Small Business Questionnaire - Option 1: Write in Numerical Values

Small Business Questionnaire - Option 1: Write in Numerical Values

Profit or Loss from Business
How to Use This Questionnaire

For your convenience, our team has put together two different form flows to help you streamline the information submission process.

Option 1: Write in Numerical Values (You are currently using this option)

This option allows you to simply type in the numercal amounts for each category taken from your business's financial records. This is best for business owners who do not have most of their financial records stored electronically for easy uploading (e.g. Cash based businesses with paper receipts).

Option 2: Upload Financial Documents

This option allows you to upload your business's financial records. This is best for business owners who have most of their financial records stored electronically and can easily upload them from their computers or information management systems.
Your full name*

First NameMiddle InitialLast Name
SSN*
Business EIN
Phone number*
Please enter a valid phone number.
Year business started
Business website (if applicable)
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Provide a description of your business
INCOME
Gross receipts/sales or earnings
Returns & Allowances
Other Income
COST OF GOODS SOLD OR OPERATIONS
Purchases (less cost of personal use items)
Labor costs (not including owner's salary)
Materials and supplies
Other costs
EXPENSES
Advertising
Car & truck expenses
Total Miles
Business Miles
Commissions & Fees
Insurance (other than health insurance)
Legal & professional services
Office expenses
Pension & Profit sharing plans
Rent (other)
Repairs
Supplies (not included in Cost of Goods Solds)
Taxes & Licenses
Travel Expenses (tolls, parking, airfare)
Meals & entertainment
Telephone (do not include personal line basic service charges)
Wages (do not include your salary)
List any other expenses here (e.g., Renovations $27,000)
Are you deducting business use of your home?

YesNo
What is the total square footage of your home or apartment?
What is the square footage of the area in your home or apartment that is used for your office?
Cost of your home (rent or mortgage Profit & Interest payment)
Homeowners or renters insurance premium
Total paid for Gas, Electric, Heat, and Water
Other Expenses

Acknowledgment & Signature
You agree that your typed name below is the same as your legal signature and that the information you entered above is accurate, true, and complete to the best of your knowledge.
Date Signed*

MonthDayYear
Date
Signee*
Should be Empty:

Small Business Questionnaire - Option 1: Write in Numerical Values

INCOME

COST OF GOODS SOLD OR OPERATIONS

EXPENSES