Farm - Profit/(Loss) Income
(IRS Schedule F)
Personal Information
Full Name
*
First Name
Last Name
Tax Year
*
Principle Crop or Activity
*
Did you make any payments that would require you to file Form(s) 1099?
*
Did you or will you file all required Form(s) 1099?
Income
Sales of purchased livestock and other resale items
Cost or other basis of livestock or other items reported above
Sale of livestock, produce, grains, and other products you raised
Cooperative distributions (Form 1099-PATR)
Agricultural program payments
Commodity Credit Corporation (CCC) loans
Crop insurance proceeds and Federal disaster payments
Custom hire income
Gasoline or fuel tax credits or refunds
Other income (specify)
Other income (specify)
Total Income Calculation
Expenses
Chemicals
Conservation expense
Custom work hired
Feed purchased
Fertilizer and lime
Freight and hauling
Gasoline, fuel and oil (excluding equipment)
Equipment gasoline, fuel and oil
Insurance
Interest - Credit cards
Interest - Loans
Rent or Lease - Equipment
Rent or Lease - Other (land, animals, etc)
Repairs and maintenance
Seeds and plants
Storage and warehousing
Supplies
Taxes
Utilities
Veterinary, breeding and maintenance
Other expenses (please specify)
Amount $
Other expenses (please specify)
Amount $
Total Expense Calculation
Form 4136 Credit for Federal Tax Paid on Fuels
Did you use gasoline or special fuels for farm purposes (other than for highway) during the year?
*
Number of gallons used on a farm for farming purposes (does not include highway)
Assets
Did you have any Major Purchases for Business Use with $2,500 or more initial cost? (Computer, laptop, furniture, equipment, tools, etc)
Major Purchases for Business Use
Item Description
Date Purchased
Cost $
1
2
3
4
5
Did you have any Assets sold or disposed of?
Assets sold or disposed of
Item Description
Sold or Disposed?
Date Sold or Disposed
Sales Price (if applicable) $
1
2
3
4
5
Did you have any Vehicles for business use?
Vehicle information/mileage
Vehicle #1
Vehicle #2
Vehicle #3
Make/Model/Year
Purchase Price
Date Placed in Service
Total Mileage for the Year
Total Business Miles for the Year
Total Commuting Miles for the Year
Expense (repairs/maintenance/insurance/gas)
Auto Loan Interest
Signature
I confirm that the information provided on this worksheet is correct and accurate to the best of my knowledge. I will notify Accent Financial Services in a timely manner if any changes occur.
*
Date
*
-
Month
-
Day
Year
Date
Print
Continue
Continue
Should be Empty: