This form should be printed and used as a worksheet.

Retirement Budget

Name: Date:

AGE Age Today Age at Retirement Years to Retirement	___________ ___________ ___________
HOUSING COSTS Mortgage or Rent Real Estate Taxes Maintenance and Repair Home Insurance Total	At Retirement $ __________ $ __________ $ __________ $ __________		Current $ __________ $ __________ $ __________ $ __________
PERSONAL EXPENSES Grooming Clothing Vacations Other Auto Expense Auto Insurance Total	$ __________ $ __________ $ __________ $ __________ $ __________ $ __________ $ __________		$ __________ $ __________ $ __________ $ __________ $ __________ $ __________ $ __________
LIVING EXPENSE Groceries Entertainment Utilities (Water, Heat, Light) Telephone Total	$ __________ $ __________ $ __________ $ __________ $ __________		$ __________ $ __________ $ __________ $ __________ $ __________
MEDICAL EXPENSES Prescription Drugs Hospitalization Insurance Total	$ __________ $ __________ $ __________		$ __________ $ __________ $ __________
RETIREMENT INCOME SOURCES Social Security Income Company Pensions Other Retirement Plans Total	$ __________ $ __________ $ __________ $ __________		$ __________ $ __________ $ __________ $ __________
SUMMARY Annual Retirement Income Required Estimated Soc. Sec., Pension, and Other Income Annual Income To Be Made Up	$ __________ $ __________ $ __________		$ __________ $ __________ $ __________

Other Helpful Forms

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