SELF-EMPLOYED BUSINESS INFORMATION SHEET
This form is to be completed for small business owners, entrepreneurs, gig workers, independent contractors and any other person claiming income and expenses on a schedule C.
Name
First Name
Last Name
Self-Employment Business Reporting for which tax year?
Please Select
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
What is your business name or DBA?
What is your business EIN?
If you do not have an EIN, enter your social security number
Select the formation of your business:
Limited Liability Company
Sole Proprietor
Scorp
Do you have a business checking account?
Please Select
Yes
No
If you do not have a business account, how do you differentiate business from personal expenses?
Business Address or place of business. (This can be your home address)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is your business phone number?
Please enter a valid phone number.
Provide a description of the services and/or products that you provide
What is your business website? Or Social media handle?
If you do not have one, type NA
What documents can you provide to prove this is a real business in the case of an audit?
EIN
Business Checking Account
Business Credit Card
Payment Records
List of Clients
Business Registration
Payment Receipts
Calendar
1099
You may select more than one answer
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Did you receive a 1099 form from others who have paid you through out the tax year?
Please Select
Yes
No
Did you issue a 1099 form to others who you paid throughout the tax year?
Please Select
Yes
No
Do you have a special license, certification or education for your business profession?
Please Select
Yes
No
If yes, type what type of license, certification or education for your business profession?
Put N/A if you don't
How do you advertise your business? Select all that apply
Word of Mouth
Social Media
Family and Friends
Referrals
Billboards
Ads
Postcards
Company Referrals
By law, you are required to keep adequate records. What type of records do you maintain to verify business income and expenses (Select all that applies)
Please Select
Accounting Records
Computer Records
Business Bank Account
Ledger
Paid Invoices
Receipts
Calendar
Mileage Log
Customer List
Lease
PayPal
CashApp
Zelle
1099
Apple Pay
Venmo
Who keep records of your business? Select all that apply
Taxpayer
Accountant
Bookkeeper
Tax Professional
Hired Help
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Self-Employed Income and Expenses Form
On this form, please use exact numbers.
How much income have you generated for the tax year from January - December?
Enter Whole number only. No cents
BUSINESS EXPENSES
List the amount that you spent in expenses for the tax year. No decimals or cents required. DO NOT USE ROUND NUMBERS
Advertising
Website, domains, marketing material, post cards, etc
How many business miles are you claiming for this tax year?
If you are claiming mileage, we will calculate the dollar amount. You must keep a mileage in case of an IRS audit. If you are claiming mileage, you can not claim any other expenses for your vehicle
How do you keep track of your business miles?
Commission and Fees
Contractor Labor
How much did you pay others that you do not consider an employee
Employee Benefits
Including health insurance you paid for your employees
Business Insurance
Business Insurance
Mortgage insurance
For business property
Loan Interest
For business loans only
Legal Expenses
Fees paid for tax preparation, an accountant, or an attorney related to your business
Office Expenses
Office supplies and postage
Continuing Education Cost
Rent Machinery/Equipment
Did you rent any items for your business, if so, what was the cost?
Rent/Lease Property
What was the total amount that you paid for renting or leasing a space?
Repairs
What is the cost of repairs for your property such as painting, or updating the space?
Supplies
Taxes and License
Meals
Utilities
For you rental/lease space
Uniforms
Business Cell Phone
Business Landline
Breakdown of other expenses and amounts
Any other information you would like to provide about your business?
I, certify that my income and expenses are correct to the best of my knowledge. In the event of an audit, I can substantiate my income and expenses from my receipts and bank statements. We shall not be held liable for any IRS audit or investigation resulting from inaccurate information provided or withheld by the taxpayer(s).
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Date
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Month
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Day
Year
Date
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