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CASH FLOW ANALYSIS MONTHLY INCOME AND EXPENSES Gross Salary & Earned Income _________________ Spouse/Partner Gross Income _________________ Social Security _________________ Spouse/Partner Social Security _________________ Pension _________________ Spouse/Partner Pension _________________ Rental Income _________________ Other Income _________________ TOTAL GROSS INCOME _________________ Mortgage Payment or Rent _________________ Residence Real Estate Taxes _________________ Second Home Mortgage _________________ Second Home Taxes _________________ Automobile Loan(s) _________________ Personal Loans/Credit Cards _________________ Child Support & Alimony _________________ Other Loans _________________ TOTAL LIABILITIES _________________ Federal Income Taxes _________________ State & Intangible Taxes _________________ Local & Property Taxes _________________ Other taxes _________________ Other taxes _________________ TOTAL TAXES _________________ FICA & Medicare - Client _________________ FICA & Medicare - Spouse _________________ TOTAL FICA AND MEDICARE _________________ Life Insurance _________________ Health Insurance _________________ Disability Income Insurance _________________ Auto Insurance _________________ Home Owners Insurance _________________ Other Insurance _________________ TOTAL INSURANCE _________________ Gasoline _________________ Car Maintenance and Repair _________________ License _________________ Public Transportation _________________ Parking _________________ Other Transportation _________________ Other _________________ TOTAL TRANSPORTATION _________________ Monthly Investments ? ________________ Payroll Deduct./Qualified Plans ________________ Adding to Credit Union? ________________ Adding to Mutual Funds? ________________ Adding to Stocks and Bonds? ________________ Adding to Real Estate? ________________ Adding to Annuities? ________________ Adding to Certificates of Deposit? ________________ IRA & Roth Contributions? ________________ Other Monthly Investments? ________________ Other ________________ Other ________________ Other TOTAL MONTHLY SAVINGS ________________ & INVESTMENT Religious Contributions ________________ Charitable Contributions ________________ TOTAL CONTRIBUTIONS ________________ Food ________________ Clothing ________________ Doctor & Dentist ________________ Prescription Drugs ________________ Professional Fees ________________ Education Expenses ________________ Day Care ________________ Personal Care ________________ Electricity, Gas, Oil ________________ Telephone ________________ Water & Sewer ________________ Garbage and Pest Control ________________ Home Maintenance & Repair ________________ Pool Maintenance & Repair ________________ Veterinarian & Pet Care ________________ Vacation and Travel ________________ Recreation, Entertain, Hobbies ________________ Veterinarian & Pet Care ________________ Club Dues ________________ Gifts ________________ Other expenses ________________ Other expenses ________________ Other expenses ________________ Other expenses ________________ Other expenses ________________ Other expenses ________________ Other expenses ________________ HOUSEHOLD EXPENSES ________________ TOTAL INCOME _____________________________________ TOTAL EXPENSES _____________________________________ DISCRETIONARY INCOME _____________________________________ 1314 East Venice Avenue, Suite A // Venice, FL 34285 // T: 941.412.1400 // T: 800.635.5870 // F: 941.412.1300

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Page 1: CASH FLOW ANALYSIS MONTHLY INCOME AND EXPENSES · CASH FLOW ANALYSIS MONTHLY INCOME AND EXPENSES ... Adding to Mutual Funds? _____ Adding ... Garbage and Pest Control _____ Home

CASH FLOW ANALYSIS MONTHLY INCOME AND EXPENSES

Gross Salary & Earned Income _________________Spouse/Partner Gross Income _________________Social Security _________________Spouse/Partner Social Security _________________Pension _________________Spouse/Partner Pension _________________Rental Income _________________Other Income _________________TOTAL GROSS INCOME _________________

Mortgage Payment or Rent _________________Residence Real Estate Taxes _________________Second Home Mortgage _________________Second Home Taxes _________________Automobile Loan(s) _________________Personal Loans/Credit Cards _________________Child Support & Alimony _________________Other Loans _________________TOTAL LIABILITIES _________________

Federal Income Taxes _________________State & Intangible Taxes _________________Local & Property Taxes _________________Other taxes _________________Other taxes _________________TOTAL TAXES _________________

FICA & Medicare - Client _________________FICA & Medicare - Spouse _________________TOTAL FICA AND MEDICARE _________________

Life Insurance _________________Health Insurance _________________Disability Income Insurance _________________Auto Insurance _________________Home Owners Insurance _________________Other Insurance _________________TOTAL INSURANCE _________________

Gasoline _________________Car Maintenance and Repair _________________License _________________Public Transportation _________________Parking _________________Other Transportation _________________Other _________________TOTAL TRANSPORTATION _________________

Monthly Investments ? ________________Payroll Deduct./Qualified Plans ________________Adding to Credit Union? ________________Adding to Mutual Funds? ________________Adding to Stocks and Bonds? ________________Adding to Real Estate? ________________Adding to Annuities? ________________Adding to Certificates of Deposit? ________________IRA & Roth Contributions? ________________Other Monthly Investments? ________________Other ________________Other ________________OtherTOTAL MONTHLY SAVINGS ________________ & INVESTMENT

Religious Contributions ________________Charitable Contributions ________________TOTAL CONTRIBUTIONS ________________

Food ________________Clothing ________________Doctor & Dentist ________________Prescription Drugs ________________Professional Fees ________________Education Expenses ________________Day Care ________________Personal Care ________________Electricity, Gas, Oil ________________Telephone ________________Water & Sewer ________________Garbage and Pest Control ________________Home Maintenance & Repair ________________Pool Maintenance & Repair ________________Veterinarian & Pet Care ________________Vacation and Travel ________________Recreation, Entertain, Hobbies ________________Veterinarian & Pet Care ________________Club Dues ________________Gifts ________________Other expenses ________________Other expenses ________________Other expenses ________________Other expenses ________________Other expenses ________________Other expenses ________________Other expenses ________________HOUSEHOLD EXPENSES ________________

TOTAL INCOME _____________________________________

TOTAL EXPENSES _____________________________________

DISCRETIONARY INCOME _____________________________________

1314 East Venice Avenue, Suite A // Venice, FL 34285 // T: 941.412.1400 // T: 800.635.5870 // F: 941.412.1300

Page 2: CASH FLOW ANALYSIS MONTHLY INCOME AND EXPENSES · CASH FLOW ANALYSIS MONTHLY INCOME AND EXPENSES ... Adding to Mutual Funds? _____ Adding ... Garbage and Pest Control _____ Home

Checking Account 1Checking Account 2 Savings Account 1Savings Account 2College Savings Plans401(k)401(k) partnerIRA 1IRA 2Roth IRA 1Roth IRA 2Annuity 1Annuity 2VehiclesPrimary ResidenceOther Assets

TOTAL GROSS ASSETS

Mortgage on Primary Residence2nd MortgagePersonal LoansAutomobile Loan(s)Credit Cards OutstandingOther Loans

TOTAL LIABILITIES

Value

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Balance?

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Owner

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Int. Rate

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Location

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Years Remaining

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BALANCE SHEETASSETS AND LIABILITES

1314 East Venice Avenue, Suite A // Venice, FL 34285 // T: 941.412.1400 // T: 800.635.5870 // F: 941.412.1300

Life Insurance 1Life Insurance 2Disability Ins?Long Term Care

RISK MANAGEMENTDo you have an “Umbrella” Policy?Do you have a Home Equity Credit Line?

Benefiting Others / LegacyDo you provide financial support to family or others? Do you regularly donate money to church & non-profits? Do you wish to leave a legacy upon your death?

Estate Planning IssuesDo you have a current will / Personal Rep? Durable Power of Attorney, Medical Directive, Living Will? Revocable Living Trust? Business Succession Plan?

Ins.Company

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Face Value

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Yes

––––––––––––––––––––––––––––––––

Yes

––––––––––––––––––––––––––––––––––––––––––––––––

Yes

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Cash Value

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How Much

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How Much

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Who

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Annual Premium

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No

––––––––––––––––––––––––––––––––

No

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No

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