Instructions for Completing Monthly Cash Flow Statement

Having been convicted in the United States District Court, you are required to prepare and file with the
probation officer a statement fully describing your financial resources, including a complete listing of all
monthly cash inflows and outflows.

If you are placed on probation or supervised release (or other types of supervision), you may be periodically
required to provide updated information fully describing your financial resources and those of your spouse,
significant others, or dependents, as described above, to keep a probation officer informed concerning
compliance with any condition of supervision, including the payment of any criminal monetary penalties
imposed by the court (see 18 U.S.C. § 3603).

Amendments were made to 18 U.S.C. §§ 3663 (a)(1)(B)(i), 3664(d)(3), and 3664(f)(2), and Rule 32(b)(4)(F)
to clarify that the assets owned, jointly owned, or controlled by a defendant; liabilities, and the financial needs
and earning ability of a defendant and a defendant’s dependents are all relevant to the court’s decision
regarding a defendant’s ability to pay. Your Cash Flow Statement should include assets or debts that are
yours alone (I-Individual), assets or debts that are jointly (J-Joint) held by you and a spouse or significant
other, assets or debts that are held by a spouse or significant other (S-Spouse or Significant Other) that you
enjoy the benefits of or make occasional contributions toward, and assets or debts that are held by a dependent
(D-Dependent) living in your home that you enjoy the benefits of or make occasional contributions toward.
Please complete the Monthly Cash Flow Statement in its entirety. You must answer “None” to any item that
is not applicable to your financial condition. Attach additional pages if you need more space for any item.
All entries must be accompanied by supporting documentation (see Request for Cash Flow Statement
Financial Records (Prob. 48C)). Initial and date each page (including any attached pages) and sign and date
the last page of the Cash Flow Statement.