251 2018 Nevada Supreme Court Page 1 of 4 226 Monthly Budget COURT CODE: Your Name: Address: City, State, Zip: Telephone: Email Address: Self-Represented DISTRICT COURT COUNTY, NEVADA MONTHLY BUDGET The Proposed Guardian(s) submit the following monthly budget for the proposed protected person. Protected Person222s Monthly Income (write 2230224 for any income the person does not have) Wages from Employment (before taxes) Unemployment Benefits Social Security Veteran222s Affairs Retirement / Pension Interest / Dividends Rental Income Mandatory Trust Distributions Discretionary Trust Distributions Other: TOTAL MONTHLY INCOME In the Matter of the Guardianship of the: PersonEstatePerson and Estate of: CASE NO.: DEPT: ( name of person who needs a guardian ) A Proposed Protected Person. American LegalNet, Inc. www.FormsWorkFlow.com 251 2018 Nevada Supreme Court Page 2 of 4 226 Monthly Budget Monthly Expenses (write 2230224 for any expense the person does not have) Housing Rent / Mortgage Facility (room and board, patient liability) Homeowner222s/Rental Insurance Property Taxes Home Maintenance (yard, pool, housecleaning, etc.) HOA Dues Utilities (electricity, gas, phone, sewer/water, other utilities) Transportation Is the Protected Person Able to Drive? Yes No If no, who is the primary driver? Car Payment Insurance Gas Maintenance Public Transportation Groceries Dining Out Personal Hygiene (toiletries, haircuts, etc.) Household Supplies Medical Expenses (including health insurance) Dental Expenses Caregiving Services Travel / Entertainment Gifts Charitable Giving Taxes Accountant Fees Child Support / Alimony paid American LegalNet, Inc. www.FormsWorkFlow.com 251 2018 Nevada Supreme Court Page 3 of 4 226 Monthly Budget Bank Fees *Guardian / Attorney Fees (see worksheet below) Other: TOTAL MONTHLY EXPENSES Projected Monthly Guardianship Fees Hourly Rate Estimated Hours Per Month Monthly Expense Guardian222s Fees: X = Attorney222s Fees X = TOTAL MONTHLY GUARDIANSHIP EXPENSES TOTALS TOTAL MONTHLY INCOME TOTAL MONTHLY EXPENSES - DIFFERENCE (income 226 expenses) * = *If this is a positive (+) number, sign and date page 4.**If this is a negative (-) number, complete all of the remaining sections.* 1.If the monthly income is not enough to cover the monthly expenses, explain how longthe shortfall can be maintained in relation to the protected person222s life expectancy: American LegalNet, Inc. www.FormsWorkFlow.com 251 2018 Nevada Supreme Court Page 4 of 4 226 Monthly Budget 2.Will assets need to be sold or liquidated to pay the proposed protected person222s monthly expenses? Yes No (if no, skip to the bottom for the date and signature) If yes, list the assets that may need to be sold or liquidated to pay the monthly expenses: (COURT APPROVAL IS NEEDED TO SELL OR LIQUIDATE ANY ASSETS): Asset Description Value TOTAL VALUE 3.If these assets are sold / liquidated, how long will they cover the monthly budget expenses? (number) Years Months The foregoing monthly budget represents a true and accurate representation of the proposed protected person222s ongoing monthly sources of income and monthly expenses. DATED (month) (day) , 20 . (First Proposed Guardian222s Signature) (Second Proposed Guardian222s Signature) (Printed Name) (Printed Name) American LegalNet, Inc. www.FormsWorkFlow.com