PRUDENTIAL FINANCIAL PLANNING SERVICES
INCOME AND EXPENSE WORKSHEET
Monthly / Annual(or indicate other mode of payment)
INCOME (Part A)
Employment Income
Salary/Wages
Self Employment (Actual)
Self Employment (Taxable)
Other Income
Taxable Pensions
Social Security Benefits
Other Taxable
Other Non-Taxable
TOTAL - Part A
TAXES (Part B)
Federal Income Taxes
State/Local Income Taxes
Property Taxes
Medicare/Social Security
Other
TOTAL - Part B
BASIC EXPENSES (Part C)
Housing
Rent
Gas/Oil
Electric
Telephone / Cellular
Water / Sewer
HOA Dues
Maintenance
Cable/Satellite TV
Lawn & Pool
Major Improvements
Transportation
Lease payment
Maintenance and Repairs
Gas
Commuting fees/tolls
Food
Groceries
Lunches
Clothing
Basic Apparel
Uniforms/Children Clothes
Dry Cleaning/Laundering
Medical/dental expenses
Co-Payments/Deductibles
Dental/Orthodontics
Prescriptions
Other Basic Expenses
Grooming/Salon
Child Care
Pet Care
School Supplies
Alimony/Child Support
Insurance
Automobile
Homeowners
Life
Disability Income
Health
Umbrella
Boat
TOTAL - Part C
DISCRETIONARY LIFESTYLE (Part D)
Charitable Contributions
Gifts
Entertainment/Dining
Recreation/Travel
Club Dues
Hobbies
Other
Funding for Long Term Objectives
College Education
Client - Retirement Plans
Spouse - Retirement Plans
Other Retirement (IRA’s)
Other
Short-Term Objectives
Emergency Fund
Vacations
Special Occasions (Weddings, Batmitsva, etc.)
Gifting Programs
TOTAL - Part D
Financial planning and investment advisory services offered through Prudential Financial Planning Services, a division of Pruco Securities, LLC.
0215846-00003-00
PRUDENTIAL FINANCIAL PLANNING SERVICES
INCOME AND EXPENSE WORKSHEET
Financial planning and investment advisory services offered through Prudential Financial Planning Services, a division of Pruco Securities, LLC.
0215846-00003-00
PRUDENTIAL FINANCIAL PLANNING SERVICES
INCOME AND EXPENSE WORKSHEET
CURRENT OBLIGATIONS (Part E)Short-Term Obligations / Creditor / Amount / Interest Rate / Current Monthly Payment / Owner
Consumer Credit / VISA
Mastercard
AMEX
Discover
Other
Installment Loans
Personal Loans
Long-Term Obligations
Mortgage 1
Mortgage 2
Home Equity
Vehicle 1
Vehicle 2
Investment Loans
Business Loans
Other Obligations
TOTAL - Part E
INCOME / TOTAL Part A
minus / EXPENSES / TOTAL Part B
TOTAL Part C
TOTAL Part D
TOTAL Part E
equals / EXCESS DISCRETIONARY INCOME
Excess Discretionary Income Willing to Save
Notes:
Financial planning and investment advisory services offered through Prudential Financial Planning Services, a division of Pruco Securities, LLC.
0215846-00003-00
PRUDENTIAL FINANCIAL PLANNING SERVICES
INCOME AND EXPENSE WORKSHEET
PRUDENTIAL FINANCIAL PLANNERS
INCOME AND EXPENSE WORKSHEET INSTRUCTIONS
Use this form to record annual cash income and expenditures for the last year. We use this information in combination with your expenditures to analyze current spending patterns. When totaling Parts A through E, remember to multiply monthly payments by 12.
Employment Income
Salary/Wages
Enter your total gross taxable wages and salaries. Include the amount of any salary reduction contributions in this amount (i.e., DO NOT reduce the total by any contributions).
Self-employment (Actual Cash)
Enter the actual money received from self-employment.
Self-employment (Taxable Amount)
Enter the amount as shown on IRS Form 1040, schedule C as Business Income. This amount could be the same as Self-employment (Actual Cash).
Other Income
Taxable Pensions
Enter the fully taxable pensions and taxable portions of other pensions.
Social Security
Enter the total annual social security benefits received.
Other Taxable Income
Enter other taxable income such as lottery winnings and other gains (IRS Form 4797).
Other Non-Taxable Income
Enter other non-taxable income. Include the portions of pensions not subject to tax. Do not enter any non-taxable interest or dividends here.
Taxes
Enter amounts as shown on IRS Form 1040.
Housing
Enter costs, of items listed (as well as any additional items), associated with running the residence.
Transportation
Enter costs, of items listed (as well as any additional items), associated with transportation needs.
Food
Enter food costs. Don’t forget lunches and dining out.
Clothing
Self Explanatory
Medical/Dental Expenses
Enter un-reimbursed medical expenses.
Other Basic Expenses
Enter items listed and/or additional basic expenses.
Insurance
Enter all payments towards insurance coverage(s).
Discretionary Lifestyle
Enter items listed and/or additional discretionary expenses
Funding for Long-Term Objectives
Enter the amount that you are currently setting aside each year for objectives listed and/or additional long-term objectives.
Short-Term Objectives
Enter the amount that you are currently setting aside this year for objectives listed and/or additional short-term objectives.
Short-Term Obligations
Enter all payments towards short-term obligations.
Long-Term Obligations
Enter all payments towards long-term obligations.