Monthly Income & Expenses Worksheet - T.e.a.c.h. Nevada
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1
2Monthly Income & Expenses Worksheet
This sheet helps us determine your monthly earnings from your home child care/learning
facility. Use figures from last month to answer the following questions; if last month does
not reflect an average month, then please use the most recent month which does. Receipts
are not required, but you must sign where indicated to verify the accuracy of this
completed document. This is a two-part worksheet – please complete both parts.
Part One: Income
To show your income, please complete the following chart. Names of children are not necessary, but you must indicate how
much you receive for the care of each child in your home child care.
Under Parent Fees, list only the amount paid to you by the parent(s) of each child. Indicate whether or not these payments
are weekly or monthly.
If subsidy helps pay the cost of care, write the amount you receive in subsidy for each child in the appropriate section.
What time does each child typically arrive and leave? Please list the typical days and hours each child attends your program
in the appropriate section.
Please list income from drop-in care and food programs in the section below the Income Table. If you provide shift care and
need more space, please write the additional information on a separate sheet and sign your name to verify accuracy.
Children
Parent fees received for each
Subsidy received for each
Age
Typical days and hours of
in care
child
child
of
care for each child (list
(do NOT include subsidy here)
(if applicable)
child
days & arrival/departure
times)
Example
100_
0
$___
__ per week/month
$____
_____ per month
4 yrs.
Mon-Fri/8am – 5pm
(circle one)
Example
200
233
$___
___ per week/month
$____
___ per month
6 mos.
Mon-Fri/10am – 6pm
(circle one)
Child 1
$__________ per week/month
$__________ per month
(circle one)
Child 2
$__________ per week/month
$__________ per month
(circle one)
Child 3
$__________ per week/month
$__________ per month
(circle one)
Child 4
$__________ per week/month
$__________ per month
(circle one)
Child 5
$__________ per week/month
$__________ per month
(circle one)
Child 6
$__________ per week/month
$__________ per month
(circle one)
Child 7
$__________ per week/month
$__________ per month
(circle one)
Child 8
$__________ per week/month
$__________ per month
(circle one)
Drop-in care:
I average $__________ per week/month (circle one) from drop-in care.
Food programs:
I received $__________ last month from the ______________________________ program.
How many hours do you work per week? __________
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