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CASH FLOW STATEMENT PER16 INCOMELAST YEARTHIS YEAR NEXT YEARHusband's gross wages or salary ______ ______ ______ ______ ______ ______Wife's gross wages or salary ______ ______ ______ ______ ______ ______Dividends and interest ______ ______ ______ ______ ______ ______Child support/alimony ______ ______ ______ ______ ______ ______Annuities, pension, ______ ______ ______ ______ ______ ______Social Security ____________ ____________ ____________Rents, royalties, fees ______ ______ ______ ______ ______ ______ Notes receivable ______ ______ ______ ______ ______ ______TOTAL INCOME $ ____________ ______ ______ ______ ______TAXES Federal income tax ____________ ____________ ____________State, City income tax ______ ______ ______ ______ ______ ______Social Security ______ ______ ______ ______ ______ ______Property taxes ______ ______ ______ ______ ______ ______ TOTAL TAXES $_____ _______ ______ ______ ______ ______LIVING EXPENSESRent or mortgage payments ______ ______ ______ ______ ______ ______Food ______ ______ ______ ______ ______ ______Clothing ______ ______ ______ ______ ______ ______Utilities ______ ______ ______ ______ ______ ______Home maintenance and improvement ____________ ____________ ____________Automobile, transportation____________ ____________ ____________ Meals out ______ ______ ______ ______ ______ ______Recreation, entertainment, vacations____________ ____________ ____________Furniture and other durable goods____________ ____________ ____________Medical (unreimbursed by insurance)____________ ____________ ____________Charge card payments ____________ ____________ ____________Education, day care ____________ ____________ ____________Auto insurance premiums ______ ______ ______ ______ ______ ______Life insurance premiums ____________ ____________ ____________Health insurance premiums ______ ______ ______ ______ ______ ______Legal fees ____________ ____________ ____________Loan payments____________ ____________ ____________Other________________________________________________ ____________ ____________TOTAL LIVING EXPENSES $_____ _______ ______ ______ ______ ______FUNDS AVAILABLEFor Savings & Investments ____________ ____________ ____________

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