Custody Mediation Los Angeles, Family Law Mediation
Family Conflict Resolution  
Divorce Mediation California, Child Custody Mediation
Divorce Mediation California, Child Custody Mediation
Divorce Mediation California, Child Custody Mediation
Divorce Mediation California, Child Custody Mediation

“When Peace Talks mediators say that they creates peace in the world one family at a time, they mean it and they deliver. I never hesitate to refer friends and family in conflict to Peace Talks; they are truly the leaders in the field of divorce mediation. I know the people I refer will receive the utmost in caring, professional and expert service.”



Nina Andro, Owner, Acclaim Mgmt. Consulting Inc.


Divorce Mediation California, Child Custody Mediation

 

 

 

 

 

Divorce Mediation California, Child Custody Mediation
Divorce Mediation California, Child Custody Mediation

Worksheet of Monthly Income and Expenses

Name:
Email :
Note:  The first 4 pages of this form are the most important.  If you can complete them before our discussion of support, that will save you time and money.  If you prefer to complete them during a mediation session, or with our Dispute Resolution Associate, that’s fine, too.
  BUDGET INFORMATION
  Please base these figures on a monthly average.  Please translate all items (e.g., weekly allowances, semi-annual insurance, etc.) into average monthly amounts.
1) Rental/mortgage and household:
 
a) Rental/mortgage payment--total $
i)   average principal $
ii)   average interest $
b) Property Taxes: $
c) Property Insurance: $
d) Maintenance and Repairs Gardener & Mowing $
  Housekeeper       $
  Repairs $
  Replacement costs budgeted For furnace, water heater, roof, Etc. $
  Plumbers, electricians
$
d) Maintenance and Repairs subtotal $
e) Homeowner’s Insurance $
 
2)
 

 

 
Medical (not covered by insurance)
a) Doctor $
b) Dentist $
c) Optometrist $
d) Contacts/glasses $
e) Orthodontist $
f) Prescriptions $
g) Medical Insurance $
h) Dental Insurance Premium $
i) Vitamins and supplements $
j)
Other:

$
  Total:  
   
3) Childcare: daycare, nanny, work-related
 
  sitters $
  Childcare: occasional sitters $
   
4) Food and supplies
 
a) Groceries $
b) Shampoo, toothbrushes, cleaning supplies (misc. grocery store
$
  Total Grocery $
c) Eating Out (alone or w/friends $
d) Lunches out while at work $
e) Eating out w/children $
  Total eating out:  
     
5) Utilities  
 
a) Gas $
b) Electric
$
c) Water $
d) Garbage collection $
e) Cable television $
f) Satellite Radio $
g) Other $
  Total: $
     
6) Telephone  
 
a) Telephone $
b) Cellular phone $
c) Children’s cell phones $
d) Internet access $
e) E-mail accounts $
f) Other telephone $
  Total: $
     
7) Laundry  
 
a) Laundry at Dry Cleaners $
b) Dry Cleaning
$
c) Household supplies for Laundry $
d) Laundromat $
  Total: $
     
8) Clothing  
 
a) Your clothing $
b) Children $
c) Shoes $
d) Shoe Repair $
e) Alterations $
f)
Other:
$
  Total: $
     
9) Education  
 
a) Your tuition & school fees $
b) Continuing Education fees for your profession $
c) Private School Tuition $
d) Tutors, books, videos $
e) Outside classes (self orchildren) $
     
10) Other  
 
a) Travel (you and children) ....Annual vacation, trip to see Grandparents, unreimbursed work Travel, weekend trips, school trips, etc. $
b) Entertainment...Videos, children’s parties, movies, Concerts, CD’s, I-Pod downloads, Theater, etc.
$
c) Haircuts, manicures, personalcare $
d) Gym membership, YMCA, other Dues and club memberships $
  Total: $
     
11) Transportation
 
a) Car payments $
 
Name of creditor
b) Gas and Oil $
c) Repairs $
d) Oil changes $
e) License $
f) Car Wash $
g) Auto club $
h) Parking $
i) Public transportation $
j)
Other:
$
  Total:  
     
12) Insurance  
 
a) Auto $
b) Medical and Dental $
c) Life $
d) Disability $
e)
Other:
$
  Total:  
   
13)
Savings and Investments $
   
14)
Charitable Contributions $
     
15) Children
 
a) Allowance $
b) School lunches $
c) Summer camp $
d) Private School $
e) Nursery school $
f) Lessons $
g) Activities $
h) Participatory sports $
i) Tutors $
j) School activities $
k) School pictures $
l) Yearbooks $
m)
Other:
$
  Total:  
     
16) Debts  
  a) List of installment debts (car payments, credit cards, etc.):
 
Payment to Payment for Monthly Payment Balance Date Last Payment Made

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