SELF EMPLOYMENT INCOME AND EXPENSES

Please complete this form if you or your spouse (if married filing jointly) are self employed taxpayer(s), if you operate more than one business a form must be completed for each business.

*Please note that you may be required by a taxing authority to prove the legality of your business, please keep any and all documentation pertaining to all income and expenses you are claiming, in the event of an audit, you will have to prove every item you have listed on this form. You hereby certify that the information on this form is accurate and true (please refer to your Client Engagement Letter between you and Tax Angels-Jordan & Associates, LLC). If you are unsure of the accuracy of your calculations and would like for us to provide you with bookkeeping services at a rate of $60.00 per hour let us know, if not, please initial here indicating your waiver of our bookkeeping services*

Please Initial to indicate your waiver of our bookkeeping services:

Taxpayer Name:

First NameMiddle InitialLast Name

Is your filing status Married Filing Jointly?

YesNo

Please list spouse info below if married filing jointly, if spouse is also self employed in an industry different from the Taxpayer, please complete a separate form for your spouse:

Spouse Name (if married filing jointly):

Spouse NameMiddle InitialLast Name

Occupation

Business Income

State Taxes Paid

Fed. Taxes Paid

When did you start this business?

Do you have documentation to support the information listed on this form?

YesNo

If so, did you bring the documentation with you to assist in the preparation of your tax return?

YesNo

If you operate your business out of your home, what percentage of your home out of 100% is being used for business purposes or ex: out of a total of 8 rooms in your home, how many rooms are and/or were being used for business purposes?

Total Rooms in Home and/or 100%:

Total Rooms in Home used for business purposes:

Please list your business expenses below, expenses must be itemized.

Advertising:

Contract Labor:

Rent:

Utilities:

Car and Truck Expenses:

Commissions and fees:

Insurance, other than health:

Legal and professional services:

Vehicle(s) Rent and/or Lease:

Mortgage (paid to banks etc.):

Other:

Repairs and maintenance:

Supplies:

Travel:

Meals:

Cell Phone and/or Business Telephone:

Business apparel:

Cost of Goods Sold:

Business Equipment:

TOTAL BUSINESSEXPENSES:

Initial to confirm Total Business Expenses:

Date

Taxpayer Signature:

Date

Spouse Signature if filing jointly:

*If you are married filing jointly and husband & wife are both self employed and their businesses are separate, you must complete another form.*

Preferred Tax Professional

Tax Year