PROFIT AND LOSS STATEMENT - Bank of America

PROFIT AND LOSS STATEMENT

Please complete a separate Profit and Loss Statement for each business owned by the borrower(s). Name(s) of Borrower(s):

Company Name:

Type of Business:

For the Period:

DD/MM/YYYY

through

DD/MM/YYYY

Income: Other Income:

Business Only Expenses:

Gross Sales and Receipts............................................................................................

Other Income (interest, fees earned, etc.)...............................................................

Total Income (Gross Sales plus Other Income)..........................................................

Salaries Paid to Owners (other than me/us)........................... Salaries Paid to Employees (other than me/us)....................... Benefits to Owners/Employees (other than me/us)................ Payroll Taxes.................................................................... Business Utilities.............................................................. Business Rent and/or Mortgage Payments............................. Insurance........................................................................ Advertising...................................................................... Telephone....................................................................... Office Expenses.............................................................. Repairs and Maintenance.................................................. Business Travel, Meals, and Entertainment......................... Other Business Expenses.................................................

Total Business Expenses............................................ Net Income/Loss: (Total Income minus Total Expenses)..............................................................

Amount of Net Income That Borrower(s) Received.......................................................................

This form accurately states my/our business expenses and self-employed income for the stated period.

_______________________________________ Borrower Signature

__________________ Date

_______________________________________ Co-Borrower Signature

__________________ Date

C3_12873_640375

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