Self-Employment Affidavit Form
To help accurately prepare your tax return, we need to calculate your income from self-employment activities. This worksheet will guide you in listing out all the different ways you’ve received payments over the year, like bank deposits, cash sales, and app transfers (e.g., Cash App or PayPal) as well as tracked expenses.
Please choose your tax professional
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SIERRA WASHINGTON
NADIA MORENO
OLYMPIA HOFFMAN
MARSHA LOGAN
LYNDRACIA WRIGHT
CYNTHIA MILLER
ROGELIO MARQUEZ
JOSIE HOLLABAUGH
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Which tax year are you filing?
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2024 (Current Tax Year)
2023
2022
2021
2020
2019
Taxpayer Name
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First Name
Last Name
Business Name
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Federal EIN ( Employer Identification Number) if applicable:
Business Phone Number
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Business Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Industry/Type
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How long have you been in business?
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Where did you operate your business?
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How do customers find you?
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Estimate Your Monthly Income
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Frequency (Daily/Weekly/Monthly)
Total Estimated Income ($)
Direct Bank Deposits
Cash App/PayPal/Venmo Transfers
Zelle Payments
Cash Sales
Invoices
Checks Received
Other
Estimate Your Monthly Expenses
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Description
Amount
Operational Costs
Legal and Professional Services
Advertising Costs
Costs for Supplies
Rent/Lease of Equipment
Rent/Lease of Property
UTILITIES
Auto Expense
Office Expense
Repairs/Maintenace
TRAVEL
Commission and Fees
Contract Labor
Meals (50%)
Enter 100% of the expenses.
Meals (80%)
Enter 100% of the expenses.
Pension and profit sharing
Mortgage interest
Other Interest
Health Insurance
Depletion
Insurance (Other than Health)
Employee benefit programs
Taxes and licenses
OTHER EXPENSES
OTHER EXPENSES
OTHER EXPENSES
OTHER EXPENSES
OTHER EXPENSES
OTHER EXPENSES
OTHER EXPENSES
OTHER EXPENSES
OTHER EXPENSES
OTHER EXPENSES
Upload any documents that verifies the legitimacy of your business such as EIN confirmation letter, Articles of Incorporation, etc.
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Attestation:
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I affirm that the information provided is true and correct to the best of my knowledge.
I understand that this affidavit may be used to support my tax filings and that any false statements may result in penalties.
Signature
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Date Signed
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Month
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Day
Year
Date
Submit
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