Business Expense

Business Name*

When did you start this business?*

Federal ID #*

Do you have any 1099 to file?*

YesNo

Total Gross Business Income (not necessarily amount shown on 1099’s)*

Retail Businesses ONLY:

	Dollar Amount
Beginning Inventory
Merchandise Purchased for Resale
Cost of labor (Do not include $’s paid to yourself)
Materials & Supplies
Other Direct Sales Costs
Ending Inventory

All Businesses:*

	Amount
Advertising
Repairs and Maintenance
Commissions and Fees
Supplies (not included above)
Contract Labor (1099’s Issued, if app)
Real Estate Taxes(If paid for business)
Insurance (other than health)
Other Taxes (Payroll)
Health Insurance (for you)
Travel (do not include meals)
Health Insurance (for your employees)
Meals and Entertainment
Mortgage Interest (If paid for Business)
Utilities
Other Interest Paid
Wages (W-2’s Issued)
Professional Fees
Bank and CC Charges
Office Expenses
Tools
Rent on Business Property
Uniforms
Equipment Rentals
License / Dues
Telephone
Other

Business Mileage*

	Mileage
January-June
July–December

Do you have “evidence” to support your mileage?*

YesNo

If yes, is the “evidence” written?

YesNo

Did you purchase any major pieces of equipment?

YesNo

I certify that I have listed all income, all expenses, and I have documentation to back up the figures entered on this worksheet.

Name*

First NameLast Name

Signature*