Self-Employed/Business Monthly Worksheet
[Pages:4]Self-Employed/Business Monthly Worksheet
Name of Proprietor
Social Security Number
Principal Business or Profession, Including Product or Service
Income
January February March April
May
June
July August Sept October Nov
Dec
TOTALS
Gross Sales
Expenses
January February March April
May
June
July August Sept October Nov
Dec
TOTALS
Accounting Advertising Answering Service Auto & Truck Expense Bad Debts Bank Charges Business Contributions Business Taxes Commissions Delivery & Freight Dues & Subscriptions Equipment Rental Gifts Insurance Interest
January February March April
May
June
July August Sept October Nov
Dec
Laundry & Cleaning
Legal & Professional
License & Permits
Meals & Entertainment
Miscellaneous
Office Expenses
Outside Services
Parking & Tolls
Postage
Printing
Rent
Repairs & Maintenance
Rubbish Removal
Security
Supplies
Telephone
Tools
Travel
Utilities
Other
Other
Other
TOTALS
TOTAL
Information on Your Vehicle
When did you place your vehicle in service
for business purposes?
/ /
Vehicle is used primarily by a more than 5% owner? Is vehicle available for off-duty personal use? Is any other vehicle available for personal use?
Yes
No
Yes
No
Yes
No
Description of Vehicle:
Mileage
January February March April
May
June
July August Sept October Nov
Dec
TOTALS
Personal Mileage Business Mileage Commuting Mileage
Actual Expenses January February March April
May
June
July August Sept October Nov
Dec
TOTALS
Gasoline, Lube, Oil Repairs/Maintenance Insurance Miscellaneous Auto License Personal Prop. Taxes Interest (Car Loan) Vehicle Lease Pymts
TOTALS
Description of Property (Ex. Fax, Computer, Office Equipment, Etc.)
Description
Date Placed in Service
Property A Property B Property C
Business Use of Home
Business Use Area (Square feet) Total Area of Home (Square feet)
Description (Provide us with the total amount paid for the year)
Indirect * Expenses
Direct ** Expenses
Mortgage Interest Real Estate Taxes
Rent
Insurance Association Dues
Repairs & Maintenance
Utilities Security
Telephone/Internet Miscellaneous TOTALS
* Indirect Expenses are related to the entire home. ** Direct Expenses are related to the business portion of the home and are fully deductible.
Cost or Basis
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