Prepared by:			Date Originally Prepared:
ITEM	PAID TO:	MONTHLY AMT.	PROPOSED AMT.	HOW	SAVINGS
Housing Costs
Mortgage or Rent
2nd Mortgage
Electric
Phone
Water/Sewer
Fuel gas or oil
Trash removal
Cable
Supplies
Maintenance/repairs
Other:___________________
Automobile(s)
Payment 1
Payment 2
Insurance
Gas/oil
Maintenance
Licensing
Other:______________
Insurance
Homeowners'
Auto
Life
Health
Disability
Other:______________
Total, this page