THE BREARLEY SCHOOL_x000D_Monthly Family Budget
            Brearley's SSS Code: 1795
            Student's Last Name                       First Name         Grade applying for:
            MONTHLY HOUSEHOLD BUDGET                                     Additional Information when applicable
            PART 1: MONTHLY INCOME
            TAXABLE INCOME
               Parent/Guardian 1: Salary/Wages        $
               Parent/Guardian 2: Salary/Wages        $
               Interest/Dividend Income               $
               Profit/Loss - Business                 $
               Rental Income                          $
               Alimony Received                       $
               Other Taxible Income ((describe)       $
            TOTAL TAXABLE INCOME                      $
            NON-TAXABLE INCOME
               Child support received                 $
               Social Security benefits               $
               Untaxed IRA/SEP                        $
                Gifts                                 $
               Other non-taxable income (descrbe) $
            TOTAL NON-TAXABLE INCOME                  $
                               TOTAL MONTHLY INCOME   $
            PART 2: MONTHLY EXPENSES 
                          (not including tuition)
            Main residence: Mortgage/Rent             $
            2nd Property: Mortgage/Rent               $
            Home insurance                            $
            Health Insurance                          $
            Non-reimbursed medical expenses           $
            Credit Cards                              $
            Life Insurance                            $
            Public Transportation                     $
            Car payments                              $
                                   THE BREARLEY SCHOOL_x000D_Monthly Family Budget
           Gas/tolls/parking/insurance           $
           Gas and electric                      $
           Internet and telephone                $
           Groceries                             $
           Clothing and personal grooming        $
           Monthly debt payments                 $
           Daycare/babysitting/eldercare         $
           ADDITIONAL MONTHLY EXPENSES           $
           Lessons (all children)                $
           Summer camp (all children)            $
           Vacations                             $
           Clubs                                 $
           Entertainment                         $
           Dining out                            $
           Charitable contributuons              $
           Other monthly expenses (describe)     $
           TOTAL MONTHLY EXPENSES                $
               THE BREARLEY SCHOOL_x000D_Monthly Family Budget
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