BUSINESS EXPENSE FORM

Schedule C Certification
Name of Business
EIN:
Gross Income Received
Gross Receipts
Advertising
Car & Truck Expenses
Legal & Professional Services
Office Expenses
Rent & Lease Payments
Utilities/Telephone
Business Miles
Repair Maintenance
Supplies
Taxes & Licenses or Insurance
Travel
Meals
Other(Rental Vehicles & Machine)
Total Miles
I, ____________________________________, certify that all the above information given to the tax preparer to prepare my income tax return is accurate and true to the best of my knowledge.
Taxpayer Signature:
Date:

MonthDayYear
Date
Joint Taxpayer Signature:
Date:

MonthDayYear
Date
Should be Empty:

Schedule C Certification