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            Financial Survey
This form helps you calculate what you are actually spending.  In other words, where all your money is really going.

Housing                                                                    Miscellaneous
Mortgage/rent                                                                Toiletries
Property taxes                                                               Office supplies/postage
Property insurance                                                         Dish & laundry supplies
Electricity                                                                       Personal hygiene products
Cable TV                                                                       Habits (smoking, drinking, etc.)
Internet access 
Heat/gas                                                                         Insurance (other than auto, home, health)
Water                                                                             Life
Sewer/septic                                                                   Disability
Wired phone                                                                   Umbrella liability
Cell phone                                                                      Others
House-related professional services
                                                                    Child Care/ Adult or Child Education

Transportation                                                         Fees
Car payments                                                                 Tutoring
Gasoline                                                                         Babysitting / child care
Oil changes
License fees                                                                    Charitable Giving
Car insurance                                                                  Church
Taxes                                                                              Tithe
Repairs                                                                           Charitable organizations
Groceries                                                                          Debt Payments
Snacks (at home or away)                                                 Credit cards
Animal/pet feed                                                                 Student loans
                                                                                         Equity loans
Entertainment                                                             Cash advance
Eating out                                                                          Bank loans
Videos/movies                                                                   Friends/family loans
Vacations                                                                          Store loans
Outings/field trips                                                               Delinquent taxes
Sports                                                                               Others
Gift-giving (including Christmas,birthdays,etc.)                   Income
Hobbies                                                                            Total household take-home pay
                                                                                         Income from side jobs
Clothing                                                                        Income from hobbies
New clothing                                                       Other income
Specialty clothing (sports, costumes, etc.)

Medical insurance/co-pay
Medical supplies
Eye care
Veterinary bills

Work in pencil in order to make corrections and revisions easier.  It will probably take you between one and two hours to complete this form.  Next to each item in this list, write down how much you spend for that item per month.  Be honest and write in how much you are actually spending, not how much you think you should or how much you wish to in the Future.  If an item is not a monthly expense, then divide it by how many months it covers to convert it to a monthly amount.  For example, if you pay a life insurance premium every six months, then divide it by six to get the a mount per month.  Any items that don't apply to you or that you don't spend any money on, write in zero.  Write in any items you spend money on which are not already on this form, under the category that makes the most sense for that expense.  Under the 'Income' category, write down all income, then covert it to income per month.  Use actual take-home pay for the 'Income' category.  In other words, use your net not your gross income.  If you're not sure how to convert your income to a monthly amount, then read the article You Need A Plan.  Once you have written in all of the monthly amounts for each item, add up all of the items under each category and write the total for that category next to the category name.  As you write in each category total, circle it so it won't become confused with the other amounts written on the form.  For example. Under the food category, you would add up all the money you spend per month on groceries plus all the money you spend on animal/pet feed plus all the money you spend on snacks.  You would write this total next to where it says 'Food' and circle that total.  Do the same for all categories.

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