HTML Preview Blank Budget page number 1.
Name: AER Client
ID:
1
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IT
E
M
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Army
Emergency
Relie
f
(AER)
Budget
Sheet
For use of this form see the AER Section Reference Manual
3
4
DEDUCTIONS
(INCLUDED
IN
GROSS
ENTITLEMENTS
)
Federal Income Tax
Social Security (FICA)
Medicare
AMOUNT
2
FIXED MONTHLY
EXPENDITURES
AMOUNT
Food
Rent/Mortgage
Utilities (Electricity/Water/Sewer/Gas)
Phone/Internet/Cable
Cell Phone
Dental Plan
IT
E
M
Insurance (SGLI/TSGLI/FSGLI)
State Income Tax
(block
6
)
TOTAL
MONTHLY ENTITILEMENTS
1l
2l
(block
5
)
Military/Retired Pay
BAS
BAH
BASE MONTHLY
ENTITLEMENTS
Special Duty Pay
Survivor Income
O
t
h
e
r
O
O
t
h
e
r
O
Other
Other
Other
k
l
Total Indebtedness from block 3f
TOTAL
MONTHLY
EXPENDITURES
(
Comp
l
ete blocks 1 through 8 ensuring block 8 reflects a balance.
Spouse Income
Other
Other
Other
Other
TOTAL
MONTHLY
ENTITLEMENTS
(amount
from
Box
1
l)
TOTAL
MONTHLY
EXPENDITURES
(amount
from
Box
2l)
TOTAL
DEDUCTIONS
(amount
from
Box
4m)
BALANCE:
+
OR
(-)
TOTAL
MONTHLY
PAYMENTS
TOTAL
DUE
AER
FORM
57R, dated 14 July 2015 (Local
Reproduction
Authorized). Previous
editions
of
this
form
are
obsolete.
Other
Other
Other
Other
NOTE: A Soldier’s monthly surplus does not automatically dictate rendering a decision to provide a loan. Full or
Partial grants should be considered in every case.
TSP
Other
Other Allotment 1
Other Allotment 2
Other Allotment 3
Other Allotment 4
TOTAL DEDUCTIONS
ORIGINAL
AMOUNT
CREDITOR
Other
AMOUNT AMOUNT
MONTHLY
AMOUNT
BALANCE
DUE
DATE
VERIFIED
PURPOSE
DATE
INCURRED
DATE
LAST PYMT
IN
DEB
T
ED
N
E
SS
(Transfer amount of monthly payments from block 3f to block 2l)
$0.00
$0.00
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