI Premiums
$
Clothing, footwear
$
Health care (therapy)
$
Pension
$
Entertainment
$
Drugs, Prescriptions
$
$
$
Dental Care(i.e.
Insurance
Alcohol/Tobacco
orthodontics)
$
Union dues
$
School Fees etc.
$
Optional Care
$
Other (specify)
$
Other (specify)
$
HOUSING
CHILDREN
SAVINGS FOR FUTURE
Rent/Mortgage
$
School Fees/Supplies
$
RRSP
$
Insurance
$
School Activities
$
RESP
$
Condo Fees
$
Clothing, Footwear
$
Other (Specify)
$
Property Taxes
$
Daycare, Sitter
$
Water, Sewer
$
Allowances, Gifts
$
Repairs/ Maint.
$
Other (Specify)
$
Heat, Fuel
$
Electricity
$
Telephone
$
Cable
$
Internet
$
Other (Specify)
$
HOUSEHOLD EXPENSES
TRANSPORTATION
OTHER
Groceries,
Household Supp.
$
Car Payment
$
Support paid in this case
$
Meals outside
Support pain in any other
home
$
Insurance
$
case
$
Dry Cleaning,
Banking, legal,
laundry
$
Licences
$
accounting
$
Public Transit,
Church, charitable
Furnishings
$
Taxis
$
donations
$
Repairs,
Maintenance
$
Gas, Oil
$
Life Insurance Premiums
$
Other (Specify)
$
Maintenance
$
Newspapers, Publications
$
Debts (other than
Parking
$
mortgage) (specify)
$
Other (Specify)
$
Other (specify)
$
Total Monthly Expenses
$
SCHEDULE “C”
(04/07)
IN THE PROVINCIAL COURT OF NEWFOUNDLAND AND LABRADOR
COURT CENTRE: _____________________________
Court File No. ______________________________
NAME: _____________________________
DATE: _____________________________
MONTHLY INCOME AND EXPENSES
My gross monthly income is: $______________________
(Attach a record of earnings, a letter from your employer
or other written verification of your earnings.)
My employer and/or other source(s) of income is/are: _____________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
My social insurance number is: ____________________________
(optional)
DEDUCTIONS FROM INCOME
PERSONAL
HEALTH
Medical, Dental Premiums
CPP
$
Hair Care, Toiletries
$
(not deducted at source)
$
EI Premiums
$
Clothing, footwear
$
Health care (therapy)
$
Pension
$
Entertainment
$
Drugs, Prescriptions
$
$
$
Dental Care(i.e.
Insurance
Alcohol/Tobacco
orthodontics)
$
Union dues
$
School Fees etc.
$
Optional Care
$
Other (specify)
$
Other (specify)
$
HOUSING
CHILDREN
SAVINGS FOR FUTURE
Rent/Mortgage
$
School Fees/Supplies
$
RRSP
$
Insurance
$
School Activities
$
RESP
$
Condo Fees
$
Clothing, Footwear
$
Other (Specify)
$
Property Taxes
$
Daycare, Sitter
$
Water, Sewer
$
Allowances, Gifts
$
Repairs/ Maint.
$
Other (Specify)
$
Heat, Fuel
$
Electricity
$
Telephone
$
Cable
$
Internet
$
Other (Specify)
$
HOUSEHOLD EXPENSES
TRANSPORTATION
OTHER
Groceries,
Household Supp.
$
Car Payment
$
Support paid in this case
$
Meals outside
Support pain in any other
home
$
Insurance
$
case
$
Dry Cleaning,
Banking, legal,
laundry
$
Licences
$
accounting
$
Public Transit,
Church, charitable
Furnishings
$
Taxis
$
donations
$
Repairs,
Maintenance
$
Gas, Oil
$
Life Insurance Premiums
$
Other (Specify)
$
Maintenance
$
Newspapers, Publications
$
Debts (other than
Parking
$
mortgage) (specify)
$
Other (Specify)
$
Other (specify)
$
Total Monthly Expenses
$