Estimate of Family Resources and Expenses
Survivor's salary
__________
Interest
__________
Dividends
__________
Rent received
__________
Annuity income
__________
Benefits
__________
Social Security
__________
Veterans
__________
Life insurance
__________
Pension
__________
Trust income
__________
Investment income
__________
Other income
__________
SUBTOTALS
TOTAL $
__________
Housing
__________
Rent
__________
Mortgage
__________
Utilities
__________
Other
__________
Food
__________
Home
__________
Away
__________
Clothing/upkeep
__________
Transportation
__________
Education
__________
Entertainment and recreation
__________
Medical and dental expenses
__________
Child care expenses
__________
Insurance premiums
__________
Life
__________
Health
__________
Disability
__________
Auto
__________
Other
__________
Payments
__________
Loan
__________
Installment
__________
Taxes
__________
Local
__________
State
__________
Property
__________
Income
__________
Other
__________
SUBTOTALS
TOTAL $
__________
TOTAL INCOME $
__________
TOTAL EXPENSES $
__________
You should now have a better grasp of your
income, assets, expenses and liabilities. This will help you determine the
financial resources available to your family and the amount of income that
would be needed in the event of the policyholder's death. You should adjust
these figures periodically to take into account changes in family
circumstances, new living arrangements, inflation and other variables.