Sample Profit and Loss Statement (PDF)
SAMPLE PROFIT & LOSS STATEMENT
Loan Number:
Percentage of Ownership ______%
Business Owner Name(s): Company Name: Company Address: Type/Nature of Business: Dates Reported (mm/dd/yyyy): from ____/ ____/ ________ to ____/ ____/ ________
(Must be minimum of 3 full months. If seasonal, please provide 12 months profit and loss.)
Please fill in the fields that apply to your business. GROSS INCOME
Gross Sales
$
(Total amount of income from sales or service before subtracting expenses)
Other Income
$
(Any other additional funds earned through the company such as payments
from people leasing space or payments from investors)
Total GROSS INCOME BEFORE TAXES
$
EXPENSES
Cost of Goods Sold (Direct costs to produce or obtain the goods sold by the company)
Accounting and Legal Fees
Advertising
Insurance (Do not include homeowners insurance)
Maintenance and Repairs
Supplies
Payroll Expenses (Salaries and wages for owner(s) on the mortgage loan)
Payroll Expenses (Salaries and wages for employees who are not owner(s) on the mortgage loan)
Postage
$ $ $ $
$ $ $
$
$
(Next page, please)
Please fill in the fields that apply to your business.
Rent
(Do not include rent from subject property)
$
Licenses
$
Taxes
$
(Do not include real estate taxes on the property; do not include income
taxes on the business - include the total of any other taxes that you have to
pay for the business)
Telephone
$
Travel/Transportation
$
Utilities
$
Other
$
(Total and explanation of any other expenses not already
listed; do not include depreciation, depletion or amortization)
Total EXPENSES
$
NET INCOME
Net Income Before Taxes
$
Taxes
$
(Paid on business income)
Total NET INCOME AFTER TAXES
$
By signing this document, I/we certify the following: 1. That I am self-employed/independent contractor/1099 employee. 2. That all the information is truthful.
I/we understand that knowingly submitting false information may constitute fraud.
Business Owner's Signature__________________ Date ___________________________________
Business Owner's Signature__________________ Date ___________________________________
ID 3226406 FM293
016205 PL 0812
................
................
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