Business Income & Expenses Report Form

First Name

Last Name

Spouse Name (if listed as co-owner of business)

Tax Year *

BUSINESS 1 INFORMATION

Business Name
Is this business a LLC
Month & Year business started
Your Title
EIN or SS#
DUNs Number
Email
Phone
Address
Website
Social Media Pages
What was your gross income last year
Last year total business expenses
Number of active months in tax year
Hours you work the business per week
Where do you operate your business
Home office square footage
Total square footage of home
Activity: Sales, Service, Manufacturing
Products sold or services offered
Do you have 1099 employees
Did you file a Schedule C last year
Type of Payment Methods
Vehicle year, make and model
Business milage in tax year
Non business milage in tax year
Advertising Expense
Insurance Expense (other than health)
Mortgage interest
Other interest
Legal and professional services
Office expense
Rent or lease of equipment
Rent or lease of property
Repairs and maintenance
Taxes and licenses
Travel Expenses
Meal Expenses

Describe Business 1 daily work activities. *

How do you get business 1 clients/customers? *

What tools, equipment, or materials do you use for business 1? *

Business 1 Expenses (Example: Business Cards $200, Advertising $2000, Car Milage 3400, Utilities $4532, Home Office 200 sq ft, etc.)

List Business 1 Depreciating Assets: Must be valued over $1,000 and can be written off over a 5 year period. If vehicle (car, truck etc.) include Yr, Make, Model, total cost of vehicle and total amount spend on it during the tax year.

BUSINESS 2 INFORMATION

Business Name
Is this business an LLC
Month & Year business started
Your Title
EIN or SS#
DUNs Number
Email
Phone
Address
Website
Social Media Pages
What was your gross income last year
Last year total business expenses
Number of active months in last year
Hours you work the business per week
Where do you operate your business
Home office square footage
Total square footage of home
Activity: Sales, Service, Manufacturing
Products sold or services offered
Do you have 1099 employees
Did you file a Schedule C last year
Type of Payment Methods
Vehicle year, make and model
Business milage in tax year
Non business milage in tax year
Advertising Expense
Insurance Expense (other than health)
Mortgage interest
Other interest
Legal and professional services
Office expense
Rent or lease of equipment
Rent or lease of property
Repairs and maintenance
Taxes and licenses
Travel Expenses
Meal Expenses

How do you get business 2 clients/customers?

Describe Business 2 daily work activities.

What tools, equipment, or materials do you use for business 2?

Business 2 Expenses (Example: Business Cards $200, Advertising $2000, Car Milage 3400, Utilities $4532, Home Office 200 sq ft, etc.)

List Business 2 Depreciating Assets: Must be valued over $1,000 and can be written off over a 5 year period. If vehicle (car, truck etc.) include Yr, Make, Model, total cost of vehicle and total amount spend on it during the tax year.

BUSINESS 3 INFORMATION

Business Name
Is this business an LLC
Month & Year business started
Your Title
EIN or SS#
DUNs Number
Email
Phone
Address
Website
Social Media Pages
What was your gross income last year
Last year total business expenses
Number of active months in last year
Hours you work the business per week
Where do you operate your business
Home office square footage
Total square footage of home
Activity: Sales, Service, Manufacturing
Products sold or services offered
Do you have 1099 employees
Did you file a Schedule C last year
Type of Payment Methods
Vehicle year, make and model
Business milage in tax year
Non business milage in tax year
Advertising Expense
Insurance Expense (other than health)
Mortgage interest
Other interest
Legal and professional services
Office expense
Rent or lease of equipment
Rent or lease of property
Repairs and maintenance
Supplies
Taxes and licenses
Travel Expenses
Meal Expenses

How do you get business 3 clients/customers?

Describe Business 3 daily work activities.

What tools, equipment, or materials do you use for business 3?

Business 3 Expenses (Example: Business Cards $200, Advertising $2000, Car Milage 3400, Utilities $4532, Home Office 200 sq ft, etc.)

List Business 3 Depreciating Assets: Must be valued over $1,000 and can be written off over a 5 year period. If vehicle (car, truck etc.) include Yr, Make, Model, total cost of vehicle and total amount spend on it during the tax year.

Upload all supporting tax documents: DL, ID, W2a 1040, Social Security Card screenshot of pictures of social media business pages, pictures of products, business income statement, business mileage, business logo, etc.)

TAXPAYER INCOME AFFIDAVIT

I acknowledge that My Tax Preparer have informed me that I am required to report all income I received during the tax year from all sources.
I acknowledge that My Tax Preparer have informed me that it is unlawful to overstate my income to receive a large refund.
I acknowledge that My Tax Preparer, have explained to me in detail the rules regarding Earned Income Tax Credits and the reporting of self-employment income and based on my understanding of those rules I qualify for the Earned Income Tax Credit
I understand that I will be signing my income tax return under penalties of perjury and all items included on the return are true and correct.
I acknowledge that My Tax Preparer have advised me of my duty to keep complete and accurate records supporting the source and amount of my income and the legitimacy of any deduction or credit I claim on my tax return.

Full Name *

Signature *

Clear

Date *

Spouse Name

Spouse Signature

Clear

Spouse Signature Date