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Household Budget Worksheet
List all current, regular gross income for the borrower and any co-borrower
Income
Borrower
Co-Borrower
Monthly pay (before taxes)
Part-time or seasonal income
Dividends/interest earnings
Business or investment earnings
Pension/Social Security benefits
Unemployment compensation
Public assistance
Alimony or child support received
Other income
Total Monthly Income
Expenses: Housing
Mortgage or rent
Real estate property tax
Personal property tax
Homeowner’s or renter’s insurance
Homeowner’s association or condo fees
Total Housing Expenses
List all current expenses. Determine the monthly average for quarterly and annual expenses.
Expenses: Utilities
Electric
Gas/heating oil
Water/sewage
Telephone
Trash collection
Cable TV
Internet provider
Cell phone
Total Utilities
Expenses: Health/Medical
Life insurance
Medical insurance
Dental insurance
Doctor/lab
Dentist/Orthodontist
Therapist
Eyeglasses/ophthalmologist
Hospital/emergency
Medicines
Other
Total Health/Medical
Expenses: Transportation
Car payments
Car Insurance
Car maintenance/repair
Mass transit costs
Gas
Parking/tolls
Tags/inspection
Total Transportation Expenses
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