| Monthly Expense Description |
Present Expenses |
Senior Living |
| Property Tax and Insurance |
$____________ |
included |
| Utility Payments (Gas, water, sewage, trash, electricity) |
$____________ |
included |
| Homeowners or renters Insurance |
$____________ |
|
| Transportation (Insurance, gas, repairs, registration) |
$____________ |
included |
| Groceries (Meals, snacks, beverages) |
$____________ |
included |
| Activities and Entertainment |
$____________ |
included |
| Housekeeping and Linen Service |
$____________ |
included |
| *Note: Based on a national average of senior living alternatives. |