CHAPTER II: DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
PART 1075 SAVINGS BANK ACT
SECTION 1075.APPENDIX A ESTIMATED MONTHLY INCOME AND EXPENSES WORKSHEET
Section 1075.APPENDIX A Estimated Monthly Income and Expenses Worksheet
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ESTIMATED MONTHLY INCOME: |
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1. |
Paycheck (Net/"Take Home") |
$ |
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2. |
Interest/Dividends |
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3. |
Social Security/Pension |
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4. |
Alimony/Child Support |
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5. |
Other |
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6. |
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Total Estimated Monthly Income |
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$ |
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(Add Lines 1 through 5) |
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ESTIMATED MONTHLY EXPENSES: |
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7. |
Mortgages/Rent |
$ |
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8. |
Homeowner's/Renter's Insurance |
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9. |
Real Estate Taxes |
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10. |
Water & Sewer |
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11. |
House Repairs |
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12. |
Groceries |
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13. |
Telephone |
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14. |
Gas (House) |
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15. |
Electric |
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16. |
Credit Cards |
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17. |
Car Payments |
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18. |
Car Insurance |
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19. |
Licenses (Car) |
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20. |
Gas (Car) |
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21. |
Car Repairs/Maintenance |
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22. |
Clothing |
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23. |
Medical/Dental |
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24. |
Medical Insurance |
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25. |
Prescriptions |
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26. |
Loan Payments |
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(Not included in Line 2 or 17) |
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27. |
Tuition |
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28. |
Contribution |
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29. |
Cellular Telephone |
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30. |
Pager |
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31. |
Recreation/Vacation |
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32. |
Other Insurance (Life, etc.) |
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33. |
Income Taxes |
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34. |
Alimony/Child Support |
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35. |
Transportation |
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36. |
Miscellaneous |
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37. |
Other |
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38. |
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Total Estimated Monthly Expenses |
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$ |
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(Add Lines 7 through 37) |
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39. |
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*Excess/Deficit |
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$ |
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(Subtract Line 38 from Line 6) |
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*If Line 38 is greater than Line 6, your estimated monthly expenses exceed your estimated monthly income. |
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(Source: Added at 25 Ill. Reg. 6197, effective May 17, 2001)