Income and expenditure form

Income and expenditure form
Name:___________________________________Telephone number:____________ Address:_____________________________________________________________ ____________________________________________________________________ No of people in property:________No. of children:__________Ages:_____________
Net weekly/monthly wages		weekly/monthly expenditure
Average wages	£________	Mortgage/rent	£________
Average wages	£________	Secured loan	£________
Maintenance	£________	Endowment/life ins	£________
Other income	£________	Buildings/contents ins	£________
Total 1	£________	Water charges	£________
		Gas	£________
Benefits	£________	Electricity	£________
Child Benefits		Council tax	£________
Family Credit	£________	TV licence/rental	£________
Income support	£________	Telephone	£________
Other benefits (state)	£________	Fines	£________
	£________	Housekeeping	£________
	£________	Cigarettes/alcohol	£________
	£________	Prescriptions/dentist	£________
	£________	Clothing	£________
Total 2	£________	Child care	£________
Total Income: A		Maintenance	£________
1+2	£________	Meals at work/school	£________
		Public transport	£________
Priority arrears payment		Car insurance	£________
		Road tax	£________
Mortgage/rent	£________	Petrol/repairs	£________
Secured loan	£________	Hire purchase	£________
Endowment/life ins	£________	Other (please state)	£________
Buildings/contents ins	£________		£________
Electricity	£________		£________
Gas	£________		£________
Water charges	£________	Total B	£________
Council tax	£________
Fines	£________
Hire purchase	£________	Total income: A	£________
Telephone	£________	minus
Total C	£________	Total expenditure: B+C	£________
		=	£________
		Available income for creditors	£________

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