This is your Member Reference Number (MRN). You’ll need to provide this when you make an appointment with an EAP counselor or contact your EAP by phone.

Anthem provides automatic translation into multiple languages, courtesy of Google Translate. This tool is provided for your convenience only. The English language version is considered the most accurate, and in the event of a discrepancy between the translations, the English version will prevail. This translation tool is not controlled by Anthem, and the Anthem Privacy Statement will not apply. Please read Google's privacy statement. If you want Google to translate the Anthem website, select a language.

Benefits with SISC - Self Insured Schools of California-

Your EAP offers these great resources.

Personal Payday Budget Worksheet

Match your expenses and income—according to each pay period you get in a month—in the table below. Feel free to customize the fields so that they apply to you.

Personal Payday Budget Plan

MONTH: ________________________________

Paycheck 1
Pay Period (e.g. 1st—15th): _______________________

Income  ActualProjectedNet Income 1 $________.____ $________.____Net Income 2 $________.____ $________.____Interest/Dividends $________.____ $________.____Child Support $________.____ $________.____Benefits $________.____ $________.____Retirement Pay $________.____ $________.____Other Income $________.____ $________.____Other Income $________.____ $________.____Remainder in Checking $________.____ $________.____ Total Net Income $_______.____ $_______.____
Savings/Investments
  Actual Projected Balance
Emergency Fund $________.____ $________.____ $________.____
Special Goals Fund $________.____ $________.____ $________.____
College Funds $________.____ $________.____ $________.____
Retirement/Investments $________.____ $________.____ $________.____
Other $________.____ $________.____ $________.____
Total Savings/Investments $_______.____ $_______.____ $_______.____

Expenses
  Actual Projected Date Due
Housing      
Rent/Mortgage $ ________.____ $ ________.____  
Storage $ ________.____ $ ________.____  
Homeowner's Assoc. $ ________.____ $ ________.____  
Maintenance $ ________.____ $ ________.____  
Other $ ________.____ $ ________.____  
Utilities      
Electricity $ ________.____ $ ________.____  
Gas $ ________.____ $ ________.____  
Water/Sewer/Trash $ ________.____ $ ________.____  
Telephone Land Line $ ________.____ $ ________.____  
Cell Phone $ ________.____ $ ________.____  
Cable/Satellite $ ________.____ $ ________.____  
Internet $ ________.____ $ ________.____  
Other Utilities Combined $ ________.____ $ ________.____  
Food Costs      
Groceries $ ________.____ $ ________.____  
Lunches (Work) $ ________.____ $ ________.____  
Dinner Out $ ________.____ $ ________.____  
Quick Stops $ ________.____ $ ________.____  
Transportation Costs      
Car Payment $ ________.____ $ ________.____  
Bus Fare/Subway Fare/Taxis $ ________.____ $ ________.____  
Fuel and Oil $ ________.____ $ ________.____  
Auto Insurance $ ________.____ $ ________.____  
Maintenance $ ________.____ $ ________.____  
Motorcycle Payment $ ________.____ $ ________.____  
Dependent Care Costs      
Child Care $ ________.____ $ ________.____  
Transportation Costs $ ________.____ $ ________.____  
School Lunches $ ________.____ $ ________.____  
Extracurricular Activities $ ________.____ $ ________.____  
Other $ ________.____ $ ________.____  
Health Care Costs      
Medical/Eye/Dental $ ________.____ $ ________.____  
Prescriptions $ ________.____ $ ________.____  
Other $ ________.____ $ ________.____  
Education Costs      
Housing/Board $ ________.____ $ ________.____  
Tuition/Fees/Books $ ________.____ $ ________.____  
Other $ ________.____ $ ________.____  
Clothing Costs      
Clothing Purchase $ ________.____ $ ________.____  
Laundry/Dry Cleaning $ ________.____ $ ________.____  
Other $ ________.____ $ ________.____  
Entertainment      
Movies/Going Out $ ________.____ $ ________.____  
Hobbies $ ________.____ $ ________.____  
Other $ ________.____ $ ________.____  
Subscriptions      
CDs/Music $ ________.____ $ ________.____  
DVD Rental/Purchase $ ________.____ $ ________.____  
Magazines/Newspapers $ ________.____ $ ________.____  
Other $ ________.____ $ ________.____  
Personal Needs      
Haircuts/Beauty $ ________.____ $ ________.____  
Pets $ ________.____ $ ________.____  
Religious Tithes/Charity $ ________.____ $ ________.____  
Gym Membership $ ________.____ $ ________.____  
Other $ ________.____ $ ________.____  
Miscellaneous      
Checking/ATM Fees $ ________.____ $ ________.____  
Child Support/Alimony $ ________.____ $ ________.____  
Gifts $ ________.____ $ ________.____  
Alcohol/Tobacco Products $ ________.____ $ ________.____  
Other$ ________.____ $ ________.____  
Total Expenses $ _______.____ $ _______.____  

