Basic HTML Version
YOUR INCOME
Salary, Husband
Payroll Deductions
lnsurance
Salary , Wife
Taxes
lite
Social Security
Health
lnterest lncome
Company lnsur.
Homeowners
1
Dividend lncome
Other Deduct.
Renters
Automobi le
Social Security or
Contributions
.
Disability lncome
Housing
Clothing
Proceeds from Sale
Mortgage
1
Rent
Medical
1
Dental
of Assets
Utilities
Discretionary
Other lncome
Fu~nishings
Funds
Vacation / Travel
(Rental Fees, etc.)
Upkeep
Recreation
Other
Gifts
Education
Food
Savings
Withd rawals from
Savings
Transportation
Gitts
Fuel
Personal
TOTAL INCOME
Maintenance
Allowances
..
Public Trans.
Other
Car Payment
TOTAL OUTGO
.
'
NET WORTH STATEMENT
ASSETS
Securities
Charge Accounts
Stocks
Credit Card
Real Estate
Bonds
Payments
Home
Government
lnsurance
Other Properties
Securities
Premiums
Mutual Funds
Other
Personal Property
Automobiles
Gold
1
Silver
Taxes
Household
Cash
Federal Tax Due
Furnishings
Cash on Hand
State Tax Due
Painting & Art
Checking Account
LocaiTaxes
Furs
Balance
Property Tax
Jewelry
Savings Account
Taxes on
Clothing
Money Market
lnvestments
Other
Funds
Other Taxes
..
Cash Value of Lite
Debts
Long Term Assets
lnsurance
Equity in a
Auto Loan
Business
TOTAL ASSETS
Education Loan
-
Lite lnsurance
Home lmprovement
Cash Va lue
LIABILITIES
Loan
Annuities
Other Personal
Real Estate
Loans
Pensions
Vested Portion of
Balance Owed on
TOTAL LIABILITIES
~
a Company Plan
Home Mortgage
~
Other Vested
Balance Owed on
Benefits
Other Property
TOTAL ASSETS
<4
..
IRA
Current Bilis
TOTAL LIABILITIES
Keogh
Current Month' s
Other Long Term
Mortgage
1
Rent
"'
NET WORTH
Assets
Utilities
.. • 1