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000 Time Remaining MONTHLY HOUSEHOLD LIVING EXPENSES Date GROSS INCOME PER MONTH Work Income-A Investments Other LESS PAYCHECK DEDUCTIONS Pre-Tax Savings/Retirement Fed/State Taxes FICA/Medicare Other Pre-Tax Deductions Other After-Tax Deductions RENT AND HOUSE PAYMENT UTILITIES Electricity/Heat Water Cable T. V. Internet Garbage Telephone/Cellular Repairs/Service Cleaning/Laundry For People Meals Eaten Out Monthly Payments Gas Oil Repair Maint. Public Bus/Taxi License Insurance Parking...
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01
Start by locating the blank space provided for the date of birthage on the form.
02
Enter the numerical value for the day of your birthage in the designated box.
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Select the appropriate month from the drop-down menu.
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Enter the numerical value for the year of your birthage in the designated box.
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