Bankruptcy Attorney J. Charles Guilfoyle
812-206-1840
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Intake Form
Expense Report
Required Documents
Conduct To Avoid
FAQ
Contact
Expense Report
Please list all costs on a monthly basis
Name
First
Last
Rent
Rent or Mortgage
*
2nd Mortgage
Or Equity Line of Credit
Are real estate taxes included?
Yes
No
Vehicle
Vehicle Payment #1
Vehicle Payment #2
Utilities
Electricity & Heating Fuel
Water & Sewer
Garbage Pick Up
Land Line Telephone Costs
Cell Phone
Cable
Dish TV
Internet Services
Other Services
Home
Home Maintenance (repairs)
Food
Clothing
Laundry & Dry Cleaning
Medical & Dental Expenses
Transportation
Vehicle Maintenance
Recreation
Charitable Contribution
Insurance
Homeowner/Renters Insurance
Term Life Insurance
Whole Life Insurance
Health Insurance
Only If Not Taken From Pay
Dental Insurance
Only If Not Taken From Pay
Eye-care Insurance
Only If Not Taken From Pay
Automobile Insurance
Disability Insurance
Cancer Insurance
Other Insurance
Miscellaneous
Husband Prescriptions
Wife Prescriptions
Childcare Costs
School Cost for Minor Children
College Costs
401k Loan Payment Taken From Pay
Number Of Months Left to Repay 401K Loans
Real Estate Taxes
Vehicle Tags & Licensing Costs
Other Expenses
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