Tax GenieSelf-Employed Business Information Sheet

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 NameLast Name
Self-Employment Business Reporting for what tax year? *
What is your business legal name or DBA?*
If you do not have a legal business name, what is your DBA business name?
What is your business EIN?*
If you do not have an EIN, enter your social security number
Date that started your business or your LLC was formed*
Input the month, year, and date
Select the formation of your business*
Do you have a business checking account

YesNo
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

CityState / Province

Postal / Zip Code
What is your business telephone number?*

Area CodePhone Number
What is your business website? Or Social media handle?*
If you do not have one, type NA
How do your customers find your business*
Type in the box
What type of business do you have? *
Provide a description of the services and/or products that you provide*
What documents can you provide to prove this is a real business in case of an audit*
You may select more than one answer

Did you receive a 1099 form from others who have paid you through out the tax year?*
Did you issue a 1099 form to others who you paid throughout the tax year? *
Do you have a special license, certification or education for your business profession? *
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 applies*
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) *
Who keep records of your business?*

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 i
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
(SIGNATURE)

Clear
Date*

MonthDayYear
Date
Should be Empty:

SELF-EMPLOYED BUSINESS INFORMATION SHEET

Self-Employed Income and Expenses Form

BUSINESS EXPENSES