ScheduleC

for Self Employed Businesses and/or Independent Contractors

Name*

First NameLast Name

Business Name (if any)*

Address (if any)*

Is this your first year in business?*

YesNoNo If "YES' did you file required Form 1099?

Federal ID # (if any)

Total Gross Income*

Merchandise Purchased for Resale

Cost of labor (Do not include $'s paid to yourself)*

Materials & Supplies*

Advertising*

Repairs and Maintenance*

Commissions and Fees

Supplies (not included above)

Real Estate Taxes(If paid for business)

Insurance (other than health)*

Other Taxes (Payroll)

Health Insurance (for you)*

Travel Expenses for Business (do not include meals)*

Health Insurance (for your employees)

Meals *

Cell Phone*

Electric

Water

Internet

Other Interest Paid

Professional Fees*

Bank and CC Charges

Office Expenses

Rent on Business Property

Uniforms logo .. YES or NO*

Equipment Rentals

Licenses/ Dues

Other

Business Mileage*

(Do not include mileage to and from home unless your office is in your home)

Question MUST be answered>> Do you have "evidence" to support your mileage?*

YesNo

and this if applicable >> If yes, is the "evidence" written?*

YesNo

"Evidence" includes mileage logs, appointment records, calendars, etc. plus IRS could ask for odometer readings from oil changes, repair invoices, purchase and sale documents.

Did you purchase any major pieces of equipment?*

NoIF YES list: Yes

Equipment

Date

Amount

Equipment

Date

Amount

Do you have an Office in Your Home?*

YesNoIF YES Complete questions below

Sq. Ft of Office*

Sq. Ft of Home*

Real Estate Taxes

Mortgage Interest / Rent Paid

HO Insurance

Utilities (Lights and Gas)

For tax year*

Can you provide bank statements if asked by the IRS to substantiate business expenses?*

Do you keep business and personal expenses separated?*

Who maintains business records?*

Do you keep copies of receipts and invoices?*

How long have you owned your business?*

Printed Name*

Signature*

Date*

Date