"Monthly Statement of Income and Expenses for the Family Unit Template - Grant Thornton" - Nova Scotia, Canada

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Download "Monthly Statement of Income and Expenses for the Family Unit Template - Grant Thornton" - Nova Scotia, Canada

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Contact information:
Toll Free in Nova Scotia: 902-310-6060
Fax forms to: 902-453-9257
MONTHLY STATEMENT OF INCOME AND EXPENSES FOR THE FAMILY UNIT
NET MONTHLY INCOME
Mine
Spouse/Partner
Net employment income
$_______________
$_______________
(take home)
Self-employment income
$_______________
$_______________
Pensions/ annuities
$_______________
$_______________
Disability benefits/ WCB
$_______________
$_______________
Spousal or child support
$_______________
$_______________
Child tax benefits
$_______________
$_______________
Employment insurance benefits
$_______________
$_______________
Social assistance
$_______________
$_______________
+
Total monthly income
$_______________
$_______________ = $_______________(A)
NON-DISCRETIONARY EXPENSES
Spousal or child support payments
$_______________
$_______________
Childcare/ preschool/ daycare
$_______________
$_______________
Heath-related
$_______________
$_______________
Employment related
$_______________
$_______________
+
Subtotal
$_______________
$_______________ = $________________(B)
MONTHLY DISCRETIONARY EXPENSES
(Family unit)
Household Expenses:
Living Expenses:
Rent/mortgage/board
$__________________
Food/grocery
$__________________
Property tax/lot rent/condo fee
$__________________
Laundry machine/dry cleaning
$__________________
Heating
$__________________
Grooming/toiletries
$__________________
(oil/wood/gas)
Telephone/cell phone
$__________________
Clothing
$__________________
Cable/satellite/internet
$__________________
Other _________________
$__________________
Electricity
$__________________
Transportation Expenses:
Water
$__________________
Car loan/lease payment
$__________________
Personal Expenses:
Repair/maintenance/gas
$__________________
Smoking/alcohol
$__________________
Public transportation/parking
$__________________
Insurance Expenses:
Dining out/lunches
$__________________
Entertainment/sports
$__________________
Vehicle
$__________________
Spending money
$__________________
House/tenants/contents
$__________________
Gifts/charitable donations
$__________________
Life
$__________________
Child education/allowance
$__________________
Payments:
Pets
$__________________
To the trustee
$__________________
Non-Recoverable Medical Expenses:
To secured creditor
$_________________
)
(Other than mortgage or vehicle
Prescriptions/dental
$__________________
TOTAL MONTHLY DISCRETIONARY EXPENSES
$_______________(C)
Difference (= A – B - C)
$__________________
Contact information:
Toll Free in Nova Scotia: 902-310-6060
Fax forms to: 902-453-9257
MONTHLY STATEMENT OF INCOME AND EXPENSES FOR THE FAMILY UNIT
NET MONTHLY INCOME
Mine
Spouse/Partner
Net employment income
$_______________
$_______________
(take home)
Self-employment income
$_______________
$_______________
Pensions/ annuities
$_______________
$_______________
Disability benefits/ WCB
$_______________
$_______________
Spousal or child support
$_______________
$_______________
Child tax benefits
$_______________
$_______________
Employment insurance benefits
$_______________
$_______________
Social assistance
$_______________
$_______________
+
Total monthly income
$_______________
$_______________ = $_______________(A)
NON-DISCRETIONARY EXPENSES
Spousal or child support payments
$_______________
$_______________
Childcare/ preschool/ daycare
$_______________
$_______________
Heath-related
$_______________
$_______________
Employment related
$_______________
$_______________
+
Subtotal
$_______________
$_______________ = $________________(B)
MONTHLY DISCRETIONARY EXPENSES
(Family unit)
Household Expenses:
Living Expenses:
Rent/mortgage/board
$__________________
Food/grocery
$__________________
Property tax/lot rent/condo fee
$__________________
Laundry machine/dry cleaning
$__________________
Heating
$__________________
Grooming/toiletries
$__________________
(oil/wood/gas)
Telephone/cell phone
$__________________
Clothing
$__________________
Cable/satellite/internet
$__________________
Other _________________
$__________________
Electricity
$__________________
Transportation Expenses:
Water
$__________________
Car loan/lease payment
$__________________
Personal Expenses:
Repair/maintenance/gas
$__________________
Smoking/alcohol
$__________________
Public transportation/parking
$__________________
Insurance Expenses:
Dining out/lunches
$__________________
Entertainment/sports
$__________________
Vehicle
$__________________
Spending money
$__________________
House/tenants/contents
$__________________
Gifts/charitable donations
$__________________
Life
$__________________
Child education/allowance
$__________________
Payments:
Pets
$__________________
To the trustee
$__________________
Non-Recoverable Medical Expenses:
To secured creditor
$_________________
)
(Other than mortgage or vehicle
Prescriptions/dental
$__________________
TOTAL MONTHLY DISCRETIONARY EXPENSES
$_______________(C)
Difference (= A – B - C)
$__________________