1. What is your average monthly electric bill?

$

2. What is your average monthly natural gas or propane bill?

$

3. What is your monthly home heating oil cost?

$

4. What is your average monthly water and/or sewer bill?

$

5. How much do you pay monthly for garbage removal?

$

6. What is your monthly home phone cost?

$

7. What is your monthly cell phone or data plan cost?

$

8. How much do you pay monthly for internet service?

$

9. How much do you pay monthly for cable or satellite?

$

10. How much do you pay monthly for bundled services?

$

11. Do you have any other utility expenses? If yes, list the amount.

$