Debt Payments
  Actual Projected Date Due
Furniture $ ________.____ $ ________.____  
Credit/Debt $ ________.____ $ ________.____  
Credit/Debt $ ________.____ $ ________.____  
Credit/Debt $ ________.____ $ ________.____  
Credit/Debt $ ________.____ $ ________.____  
Credit/Debt $ ________.____ $ ________.____  
Credit/Debt $ ________.____ $ ________.____  
Total Debt Payments $ _______.____ $ _______.____  

Paycheck 1 TotalsActualProjected
Total Net Income $________.____ $________.____
Total Savings/Investments $________.____ $________.____
Total Expenses $________.____ $________.____
Total Debt Payments $________.____ $________.____
Surplus/Deficit $________.____ $________.____


Paycheck 2
Pay Period (e.g. 15th—End of the Month): _______________________

Income  ActualProjectedNet Income 1 $________.____ $________.____Net Income 2 $________.____ $________.____Interest/Dividends $________.____ $________.____Child Support $________.____ $________.____Benefits $________.____ $________.____Retirement Pay $________.____ $________.____Other Income $________.____ $________.____Other Income $________.____ $________.____Remainder in Checking $________.____ $________.____ Total Net Income $_______.____ $_______.____
Savings/Investments
  Actual Projected Balance
Emergency Fund $________.____ $________.____ $________.____
Special Goals Fund $________.____ $________.____ $________.____
College Funds $________.____ $________.____ $________.____
Retirement/Investments $________.____ $________.____ $________.____
Other $________.____ $________.____ $________.____
Total Savings/Investments $_______.____ $_______.____ $_______.____

