Self Employment/SCH C Form

Self-Employed/Schedule C Worksheet
To be completed by ALL 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)
What year did you start your business?
Federal ID #/Employer Identification Number (EIN) (if any)
Did you make payments requiring a Form 1099?
Total Gross Business Income (not necessarily amount shown on 1099’s)
Retail Businesses ONLY:
Merchandise Purchased for Resale
Cost of labor (Do not include money paid to yourself)
Materials & Supplies
Other Direct Sales Costs
All Businesses:
Advertising
Commissions and Fees
Supplies (not included above)
Repairs and Maintenance
Contract Labor (1099's Issued)
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 Credit Card Charges
Office Expenses
Rent on Business Property
Uniforms
Equipment Rentals
Telephone used for business
Other
Business Mileage
Make and Model of Vehicle
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.
Did you purchase any major pieces of equipment? If yes, list below:
Equipment
Amount
Equipment
Date you purchased the equipment?

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Do you have an Office in Your Home? If yes, complete questions below in order to see if you may qualify for home office deduction.
Sq. Ft of Office
Sq. Ft of Home
Real Estate Taxes
Mortgage Interest / Rent Paid
Home Owners Insurance
Utilities (Lights, Water and Gas)
I certify that I have listed all income, all expenses, and if requested I could prove it to the IRS.
For Tax Year
Printed Name
Signature
Should be Empty:

Self-Employed/Schedule C Worksheet

Retail Businesses ONLY:

All Businesses: