Personal Budget Form

I. Income Information

What is your primary source of income?

What is your gross monthly income from this source?

What is your net monthly income from this source (after taxes and other deductions)?

Do you have any secondary sources of income (e.g., part-time job, side hustle, investments), and what are they?

What are your secondary sources of income?

What is your gross monthly income from each secondary source?

What is your net monthly income from each secondary source?

Do you receive any other income (e.g., alimony, child support, government benefits, rental income), and what are they?

What are your other sources of income?

What is your monthly income from each other source?

II. Expenses

Housing:

Type of Payment:

Rent

Mortgage

Payment Amount:

Homeowner's/Renter's Insurance Amount:

Do you own your home?

Yes

Property Tax Amount:

Utilities:

	Item	Amount
	A	B
1	Electricity
2	Gas
3	Water
4	Trash
5	Internet
6	Phone
7
8
9
10
11
12	Total Utilities:	$0.00

Home Maintenance and Repairs:

	Item	Amount
	A	B
1	Home Maintenance (Supplies)
2	Home Repairs (Labor)
3	Home Repairs (Materials)
4
5
6
7
8
9	Total Maintenance and Repairs:	$0.00

Transportation:

Car Payment Amount:

Car Insurance Amount:

Gas/Fuel costs:

	Item	Amount
	A	B
1	Car 1 Fuel
2	Car 2 Fuel
3
4
5
6
7
8	Total Fuel:	$0.00

Public transportation costs:

	Item	Amount
	A	B
1	Bus
2	Train
3	Subway
4	Taxis
5	Ride-sharing
6
7
8
9
10
11	Total Public Transport:	$0.00

Parking fees:

	Item	Amount
	A	B
1	Meter Parking
2	Garage Parking
3	Parking Permits
4
5
6
7
8
9	Total Parking:	$0.00

Vehicle maintenance and repairs:

	Item	Amount
	A	B
1	Regular Maintenance
2	Repairs (Unexpected)
3	Parts/Supplies
4
5
6
7
8
9	Total Vehicle Maintenance and Repairs:	$0.00

Food:

Groceries costs:

	Item	Amount
	A	B
1	Produce
2	Meat
3	Seafood
4	Dairy
5	Pantry Items
6	Household Items
7
8
9
10
11
12	Total Groceries:	$0.00

Eating Out/Restaurants costs:

	Item	Amount
	A	B
1	Fast Food
2	Casual Dining
3	Fine Dining
4	Coffee
5	Snacks
6
7
8
9
10
11	Total Eating Out/Restaurants:	$0.00

Personal Care:

Haircuts/Salon services:

	Item	Amount
	A	B
1	Haircuts
2	Styling
3	Treatments
4	Coloring
5	Manicures
6	Pedicures
7	Other Salon Services
8
9
10
11
12
13	Total Haircuts/Salon Services:	$0.00

Toiletries and cosmetics costs:

	Item	Amount
	A	B
1	Toiletries (Soap, Shampoo, etc.)
2	Cosmetics (Makeup)
3	Skincare
4	Hair Care Products
5
6
7
8
9
10	Total Toiletries and Cosmetics:	$0.00

Other personal care expenses:

	Item	Amount
	A	B
1	Other Personal Care Item 1
2	Other Personal Care Item 2
3	Other Personal Care Item 3
4
5
6
7
8
9	Total Other Personal Care:	$0.00

Healthcare:

Health insurance premiums:

	Item	Amount
	A	B
1	Health Insurance (Individual)
2	Health Insurance (Family)
3	Health Insurance (Employer Portion)
4	Other Health Insurance
5
6
7
8
9
10	Total Health Insurance Premiums:	$0.00

Co-pays and deductibles:

	Item/Service	Date	Amount
	A	B	C
1	Doctor Visit
2	Prescription Co-pay
3
4
5
6
7
8	Total Co-pays and deductibles:		$0.00

Prescription medications:

	Medication Name	Date	Pharmacy	Amount
	A	B	C	D
1	Medication A
2	Medication B
3
4
5
6
7
8	Total Prescription Medications Costs:			$0.00

Other healthcare expenses:

	Item	Amount
	A	B
1	Other Healthcare Item 1
2	Other Healthcare Item 2
3	Other Healthcare Item 3
4
5
6
7
8
9	Total Other Healthcare:	$0.00

Debt Payments:

Card payments:

	Card Name	Amount
	A	B
1	Card Name 1
2	Card Name 2
3	Card Name 3
4
5
6
7
8
9	Total Card Payments:	$0.00

Student loan payments:

	Loan Name	Amount
	A	B
1	Loan Name 1
2	Loan Name 2
3	Loan Name 3
4
5
6
7
8
9	Total Student Loan Payments:	$0.00

Personal loan payments:

	Loan Name	Amount
	A	B
1	Loan Name 1
2	Loan Name 2
3	Loan Name 3
4
5
6
7
8
9	Total Personal Loan Payments:	$0.00

Other debt payments:

	Debt Name/Type	Amount
	A	B
1	Other Debt 1
2	Other Debt 2
3	Other Debt 3
4
5
6
7
8
9	Total Other Debt Payments:	$0.00

Savings and Investments:

Contributions to retirement accounts (e.g., 401k, IRA):

	Item	Amount
	A	B
1	401k Contributions
2	IRA Contributions
3	Other Retirement Contributions
4
5
6
7
8
9	Total Retirement Contributions:	$0.00

Contributions to other savings accounts:

	Item	Amount
	A	B
1	Emergency Fund Savings
2	Down Payment Savings
3	Vacation Fund Savings
4	Other Savings
5
6
7
8
9
10	Total Other Savings:	$0.00

Investment contributions:

	Item	Amount
	A	B
1	Brokerage Account Contributions
2	Mutual Fund Contributions
3	Real Estate Investments
4	Other Investment Contributions
5
6
7
8
9
10	Total Investment Contributions:	$0.00

Entertainment:

Streaming services:

	Item	Amount
	A	B
1	Netflix
2	Hulu
3	Disney+
4	Spotify
5	YouTube Premium
6	Other Streaming Services
7
8
9
10
11
12	Total Streaming Services:	$0.00

Movies, concerts, and events costs:

	Item	Amount
	A	B
1	Movies
2	Concerts
3	Shows
4	Sporting Events
5	Other Events
6
7
8
9
10
11	Total Movie, Concerts and Events:	$0.00

Hobbies and recreation costs:

	Item	Amount
	A	B
1	Sports
2	Fitness
3	Creative Hobbies
4	Outdoor Recreation
5	Other Hobbies and Recreation
6
7
8
9
10
11	Total Hobbies and Recreation:	$0.00

Education:

Tuition fees:

	Item/Term	Date	Paid? Tick if Yes	Notes	Amount
	A	B	C	D	E
1	Tuition - Fall
2	Tuition - Spring
3	Books - Fall
4
5
6
7
8
9	Total Tuition:				$0.00

Books and supplies costs:

	Item	Date	Notes	Amount
	A	B	C	D
1	School Supplies
2	Textbooks - Math
3	Art Supplies
4
5
6
7
8
9	Total Books and Supplies:			$0.00

Student loan interest amount:

Gifts and Donations:

Charitable donations:

	Charity	Date	Notes	Amount
	A	B	C	D
1	Charity A
2	Charity B
3
4
5
6
7
8	Total Charitable Donations:			$0.00

Gifts for birthdays, occasions, and holidays costs:

	Recipient/Occasion	Date	Notes	Amount
	A	B	C	D
1	Person A's Birthday
2	Christmas Gifts
3	Wedding Gift - Person B
4
5
6
7
8
9	Total Gifts:			$0.00

Clothing:

Clothing purchases:

	Item	Amount
	A	B
1	Dress Pants
2	Winter Coat
3	Jacket
4
5
6
7
8
9	Total Clothing Purchases:	$0.00

Dry cleaning and laundry costs:

	Item	Amount
	A	B
1	Dry Cleaning
2	Laundry Service
3	Coin Laundry
4	Laundry Supplies
5
6
7
8
9
10	Total Dry Cleaning and Laundry Costs:	$0.00

Miscellaneous Expenses:

Subscriptions (magazines, apps, etc.):

	Item	Enter text
	A	B
1	Magazine A
2	App Subscription 1
3	Other Subscriptions
4
5
6
7
8
9	Total Subscriptions:	$0.00

Pet care (food, vet, grooming) costs:

	Item	Amount
	A	B
1	Pet Food
2	Veterinary Care
3	Grooming
4	Other Pet Expenses
5
6
7
8
9
10	Total Pet Care:	$0.00

Legal fees:

	Description	Date	Amount
	A	B	C
1	Consultation
2	Retainer Fee
3	Court Filing Fee
4
5
6
7
8
9	Total Legal Fees:		$0.00

Other unexpected expenses:

	Description	Date	Amount
	A	B	C
1	Car Repair
2	Broken Appliance
3	Emergency Travel
4
5
6
7
8
9	Total Unexpected Expenses:		$0.00

Form Template Instructions

Please remove Form Template Instructions before publishing this form

Strengths:

Comprehensive Categories: It includes most of the typical income sources (primary, secondary, other) and expense categories (housing, transportation, food, personal care, healthcare, debt, savings, entertainment, education, gifts, clothing, miscellaneous). This helps ensure you capture a holistic view of your finances.
Separation of Groceries and Dining Out: A key strength is that it distinguishes between grocery expenses and restaurant spending, which is crucial for understanding food spending habits and making adjustments.
Debt Breakdown: Asking for card payments separately is helpful for tracking and managing debt.
Savings and Investments: Including contributions to retirement, savings, and investments is essential for long-term financial planning.

Overall:

This form is a good foundation, but adding more detail and clarity, especially regarding calculated fields, time periods, and tracking, would make it a much more powerful budgeting tool. The key is to make it as easy as possible for users to accurately capture their financial picture and then use that information to make informed decisions.

To configure an element, select it on the form.

To add a new question or element, click the Question & Element button in the vertical toolbar on the left.

Personal Budget Form

I. Income Information

II. Expenses

Form Template Instructionskeyboard_arrow_down

Form Template Instructions