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Your Name   *
Name of  
Spouse or Co-Borrower  
Street Address   *
City   *
State   *   Zip   *
Mobile Number   *
Mobile Number of  
Spouse or Co-Borrower  
Email   *
 
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  1st Mortgage     2nd Mortgage    
Name of Lender  
(who you pay)  
   
Loan #      
Interest Rate      
Unpaid Principal Balance      
Payment $      
Type of loan  
Example: 5 year,  
interest only taken out  
in October 2004  
   
Adjusting? Y N      
Date of adjustment      
Number of months behind      
 
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Monthly Expenses Monthly
Amt.
  Income Monthly
Amt.

Mortgage Payment   Net Salary
(after deductions)
Property Taxes
(if not included in Mtg.)
  Monthly
Every 2 Weeks
Weekly
Homeowner’s Insurance
(if not included in Mtg.)
  Gross Salary
(before deductions)
Association Fees   Monthly
Every 2 Weeks
Weekly
Other Mortgages   Spouse's Net Salary
Automobile Payment   Spouse's Gross Salary
Other Automobile
Loan Payment
  Alimony/Child Support
Automobile Insurance   Disability
Gasoline   Pension/Retirement
Electricity   Rental Property
Gas    Other Income
Water/Sewage   Total Net Income
Garbage   Total Gross Income
Telephone   Total Expenses
Cell Phone   Net Difference +/-
Cable TV   Gross Difference +/-
Credit Cards (combined
Minimum payments)
     
Other Loans (Specify)   How Many People
in Household
Health Ins. (not deducted)      
Dues/Memberships      
Medical Bills (not insured)      
Prescription Medications      
Child Care      
Alimony/Child Support      
Tuitions  
Food/Household  
Other Expenses
(Please Specify)
 
Miscellaneous  
Miscellaneous  
Miscellaneous  
Miscellaneous  
Second Property
   - 1st Mortgage
 
Second Property
   - 2nd Mortgage
 
Third Property
   - 1st Mortgage
 
Third Property
   - 2nd Mortgage
 
    *required item
Total Expenses & Balances    
 
 

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Financial Budget Form



Members of
State Bar of Nevada