State separately the amount awarded for the following items up to the date of your verdict for the plaintiff. (l) (2) (3) (4) (5) For the loss of the expectation of monetary benefits that would have resulted from the continued life of Mrs. Beck, the Plaintiff Fred Beck shall be awarded: s 0 For the loss of the portion of Mrs. Beck's earnings and income that probably would have been used for the support of her children, the Plaintiff Fred Beck shall be awarded: s O For the loss of Mrs. Beck's parental, marital, and household services, including the reasonable cost of providing for the care of minor children, the Plaintiff Fred Beck shall be awarded: s 0 For the cost of funeral expenses, the Plaintiff Fred Beck shall be awarded: $ 0 For the mental anguish suffered by Fred Beck and his children as a result of Mrs. Beck's death, the Plaintiff Fred Beck shall be awarded: s 0 Total Amount of Award: $ 0