Additional Form for Self Employed Businesses and/or Independent Contractors
IRS requires we have on file your own information to support all Schedule C's
Business Name (if any)
Address (if any)
Is this your first year in business? If no please indicate year business was established
Federal ID # (if any)
*
Did you make payments requiring a Form 1099?
*
Beginning Inventory Cost
Merchandise Purchased for Resale
Advertising
Cost of Labor
(Do not include $'s paid to yourself)
Materials & Supplies
Contract Labor
(1099's Issued, if app)
Real Estate Taxes(If paid for business)
Insurance (other than health)
Health Insurance (for you)
Mortgage Interest (If paid for Business)
Other Taxes Paid (Payroll)
Travel
Meals and Entertainment
Other Interest Paid
Professional Fees
Wages (W2’s issued)
Bank and CC Charges
Office Expenses
Rent for Business Property
Equipment Rentals
Uniforms
Logo
License/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? >> If yes, is the "evidence" written?
*
"Evidence" includes mileage logs, appointment records, calendars, etc. plus IRS could ask for odometer readings from oil changes, repair invoices, purchase and sale documents. This field is required.
Did you purchase any major pieces of equipment?
IF YES list below….
Equipment
Date
-
Month
-
Day
Year
Date
Amount
Equipment
Date
-
Month
-
Day
Year
Date
Amount
Do you have an Office in Your Home?
IF YES Complete questions below
Sq. Ft of Office
Sq. Ft of Home
I certify that I have listed all income, all expenses, and I have documentation to back up the figures entered on this worksheet for the listed tax year.
Tax Year for Schedule C
*
Name
*
First Name
Last Name
Signature
*
Date
*
-
Month
-
Day
Year
Date
Submit
Submit
Should be Empty: