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Payment Student Loan Payment (Monthly) Other Loan Payments (Monthly) Clothing Cigarettes Cable Other (Specify): Child Support Payments Legal Payments/Fines Savings Total Monthly Expenses AVERAGE MONTHLY INCOME SOURCE AMOUNT Wages/Salary (after taxes) Food Stamps Housing Subsidy Grant Amount Childcare Subsidy Child Support Received Other Income Total Monthly Income AVERAGE MONTHLY BUDGET Total Income Total Expenses Monthly Balance Large Debt Totals (example: credit card balances, car loans, back child support, tickets and fines, other loans, etc.) 1..