Social How you rate your credit? [ ] Excellent [ ] Good [ ] Fair [ ] Poor [ ] Unsure Notes: MONTHLY BUDGETING WORKSHEET DATE:_______________ Monthly Amount Comments INCOME Wages (Take home) Wages (Take home) TANF Food Stamps Child Support SSI Other Monthly Amt. Comments EXPENSES Mortgage/Rent/Lot Rent Insurance (Renters/Home Owners) Electric Fuel Oil/Gas Qtly______ ___Month(s) ____ Qtly______ ___Month(s) ____ 35% Housing Telephone Cell Phone/Pager Sub-total: Car Payments Weekly Biweekly Monthly Car Insurance Qtly______ ___Month(s) ____ Maintenance (Gas/Oil) 20% Public Transportation Transport. Sub-total: Credit Card – Furniture Bill Other Loans/Fines/Child Support – Other 15% Debts Sub-total: Groceries FS Grant Amt:______ Extra:______
Social How you rate your credit? [ ] Excellent [ ] Good [ ] Fair [ ] Poor [ ] Unsure Notes: MONTHLY BUDGETING WORKSHEET DATE:_______________ INCOME Monthly Amount Comments Wages (Take home) Wages (Take home) TANF Food Stamps Child Support SSI Other EXPENSES Monthly Amt. Comments Housing 35% Mortgage/Rent/Lot Rent Insurance (Renters/Home Owners) Electric Fuel Oil/Gas Qtly______ ___Month(s) ____ Qtly______ ___Month(s) ____ Telephone Cell Phone/Pager Sub-total: Transport. 20% Car Payments Weekly Biweekly Monthly Car Insurance Qtly______ ___Month(s) ____ Maintenance (Gas/Oil) Public Transportation Sub-total: Other Debts – 15% Credit Card Furniture Bill Other – Loans/Fines/Child Support Sub-total: Groceries FS Grant Amt:______ Extra:______
ISS-Form.docx