This form contains 38 fields organized into 31 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name	Type	Description
Budget Balance
Income Minus Expenses	Number	Enter the calculated amount representing total income minus total expenses.
Budget Period
Date Completed	Date	Provide the date when this budget form was completed.
Budget Month	Text	Enter the specific month for which this budget is being completed.
Child Care Expense
Child Care Expense Amount	Number	Please enter the total monthly cost for child care.
Cigarettes Expense
Cigarettes Expense	Number	Please provide the total amount spent on cigarettes.
Client Information
Client Name	Text	Provide the full name of the client.
CYCIS Number	Text	Enter the CYCIS identification number for the client.
Clothes Expense
Clothes Expense	Number	Enter the total amount spent on clothes.
Cooking/Heating Gas Expense
Cooking/Heating Gas Amount	Number	Provide the total amount spent on cooking and heating gas.
Diapers/Baby Care Expense
Diapers/Baby Care Expense	Number	Enter the total amount spent on diapers and baby care.
Earned Income
Employer Name	Text	Please provide the name of the employer for this earned income. Fill only if 'Earned Income Amount' has a value. Depends on: Earned Income Amount
Earned Income Amount	Number	Please provide the total amount of earned income.
Electric Expense
Electric Expense Amount	Number	Please provide the total monthly amount spent on electricity.
First Other Income
First Other Income Amount	Number	Please provide the amount for the first other income.
First Other Income Source	Text	Please provide the source for the first other income. Fill only if 'Second Other Income Amount' has a value. Depends on: Second Other Income Amount
Food Expense
Cash Food Expense	Number	Please enter the total amount spent on food paid for in cash, excluding any expenses covered by food stamps.
Food Stamps Amount
Food Stamps Amount	Number	Please provide the total amount received for Food Stamps.
Health Expense
Health Expense	Number	Please enter the total amount spent on health-related expenses.
Household/Cleaning Expense
Household/Cleaning Items Expense	Number	Please enter the total monthly amount spent on household and cleaning items.
Laundry Expense
Laundry Expense	Number	Enter the total amount spent on laundry.
Miscellaneous Expense
Miscellaneous Expense	Number	Enter the total amount for miscellaneous expenses.
Other Payments Expense
Other Payments Description	Text	Enter a detailed description for the 'Other Payments' expense. Fill only if 'Other Payments Amount' has a value. Depends on: Other Payments Amount
Other Payments Amount	Number	Provide the total amount for the specified 'Other Payments' expense.
Personal Hygiene Expense
Personal Hygiene Expense	Number	Please enter the total monthly cost for personal hygiene expenses.
Phone Expense
Phone Expense Amount	Number	Enter the total monthly cost for phone expenses.
Recreation Expense
Recreation Expense	Number	Enter the total amount spent on recreation.
Rent Expense
Rent Amount	Number	Enter the total monthly rent expense.
Savings Amount
Savings Amount	Number	Enter the total amount of your savings, including bank accounts or any other forms of savings.
School Needs Expense
School Needs Expense	Number	Please provide the total amount spent on school needs.
Second Other Income
Second Other Income Amount	Number	Please provide the amount of the second other income.
Subsidy Income
Subsidy Amount	Number	Enter the total amount of subsidy income received.
Subsidy Income Source	Text	Enter the source from which the subsidy income is received. Fill only if 'First Other Income Amount' has a value. Depends on: First Other Income Amount
TANF Income
TANF Income Amount	Number	Enter the total amount received from TANF.
TANF Income Source	Text	Provide the source for the TANF income. Fill only if 'Subsidy Amount' has a value. Depends on: Subsidy Amount
Total Expenses
Expenses Total	Number	Please enter the total sum of all expenses.
Total Income
Income Total	Number	Provide the total monthly income.
Toys/Books Expense
Toys/Books Expense Amount	Number	Please enter the amount spent on toys and books.
Transportation Expense
Transportation Amount	Number	Please enter the total monthly amount spent on transportation.

Client Monthly Budget Worksheet Instructions