Spreadsheet: 0b106858-f810-4a98-959f-8ed217704ea5
Sheet: Pers Expense Wksht

 |  | PERSONAL EXPENSE WORKSHEET: NECESSITIES |  |  |  |  |  |  |  |  |  |  |  |  |  | TOTAL AMOUNT I PAY DIRECTLY FOR MYSELF | TOTAL AMOUNT I PAY DIRECTLY FOR THE OTHER PARTY |  |  |  | TOTAL PAID DIRECTLY BY THE OTHER PARTY FOR ME
1 |  | DO NOT REPORT ANY CHILD-RELATED EXPENSES ON THIS PAGE.  A SEPARATE PAGE FOR CHILD-RELATED EXPENSES IS ATTACHED.
 | 1 | I own my home |  |  | rent / lease my home |  |  | share a home or apartment with someone else
 |  |  | I pay a monthly mortgage/rent/lease payment (for the home I live in and/or home the other party lives in) in the amount of
 |  |  | I pay a monthly second mortgage (for the home I live in and/or home the other party lives in) in the amount of
 |  |  | I pay a monthly Home Equity Line of Credit ("HELOC") (for the home I live in and/or home other party lives in) in the amount of
 |  | * | If not included in my mortgage payment(s), I pay property taxes (for the home I live in and/or home the other party lives in)  in the amount of
 |  | * | If not included in my mortgage/rent payment(s), I pay a monthly home owners/renters insurance premium (for the home I live in and/or home the other party lives in) in the amount of
 |  |  | I pay monthly Home Owner's Association dues (for the home I live in and/or the home the other party lives in) in the amount of
 |  | * | I pay a Special Assessment Fee (for the home I live in and/or the home the other party lives in) in the amount of
 | 2 | I pay the following utilities and telephone expenses (for the home I live in and/or the home the other party lives in) each month:
 |  |  | Gas/Heating Oil
 |  |  | Electricity
 |  |  | Water
 |  | * | Garbage and sewer
 |  |  | [NAME] (if part of a "bundled" service, indicate the total amount here)
 |  |  | Cellular service (if not included in the Landline/bundled service above)
 |  |  | Internet service (if not included in the landline/bundled service above)
 | 3 | I spend the following each month for healthcare related expenses for myself and/or the other party (Not paid from a Health Savings Plan):
 |  |  | Medical insurance (including hospitalization, dental, vision, etc.) for myself and/or the other party (Not already deducted from my paycheck)
 |  |  | Out-of-pocket/unreimbursed cost of medical, dental, optical, and prescription expenses for myself and/or other party
 |  |  | Out-of-pocket/unreimbursed cost of therapy or counseling (for myself and/or other party)
 | 4 | I spend the following for groceries, household goods and incidentals, not including entertainment or dining out, each month:
 | 5 | I/we own or lease |  | _______ | my car. |  | I/we own or lease |  | _______ | the other party's car.
 |  |  | ADDITIONAL VEHICLES SHOULD BE LISTED ON THE SUPPLEMENT PAGE
 |  |  | Monthly loan / lease payment (for my car and/or the other party's car)
 |  |  | Gasoline and oil (for my car and/or the other party's car)
 |  |  | Automobile Insurance (if you have policy covering more than one car, separate the amount for your car and/or for other party's car)
 |  |  | Parking, public transportation, other
 | 6 | I pay the following monthly mandatory amounts for the support of others:
 |  |  | Court-ordered child support (if paid to the other party in this case for a child of this relationship, include amount in the "Total Amount I Pay Directly For The Other Party" (middle) column. If for a child of another relationship, include amount in the "Total Amount I Pay Directly For Myself" (left) column)
 |  |  | Court-ordered spousal support (if paid to the other party in this case, include amount in the "Total Amount I Pay Directly For The Other Party (middle) column. If paid to someone else from a prior relationship, include amount in the "Total Amount I pay Directly For Myself" (left) column)
 | 7 | I spend the following each month on education, uniforms, dues, memberships, subscriptions, or other mandatory requirements to maintain employment. I DO NOT receive reimbursement from the employer for any of these expenses
9 |  | TOTAL NECESSITIES:
 |  | * Divide by 3 if paid quarterly; Divide by 6 if paid semi-annually; Divide by 12 if paid annually
 | USE THE SPACE BELOW FOR ANY NOTES/COMMENTS/EXPLANATION YOU WISH TO PROVIDE REGARDING YOUR NECESSITIES