Expenses
  Actual Projected Date Due
Housing      
Rent/Mortgage $ ________.____ $ ________.____  
Storage $ ________.____ $ ________.____  
Homeowner's Assoc. $ ________.____ $ ________.____  
Maintenance $ ________.____ $ ________.____  
Other $ ________.____ $ ________.____  
Utilities      
Electricity $ ________.____ $ ________.____  
Gas $ ________.____ $ ________.____  
Water/Sewer/Trash $ ________.____ $ ________.____  
Telephone Land Line $ ________.____ $ ________.____  
Cell Phone $ ________.____ $ ________.____  
Cable/Satellite $ ________.____ $ ________.____  
Internet $ ________.____ $ ________.____  
Other Utilities Combined $ ________.____ $ ________.____  
Food Costs      
Groceries $ ________.____ $ ________.____  
Lunches (Work) $ ________.____ $ ________.____  
Dinner Out $ ________.____ $ ________.____  
Quick Stops $ ________.____ $ ________.____  
Transportation Costs      
Car Payment $ ________.____ $ ________.____  
Bus Fare/Subway Fare/Taxis $ ________.____ $ ________.____  
Fuel and Oil $ ________.____ $ ________.____  
Auto Insurance $ ________.____ $ ________.____  
Maintenance $ ________.____ $ ________.____  
Motorcycle Payment $ ________.____ $ ________.____  
Dependent Care Costs      
Child Care $ ________.____ $ ________.____  
Transportation Costs $ ________.____ $ ________.____  
School Lunches $ ________.____ $ ________.____  
Extracurricular Activities $ ________.____ $ ________.____  
Other $ ________.____ $ ________.____  
Health Care Costs      
Medical/Eye/Dental $ ________.____ $ ________.____  
Prescriptions $ ________.____ $ ________.____  
Other $ ________.____ $ ________.____  
Education Costs      
Housing/Board $ ________.____ $ ________.____  
Tuition/Fees/Books $ ________.____ $ ________.____  
Other $ ________.____ $ ________.____  
Clothing Costs      
Clothing Purchase $ ________.____ $ ________.____  
Laundry/Dry Cleaning $ ________.____ $ ________.____  
Other $ ________.____ $ ________.____  
Entertainment      
Movies/Going Out $ ________.____ $ ________.____  
Hobbies $ ________.____ $ ________.____  
Other $ ________.____ $ ________.____  
Subscriptions      
CDs/Music $ ________.____ $ ________.____  
DVD Rental/Purchase $ ________.____ $ ________.____  
Magazines/Newspapers $ ________.____ $ ________.____  
Other $ ________.____ $ ________.____  
Personal Needs      
Haircuts/Beauty $ ________.____ $ ________.____  
Pets $ ________.____ $ ________.____  
Religious Tithes/Charity $ ________.____ $ ________.____  
Gym Membership $ ________.____ $ ________.____  
Other $ ________.____ $ ________.____  
Miscellaneous      
Checking/ATM Fees $ ________.____ $ ________.____  
Child Support/Alimony $ ________.____ $ ________.____  
Gifts $ ________.____ $ ________.____  
Alcohol/Tobacco Products $ ________.____ $ ________.____  
Other$ ________.____ $ ________.____  
Total Expenses $ _______.____ $ _______.____  

Debt Payments
  Actual Projected Date Due
Furniture $ ________.____ $ ________.____  
Credit/Debt $ ________.____ $ ________.____  
Credit/Debt $ ________.____ $ ________.____  
Credit/Debt $ ________.____ $ ________.____  
Credit/Debt $ ________.____ $ ________.____  
Credit/Debt $ ________.____ $ ________.____  
Credit/Debt $ ________.____ $ ________.____  
Total Debt Payments $ _______.____ $ _______.____  

Paycheck 2 TotalsActualProjected
Total Net Income $________.____ $________.____
Total Savings/Investments $________.____ $________.____
Total Expenses $________.____ $________.____
Total Debt Payments $________.____ $________.____
Surplus/Deficit $________.____ $________.____


Monthly Summary
  Current Projected
Monthly Net Income $ ________.____ $________.____
Monthly Save/Invest $ ________.____ $________.____
Monthly Expenses $ ________.____ $________.____
Monthly Debts $ ________.____ $________.____
Surplus/Deficit $_______.____ $_______.____

Foster, S. (Reviewed 2017). Twice per month budget. Schuette, B. (Ed.). Raleigh, NC: Workplace Options.

More about this Topics

  • Investing: Consumer Tips

  • Ways to Save Extra Money

  • Credit: How to Get It and How to Improve It

  • Prepaid Cards

  • General Debt Management Techniques

Other Topics

    • Digging Deep
    • Your Financial Checkup
    • Effective Budgeting
    • Make Your Money Work for You: A Debt Management Plan
    • Financial Wellbeing: Feeling Secure About Your Finances
    • Four Elements Define Personal Financial Wellbeing
    • Personal Finances and Budgeting
    • Choosing a Credit Counselor
    • Protections for Consumers Sending Money Abroad
    • Creditors and Debt Settlement Companies
    • Family Financial Statement
    • Financial Basics Handbook
    • Financial Calculators
    • Omni Calculator
    • Choose to Save
    • Federal Deposit Insurance Corporation
    • GasBuddy Find Gasoline Bargains
    • Mint