MONTHLY INCOMEBenefit amount from current disability income policy $____________ Income from spouse $____________ Investment income $____________ Any other income $____________ Total Monthly Income Available $____________ MONTHLY EXPENSESMortgage or Rent $____________ Car Payments $____________ Utilities $____________ Food and Clothing $____________ Child Care Expenses $____________ Loans & Credit Card Payments $____________ Medical Expenses $____________ Insurance Premiums (Home, Auto, Life, Health) $____________ Savings, Investments, Retirement Contributions $ ____________ Other Expenses (Education, Entertainment, etc.) $____________ Total Monthly Expenses $____________ AnalysisTotal Monthly Income Available: $_______________
Minus Total Monthly Expenses: $________________ Equals Need for Additional Monthly Income Due to Disability: $________________ Comments are closed.
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