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

“Patty DeDominic is always happy to encourage people and organizations to utilize mediation services and believes that Peace Talks mediators are taking this important skill and protocol to greater visibility. Peace Talks mediators live their mission and they encourage others to find ways to make peace in business and in life. I wish we could employ her immediately to stop almost all litigation in the USA!”

Patty Dedominic, Owner, DeDominic & Associates

Divorce Mediation California, Child Custody Mediation






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

Worksheet of Monthly Income and Expenses

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.
  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 $


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 $

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 $
  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 $
12) Insurance  
a) Auto $
b) Medical and Dental $
c) Life $
d) Disability $
Savings and Investments $
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 $
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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